健康南非儿童的肝脏瞬时弹性成像值。
Liver transient elastography values in healthy South African children.
机构信息
Department of Paediatrics and Child Health, Tygerberg Hospital and Stellenbosch University, PO Box 241, Cape Town, 8000, South Africa.
Family Center for Research with Ubuntu (FAMCRU), Cape Town, South Africa.
出版信息
BMC Pediatr. 2023 Jul 13;23(1):355. doi: 10.1186/s12887-023-04170-3.
BACKGROUND
Transient elastography (TE) is a rapid noninvasive ultrasound-based technology that measures liver stiffness as a surrogate for liver fibrosis and controlled attenuation parameter (CAP) as a measure of liver steatosis. However, normal ranges in children are not well defined in all populations. The aim of this study was to determine transient elastography values in healthy South African children.
METHODS
From April 2019 to December 2021, children were recruited from the HIV negative control group of a cohort study. Only children neither overweight nor obese, without evidence of liver disease, no medical condition or medication associated with hepatic steatosis or fibrosis and normal metabolic profile were included in this cross-sectional analysis. Clinical data, anthropometry and blood samples were collected on the same day as transient elastography with controlled attenuation parameter was performed.
RESULTS
104 children (median age 12.8 years [IQR 11.4-14.8, range 7.9-17.7 years]; 59 [57%] boys) were included. Liver stiffness was positively correlated with age (Pearson's r = 0.39, p < 0.001). Median liver stiffness in boys (5.2 kPa [5th to 95th percentiles 3.6 to 6.8 kPa]) was greater than in girls (4.6 kPa [5th to 95th percentiles 3.6 to 6.1 kPa; p = 0.004]), but there was no difference by ethnicity. Median CAP was 179dB/m (5th to 95th percentiles 158 to 233dB/m). There was a positive correlation between CAP and body mass index (BMI) z-score, but no difference by age, sex, ethnicity or pubertal status.
CONCLUSION
Liver stiffness values increase with age and are higher in healthy South African boys than girls, whereas CAP values vary with BMI, but not with age or sex.
背景
瞬时弹性成像（TE）是一种快速的无创超声技术，可测量肝脏硬度作为肝纤维化的替代指标，以及受控衰减参数（CAP）作为肝脂肪变性的测量指标。然而，在所有人群中，儿童的正常范围尚未得到明确界定。本研究旨在确定南非健康儿童的瞬时弹性成像值。
方法
从 2019 年 4 月至 2021 年 12 月，从队列研究的 HIV 阴性对照组中招募儿童。只有既不超重也不肥胖、无肝脏疾病证据、无与肝脂肪变性或纤维化相关的医疗状况或药物以及正常代谢特征的儿童才被纳入本横断面分析。在进行瞬时弹性成像和受控衰减参数检查的同一天采集临床数据、人体测量学和血液样本。
结果
共纳入 104 名儿童（中位年龄 12.8 岁[IQR 11.4-14.8，范围 7.9-17.7 岁]；59[57%]名男孩）。肝脏硬度与年龄呈正相关（Pearson's r=0.39，p<0.001）。男孩的肝脏硬度中位数（5.2kPa[第 5 至 95 百分位数为 3.6 至 6.8kPa]）大于女孩（4.6kPa[第 5 至 95 百分位数为 3.6 至 6.1kPa；p=0.004]），但不同种族间无差异。中位 CAP 为 179dB/m（第 5 至 95 百分位数为 158 至 233dB/m）。CAP 与体重指数（BMI）z 评分呈正相关，但与年龄、性别、种族或青春期状态无关。
结论
肝脏硬度值随年龄增长而增加，且南非健康男孩的肝脏硬度值高于女孩，而 CAP 值随 BMI 而变化，但不受年龄或性别影响。
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