Non-invasive assessment of hepatic fibrosis and steatosis by FibroScan in Egyptian children and adolescents with nonalcoholic fatty liver disease: A single center study

Abstract

Background Pediatric nonalcoholic fatty liver disease (NAFLD) has been recognized as a global health problem in pediatric. Owing to the limitations of the liver biopsy and the importance of screening and follow-up of NAFLD patients for hepatic steatosis and fibrosis, the noninvasive diagnostic methods are obviously needed. Abdominal ultrasonography has several limitations to assess the degree of fatty liver. Recently; transient elastography (TE, FibroScan) with controlled attenuation parameter (CAP) has been emerging as a relevant tool for assessing hepatic fibrosis and steatosis. The aim of this study was the noninvasive evaluation of hepatic fibrosis and steatosis by FibroScan with CAP through measuring liver stiffness and CAP values, respectively, in Egyptian children and adolescents with NAFLD proven by ultrasound. Patients and methods 60 children and adolescents proven as NAFLD patients with ultrasound, were subjected to clinical examination and anthropometric measurements, liver enzymes (serum ALT, AST, ALP), lipid profile, fasting blood glucose (FBG) level and fasting serum insulin. Insulin resistance was calculated by homeostasis model assessment method of insulin resistance HOMA-IR. Hepatic fibrosis and steatosis were assessed by measuring liver stiffness and CAP, respectively, using FibroScan. Results There were significant increasing of the laboratory data among NAFLD patients with increasing the ultrasonographic grades of liver steatosis (P=0.0001, liver steatosis score (CAP stage) by fibroscan (P=0.0001) and liver fibrosis degree by fibroscan among patients (P=0.0001). CAP values by FibroScan are significantly increasing parallel to the grades of ultrasonic steatosis in NAFLD patients with different grades of ultrasonic steatosis. Also, the values of liver stiffness by FibroScan are significantly increasing parallel to the grades of ultrasonic steatosis in NAFLD patients with different grades of ultrasonic steatosis. There were positive correlations between ultrasonic steatosis grades and each of CAP value, liver stiffness value among the studied NAFLD children. Conclusion The data confirmed that Transient Elastography (TE) with CAP is a useful tool for detection of hepatic steatosis and fibrosis. There were positive correlations between ultrasonic steatosis grades and each of CAP value, liver stiffness value among the NAFLD children.