Korean J Pediatr.  2013 Jan;56(1):19-25. 10.3345/kjp.2013.56.1.19.

The efficacy of aspartate aminotransferase-to-platelet ratio index for assessing hepatic fibrosis in childhood nonalcoholic steatohepatitis for medical practice

• Kim E
• Kang Y
• Hahn S
• Lee MJ
• Park YN
• Koh H

• KMID: 2284299
• DOI: http://doi.org/10.3345/kjp.2013.56.1.19

Abstract

PURPOSE
Childhood obesity is associated with nonalcoholic fatty liver disease (NAFLD), and it has become one of the most common causes of childhood chronic liver diseases which significant as a cause of liver related mortality and morbidity in children in the United States. The development of simpler and easier clinical indices for medical practice is needed to identify advanced hepatic fibrosis in childhood NAFLD instead of invasive method like liver biopsy. FibroScan and aspartate aminotransferase (AST)-to-platelet ratio index (APRI) have been proposed as a simple and noninvasive predictor to evaluate hepatic fibrosis in several liver diseases. APRI could be a good alternative to detect pathologic change in childhood NAFLD. The purpose of this study is to validate the efficacy of APRI for assessing hepatic fibrosis in childhood NAFLD based on FibroScan.
METHODS
This study included 23 children with NAFLD who underwent FibroScan. Clinical, laboratory and radiological evaluation including APRI was performed. To confirm the result of this study, 6 patients received liver biopsy.
RESULTS
Factors associated with hepatic fibrosis (stiffness measurement >5.9 kPa Fibroscan) were triglyceride, AST, alanine aminotransferase, platelet count, APRI and collagen IV. In multivariate analysis, APRI were correlated with hepatic fibrosis (>5.9 kPa). In receiver operating characteristics curve, APRI of meaningful fibrosis (cutoff value, 0.4669; area under the receiver operating characteristics, 0.875) presented sensitivity of 94%, specificity of 66%, positive predictive value of 94%, and negative predictive value of 64%.
CONCLUSION
APRI might be a noninvasive, simple, and readily available method for medical practice to predict hepatic fibrosis of childhood NAFLD.

Keyword

Nonalcoholic fatty liver disease; Hepatic fibrosis; APRI; Child

MeSH Terms

Alanine Transaminase
Aspartate Aminotransferases
Aspartic Acid
Biopsy
Child
Collagen
Fatty Liver
Fibrosis
Humans
Liver
Liver Diseases
Multivariate Analysis
Obesity
Platelet Count
ROC Curve
Sensitivity and Specificity
United States
Alanine Transaminase
Aspartate Aminotransferases
Aspartic Acid
Collagen
Fatty Liver