Fajrudheen Mohamed, Mahapatro Samarendra, Panigrahi Manas K, Naik Suprava, Satapathy Amit K
Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Department of Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Indian J Endocrinol Metab. 2025 Mar-Apr;29(2):230-236. doi: 10.4103/ijem.ijem_150_24. Epub 2025 Apr 29.
Childhood obesity and nonalcoholic fatty liver disease (NAFLD) are emerging as significant health concerns. While liver biopsy remains the gold standard for diagnosis, there is a pressing need for a noninvasive alternative to identify early fibrosis.
A cross-sectional investigation was carried out from January 2020 to December 2021 involving overweight and obese children attending the pediatric outpatient department (OPD). The aim is to determine the occurrence of fibrotic and steatotic changes in the liver of overweight and obese children using transient elastography (TE) and to establish correlations between TE results, Pediatric NAFLD Fibrosis Index (PNFI), and other biochemical parameters. TE was utilized to assess both fibrotic and steatosis changes, while ultrasound (USG) was employed to detect steatosis in the liver.
Two hundred and fifty-nine eligible children participated in the study. Mean age of the study cohort was 10.8 years, with males constituting 63%. Mean Z score for BMI was 1.71 ± 0.57. Fibrosis was detected in 29.3% of children by TE, while steatosis was observed in 27.7% of children. Steatosis was identified in 23.8% of cases through USG. BMI Z score, ALT (Alanine aminotransferase), AST and PNFI score exhibited significant associations with grades of liver fibrosis and steatosis as determined by TE, as well as with grades of steatosis according to USG findings.
A notable prevalence of increased liver stiffness was observed in overweight and obese children. TE proves to be a valuable tool in identifying fibrotic and steatotic changes in these children, complementing existing noninvasive modalities.
儿童肥胖和非酒精性脂肪性肝病（NAFLD）正成为重大的健康问题。虽然肝活检仍是诊断的金标准，但迫切需要一种非侵入性替代方法来识别早期纤维化。
于2020年1月至2021年12月对儿科门诊的超重和肥胖儿童进行了一项横断面调查。目的是使用瞬时弹性成像（TE）确定超重和肥胖儿童肝脏中纤维化和脂肪变性变化的发生率，并建立TE结果、儿童NAFLD纤维化指数（PNFI）和其他生化参数之间的相关性。TE用于评估纤维化和脂肪变性变化，而超声（USG）用于检测肝脏中的脂肪变性。
259名符合条件的儿童参与了研究。研究队列的平均年龄为10.8岁，男性占63%。BMI的平均Z评分为1.71±0.57。通过TE在29.3%的儿童中检测到纤维化，而在27.7%的儿童中观察到脂肪变性。通过USG在23.8%的病例中识别出脂肪变性。BMI Z评分、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）和PNFI评分与TE确定的肝纤维化和脂肪变性分级以及根据USG结果确定的脂肪变性分级均表现出显著相关性。
在超重和肥胖儿童中观察到肝脏硬度增加的显著患病率。TE被证明是识别这些儿童纤维化和脂肪变性变化的有价值工具，补充了现有的非侵入性方法。
