The performance of noninvasive indexes of adults in identification of nonalcoholic fatty liver disease in children

Abstract

To evaluate the performance of three existing prediction scores which are applicable to adults for identifying nonalcoholic fatty liver disease (NAFLD) in Chinese children. We used data from routine check-up based medical records of 1845 children to validate the performance of three existing scoring systems including hepatic steatosis index (HSI), Zhe Jiang University index (ZJU) and Triglyceride Glucose index (TyG) in detection of NAFLD in children. Propensity score matching (PSM) was applied to adjust for potential confounding effects in both training and validation cohorts. Area under the curve (AUC) of the receiver operating characteristic curve (ROC) analysis was utilized to assess the performance of three scoring systems. Children with NAFLD would like to have higher scores of HSI, ZJU, and TyG as compared to their counterparts. Elevated HSI, ZJU and TyG scores were significantly associated with the presence of pediatric NAFLD since adjusted odds ratio and 95% confidence interval with per interquartile range elevation of HSI, ZJU and TyG were 32.81(20.48,52.55), 26.31(16.97,40.79) and 1.83(1.57,2.13), respectively. In terms of discrimination of NAFLD in children, the AUCs of HSI, ZJU and TyG depending on the validation cohort were 0.964, 0.960 and 0.769, respectively. HSI and ZJU could be appropriate non-invasive biomarkers in distinguishing NAFLD in children from their controls with satisfied accuracy, which would emphasize the clinical and public health policy relevance of pediatric NAFLD. Our findings need to be confirmed by additional longitudinal studies. This article is protected by copyright. All rights reserved.