Pediatric percentiles for transient elastography measurements - effects of age, sex, weight status and pubertal stage

Abstract

Background and aimsTransient Elastography is a non-invasive, cost-efficient, non-ionizing, observer-independent and reliable method to detect liver fibrosis using Liver Stiffness Measurement (LSM) and the degree of fat accumulation in the liver using Controlled Attenuation Parameter (CAP). This study aims to derive reference values for both measures from healthy children and adolescents. Further, we aim to assess the potential influence of age, sex, puberty, and BMI-SDS on CAP and LSM.MethodsWithin the LIFE Child study, amongst others, anthropometric data and pubertal status were assessed. Transient Elastography (TE) was performed using the FibroScan® device in a population-based cohort at 982 study visits of 482 healthy children aged between 10 and 18 years. Percentiles for LSM and CAP were estimated, and the effects of age, sex, puberty and weight status were assessed through hierarchical regression models.ResultsThere was a strong age dependency for LSM with higher values for older children, most pronounced in the upper percentiles in boys. Contrarily, CAP was relatively stable across the age span without considerable difference between boys and girls. We found a significant positive correlation between BMI-SDS and both CAP and LSM for BMI-SDS >1.28. For BMI-SDS < 1.28, the association was also positive but reached statistical significance only for CAP. Further, the association between BMI-SDS and CAP was significantly stronger in younger than in older children. There was no association between pubertal status and CAP. For LSM, we found that children with a high BMI-SDS but not children with normal weight had significantly higher LSM values in Tanner stage 4.ConclusionsAge, sex, pubertal status and weight status should be considered when interpreting LSM and CAP in pediatric patients to facilitate and improve early detection of abnormal liver function, which is associated with common pathologies, such as NAFLD.

Clinical research of fibroscan ‒ TE-CAP at noninvasive diagnosis of hepatic steatosis in children

“…Studies have reported that TE-CAP was relatively stable in different age stages, and there was no significant difference between boys and girls. 33 , 34 Previous study had used TE-CAP to predict the severity of liver disease in children. 35 TE-CAP was also used in adolescents without liver disease.…”

Neue(re) Techniken in der Pädiatrischen Sonografie

“…Im menschlichen Körper können fokale und diffuse Veränderungen über ihre Steifig- Für Kinder und Jugendliche gibt es etliche Referenzwertstudien. In der LIFE-Child-Studie konnte für die TE eine positive Korrela-tion mit dem Alter erhoben werden mit zunehmender Steifigkeit, wobei nur Kinder ab 10 Jahren untersucht wurden [24]. Körpergewicht und Geschlecht sind bei der Bewertung der Ergebnisse zu berücksichtigen.…”

Obesity and Body Composition in Relation to Liver and Kidney Ultrasound Elastography in Paediatric Patients with Either Hypertension or Chronic Kidney Disease

“…Weight status, along with other patient-based factors, significantly affects UE measurement in children [4]. Liver stiffness is strongly related with body mass index (BMI) in children with obesity.…”