Transient Elastography-Based Liver Profiles in a Hospital-Based Pediatric Population in Japan.
Transient Elastography-Based Liver Profiles in a Hospital-Based Pediatric Population in Japan.
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DOI：
10.1371/journal.pone.0137239
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Shintaku H
中科院分区：
文献类型：
--
作者：
Cho Y;Tokuhara D;Morikawa H;Kuwae Y;Hayashi E;Hirose M;Hamazaki T;Tanaka A;Kawamura T;Kawada N;Shintaku H
瞬态弹性成像 (FibroScan) 的实用性在成人中得到了充分研究，但在儿童中尚未得到研究。我们试图评估在日本肥胖和非肥胖儿童中进行 FibroScan 的可行性以及基于 FibroScan 的肝脏概况的特征。 FibroScan 检查是在大阪市立大学医院就诊的儿科患者（年龄，1-18 岁）中进行的。通过受控衰减参数（CAP）测量的肝脏脂肪变性和通过肝脏硬度测量（LSM）评估的肝纤维化，在肥胖受试者（BMI百分位数≥90％）、非肥胖健康对照和患有肝病的非肥胖患者之间进行比较。在接受检查的 214 名儿童中，201 名儿童成功进行了 FibroScan（93.9%；中位年龄 11.5 岁；范围 1.3-17.6 岁；115 名男性）。肥胖组 (n = 52, 285±60 dB/m) CAP 值 (平均值±标准差) 高于肝病组 (n = 40, 202±62, P<0.001) 和对照组 (n = 107, 179±41, P<0.001)。肥胖组的LSM值（5.5±2.3 kPa）显着高于对照组（3.9±0.9，P<0.001），但肝病组的LSM值（5.4±4.2）与肥胖组和对照组之间无显着差异。在肥胖组 (ρ = 0.511) 中，LSM 与 CAP 高度相关，但在对照组 (ρ = 0.129) 或肝病组 (ρ = 0.170) 中则不然。儿童肥胖症与肝脏硬度增加相关的肝脏脂肪变性的风险很高。 FibroScan方法可同时测定CAP和LSM，适用于任何年龄的儿童，是日本肥胖儿童肝脂肪变性和肝纤维化的无创有效筛查方法。
The utility of transient elastography (FibroScan) is well studied in adults but not in children. We sought to assess the feasibility of performing FibroScans and the characteristics of FibroScan-based liver profiles in Japanese obese and non-obese children. FibroScan examinations were performed in pediatric patients (age, 1–18 yr) who visited Osaka City University Hospital. Liver steatosis measured by controlled attenuation parameter (CAP), and hepatic fibrosis evaluated as the liver stiffness measurement (LSM), were compared among obese subjects (BMI percentile ≥90%), non-obese healthy controls, and non-obese patients with liver disease. Among 214 children examined, FibroScans were performed successfully in 201 children (93.9%; median, 11.5 yr; range, 1.3–17.6 yr; 115 male). CAP values (mean±SD) were higher in the obese group (n = 52, 285±60 dB/m) compared with the liver disease (n = 40, 202±62, P<0.001) and the control (n = 107, 179±41, P<0.001) group. LSM values were significantly higher in the obese group (5.5±2.3 kPa) than in the control (3.9±0.9, P<0.001), but there were no significant differences in LSM between the liver disease group (5.4±4.2) and either the obese or control group. LSM was highly correlated with CAP in the obese group (ρ = 0.511) but not in the control (ρ = 0.129) or liver disease (ρ = 0.170) groups. Childhood obesity carries a high risk of hepatic steatosis associated with increased liver stiffness. FibroScan methodology provides simultaneous determination of CAP and LSM, is feasible in children of any age, and is a non-invasive and effective screening method for hepatic steatosis and liver fibrosis in Japanese obese children.