J Korean Med Sci.
2019 Dec;34(47):e298. 10.3346/jkms.2019.34.e298.
Correlation of Clinical and Histopathologic Parameters with Ultrasonographic Grades in Pediatric Non-Alcoholic Fatty Liver Disease
- Affiliations
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- 1Department of Radiology, Hanyang University College of Medicine, Hanyang University Medical Center, Seoul, Korea.
- 2Department of Pathology, Hanyang University College of Medicine, Hanyang University Medical Center, Seoul, Korea.
- 3Department of Pediatrics, Hanyang University College of Medicine, Hanyang University Medical Center, Seoul, Korea. kyjoo@hanyang.ac.kr
- KMID: 2465004
- DOI: http://doi.org/10.3346/jkms.2019.34.e298
Abstract
- BACKGROUND
Liver biopsy is the gold standard for diagnosing non-alcoholic steatohepatitis (NASH), but liver biopsy in children is not available in many institutes and many parents are reluctant to agree with the procedure. We investigated the correlation of clinical and pathologic parameters with the severity of non-alcoholic fatty liver disease (NAFLD) in pediatric patients using ultrasonographic examination methods and measured the prevalence of fatty pancreas in pediatric NAFLD.
METHODS
Liver biopsy and abdominal ultrasound (US) examinations were performed in 58 children (42 boys, 16 girls; mean age, 12 years; age range, 4-19 years) between March 2006 and August 2017. Fatty liver and fatty pancreas were evaluated by two independent radiologists using US according to 4- and 3-point scales, respectively. We then analyzed the correlations of clinical, laboratory, and histopathologic parameters with the ultrasonographic grade of steatosis.
RESULTS
Forty-two children showed simple steatosis (NAFLD activity score [NAS] ≤ 5) while 16 showed NASH (NAS > 5). Higher body mass index (BMI) percentile, waist circumference, hematocrit, insulin resistance, and lower insulin sensitivity index were significantly positively correlated with the grade of fatty liver. NAFLD activity score, amount of steatosis, and fibrosis significantly worsened as the fatty liver grade increased. Higher BMI, lower insulin sensitivity index, and boy were significantly positively correlated with the fatty pancreas grade.
CONCLUSION
Altogether, ultrasonographic severity of fatty liver shows good correlation with that of clinical parameters and hepatic pathology.
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