Abstract
The aim of this study was to assess the liver stiffness values in children with obesity versus healthy children on 2D-SWE and TE taking into account different laboratory parameters. We performed a case-control study on 287 children aged between 3 to 18 years, admitted in a Romanian Pediatric Tertiary Hospital, which we divided according to the body mass index (BMI) into two groups: the study group-77 children with obesity, and control group-210 children with normal weight. All children underwent anamnesis, clinical exam, laboratory parameters, ultrasound exam, and elastography. Children with obesity presented higher values of platelets, AST, ALT, and AAR as compared to control group (p = 0.0005/p = 0.0065/p < 0.0001/p < 0.0001). We found no significant differences for APRI between the two groups (p = 0.9827), although the values were higher in children with obesity. Significantly higher values of liver stiffness in children with obesity on both 2D-SWE and TE (p = 0.0314/p < 0.0001) were obtained. Similarly, the velocity values measured by 2D-SWE were also significantly higher in the study group (p < 0.0001). Our findings revealed significantly higher levels of platelets, transaminases, AAR, and liver stiffness values on both TE and 2D-SWE in children with obesity. 2D-SWE and TE might represent useful non-invasive methods for predicting liver impairment associated to pediatric obesity.
Highlights
The aim of this study was to assess the liver stiffness values in children with obesity versus healthy children on 2D-SWE and Transient elastography (TE) taking into account different laboratory parameters
Contrariwise, we found no significant differences in terms of APRI between the two groups (p = 0.9827), the values were higher in children with obesity, 0.22 ± 0.20 as compared to those encountered in control group, 0.20 ± 0.12
Elastography is a valuable non-invasive method that should be used in order to assess liver fibrosis associated to obesity in children since pediatric obesity reached alarming rates worldwide during the last decades
Summary
The aim of this study was to assess the liver stiffness values in children with obesity versus healthy children on 2D-SWE and TE taking into account different laboratory parameters. 2D-SWE is a novel, non-invasive method that assesses the elasticity of the liver tissue depending on the viscous and elastic properties of the hepatic tissue It evaluates in real time the velocity (m/s) and stiffness (kPa), which are not influenced by respiratory phases, and it does not require for children to hold their breath during the examination[14]. This probe will transmit a low-amplitude signal to the hepatic tissue triggering an elastic shear wave that propagates through this tissue Based on this process, TE allows the measurement of wave velocity, expressed in kPa, which is directly proportional to liver elasticity, varying from 2.5 to 74 kPa6. Certain studies tried to identify different combinations between certain laboratory parameters which would have a higher accuracy in diagnosing liver fibrosis, among which aspartate aminotransferase (AST)/platelets ratio index (APRI)[19], or AST/alanine aminotransferase (ALT) ratio (AAR)[20,21]
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