Relationship of Enhanced Liver Fibrosis Score with Pediatric Nonalcoholic Fatty Liver Disease Histology and Response to Vitamin E or Metformin.
Relationship of Enhanced Liver Fibrosis Score with Pediatric Nonalcoholic Fatty Liver Disease Histology and Response to Vitamin E or Metformin.
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增强的肝纤维化评分与小儿非酒精脂肪肝疾病组织学以及对维生素E或二甲双胍的反应的关系。
DOI：
10.1016/j.jpeds.2021.08.012
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Molleston JP
中科院分区：
文献类型：
--
作者：
Gawrieh S;Harlow KE;Pike F;Yates KP;Wilson LA;Cummings OW;Rosenberg WM;Chalasani N;Molleston JP
研究增强型肝纤维化评分（ELF）检测不同阶段纤维化的诊断性能及其在检测参与维生素E或二甲双胍治疗儿童NAFLD（TONIC）试验的非酒精性脂肪性肝病儿童对维生素E或二甲双胍的组织学反应中的有用性。在基线和第24、48和96周对来自166名TONIC参与者的血清测量ELF。使用χ2检验和逻辑回归模型评估ELF与基线和试验结束（EOT）纤维化分期及其他组织学特征之间的相关性。ELF与基线和EOT时的纤维化严重程度显著相关。区分具有临床意义和晚期纤维化患者的ELF曲线下面积分别为0.70（95% CI，0.60-0.80）和0.79（95% CI，0.69-0.89）。EOT时ELF降低1个单位与总体组织学改善相关（OR，1.86; 95% CI，1.11-3.14; P = .02），脂肪性肝炎消退（OR，1.88; 95% CI，1.09-3.25; P = 0.02），脂肪变性分级改善（OR，1.76; 95% CI，1.06-2.82; P = .03），肝细胞气球样变（OR，1.79; 95%CI，1.06-3.00; P = .03），但纤维化分期未改善（OR，1.26; 95%CI，0.78-2.03; P = .34）。ELF与参与TONIC的儿童的纤维化分期相关。尽管与纤维化改善无关，但EOT时ELF降低与非酒精性脂肪性肝炎消退和非酒精性脂肪性肝病组织学改善相关。ELF可能是一种有用的无创测试，可用于监测非酒精性脂肪肝儿童的治疗反应。
To study the diagnostic performance of the enhanced liver fibrosis score (ELF) for detecting different stages of fibrosis and its usefulness in detecting histologic response to vitamin E or metformin in children with nonalcoholic fatty liver disease who participated in the Vitamin E or Metformin for the Treatment Of NAFLD In Children (TONIC) trial. ELF was measured at baseline and weeks 24, 48, and 96 on sera from 166 TONIC participants. Associations between ELF with baseline and end of trial (EOT) fibrosis stages and other histologic features were assessed using χ2 tests and logistic regression models. ELF was significantly associated with severity of fibrosis at baseline and EOT. ELF areas under the curve for discriminating patients with clinically significant and advanced fibrosis were 0.70 (95% CI, 0.60–0.80) and 0.79 (95% CI, 0.69–0.89), respectively. A 1-unit decrease in ELF at EOT was associated with overall histologic improvement (OR, 1.86; 95% CI, 1.11–3.14; P = .02), resolution of steatohepatitis (OR, 1.88; 95% CI, 1.09–3.25; P = .02), improvement in steatosis grade (OR, 1.76; 95% CI, 1.06–2.82; P = .03), and hepatocellular ballooning (OR, 1.79; 95% CI, 1.06–3.00; P = .03), but not with improvement in fibrosis stage (OR, 1.26; 95% CI, 0.78–2.03; P = .34). ELF was associated with fibrosis stage in children who participated in TONIC. Although not associated with improvement in fibrosis, a decrease in ELF at EOT was associated with Nonalcoholic Steatohepatitis resolution and improvement in nonalcoholic fatty liver disease histology. ELF may be a useful noninvasive test to monitor treatment response in children with nonalcoholic fatty liver disease.
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DOI：
10.1056/nejmoa0907929
发表时间：
2010-05-06
期刊：
The New England journal of medicine
影响因子：
--
作者：
Sanyal AJ;Chalasani N;Kowdley KV;McCullough A;Diehl AM;Bass NM;Neuschwander-Tetri BA;Lavine JE;Tonascia J;Unalp A;Van Natta M;Clark J;Brunt EM;Kleiner DE;Hoofnagle JH;Robuck PR;NASH CRN
通讯作者：
NASH CRN
影响因子：
3.1
作者：
Mansoor, Sana;Yerian, Lisa;Alkhouri, Naim
通讯作者：
Alkhouri, Naim
影响因子：
13.5
作者：
Anstee, Quentin M.;Lawitz, Eric J.;Younossi, Zobair M.
通讯作者：
Younossi, Zobair M.
影响因子：
8
作者：
Sahota, Amandeep K.;Shapiro, Warren L.;Schwimmer, Jeffrey B.
通讯作者：
Schwimmer, Jeffrey B.
影响因子：
29.4
作者：
Angulo P;Kleiner DE;Dam-Larsen S;Adams LA;Bjornsson ES;Charatcharoenwitthaya P;Mills PR;Keach JC;Lafferty HD;Stahler A;Haflidadottir S;Bendtsen F
通讯作者：
Bendtsen F