Gülcü Taşkın Didem, Kayadibi Yasemin, Baş Ahmet, Ayyıldız Civan Hasret, Beşer Ömer Faruk, Adaletli İbrahim, Çullu Çokuğraş Fügen, Erkan Tülay, Kutlu Tufan
Department of Pediatric Gastroenterology, Adana City Training and Research Hospital, Adana, Turkey.
Department of Radiology, İstanbul University Cerrahpaşa Faculty of Medicine istanbul, Turkey.
Turk Arch Pediatr. 2023 Jul;58(4):436-441. doi: 10.5152/TurkArchPediatr.2023.22255.
The aim of this study was to compare the accuracy rate of liver stiffness calculated by shear wave elastography with liver biopsy results in obese and overweight children.
Obese and overweight children between 3 and 18 years of age, who had hepatic steatosis and a healthy control group were included in this study. A blood sample was obtained for laboratory tests and shear wave elastography was performed for all subjects. Liver biopsies were performed only in patients with hepatosteatosis, providing permission for biopsy, and for whom the biopsy procedure was not contraindicated.
A cohort of 142 children (78 overweight/obese and 64 healthy) was included in this study. Shear wave elastography values were significantly higher in the patient group as com- pared to the control group (34.0 vs. 8.2 kPa; P < .001). Obese children had higher elastog- raphy values compared to non-obese children (50.2 vs. 23.7 kPa, P < .001). No correlation was detected between fibrosis score and elastography values. Elastography increased with increasing weight (correlation coefficient: 0.334, P = .003) and body mass index (correlation coefficient: 0.364, P = .001).
In obese and overweight patients, elastography values are higher than in healthy subjects as well as patients with liver fibrosis. Disease-specific cut-off, mean, and normal ref- erence range values should be defined with large-scale studies to improve interpretation of elastography values. Our results are contradictory in the determination of liver fibrosis with shear wave elastography in obese and overweight patients, thus further research with a larger patient population is recommended.
本研究旨在比较剪切波弹性成像计算得出的肝脏硬度准确率与肥胖及超重儿童肝脏活检结果。
本研究纳入了3至18岁患有肝脂肪变性的肥胖及超重儿童以及一个健康对照组。采集血样进行实验室检测，并对所有受试者进行剪切波弹性成像检查。仅对获得活检许可且活检操作无禁忌证的肝脂肪变性患者进行肝脏活检。
本研究纳入了142名儿童（78名超重/肥胖儿童和64名健康儿童）。与对照组相比，患者组的剪切波弹性成像值显著更高（34.0对8.2 kPa；P <.001）。肥胖儿童的弹性成像值高于非肥胖儿童（50.2对23.7 kPa，P <.001）。未检测到纤维化评分与弹性成像值之间的相关性。弹性成像值随体重增加而升高（相关系数：0.334，P =.003）以及随体重指数升高而升高（相关系数：0.364，P =.001）。
在肥胖及超重患者中，弹性成像值高于健康受试者以及肝纤维化患者。应通过大规模研究确定疾病特异性的临界值、平均值和正常参考范围值，以改善对弹性成像值的解读。我们的结果在肥胖及超重患者中利用剪切波弹性成像确定肝纤维化方面存在矛盾，因此建议对更多患者群体进行进一步研究。
