Non invasive evaluation of liver fibrosis in paediatric patients with nonalcoholic steatohepatitis.
OBJECTIVE
To identify the independent predictors of hepatic fibrosis in 69 children with nonalcoholic steatohepatitis (NASH) due to nonalcoholic fatty liver disease (NAFLD).


METHODS
All patients with clinically suspected NASH underwent liver biopsy as a confirmatory test. The following clinical and biochemical variables at baseline were examined as likely predictors of fibrosis at histology: age, body mass index (BMI), systolic blood pressure (SBP), dyastolic blood pressure (DBP), fasting glucose, fasting insulin, homeostatic model assessment for insulin resistence (HOMA-IR), cholesterol, tryglicerides, alanine aminotransferase (ALT), aspartate aminotransferase (AST), AST/ALT ratio, gamma glutamil transferase (GT), platelet count, prothrombin time (PT).


RESULTS
At histology 28 (40.6%) patients had no fibrosis and 41 (59.4%) had mild to bridging fibrosis. At multivariate analysis, BMI > 26.3 was the only independent predictor of fibrosis (OR = 5.85, 95% CI = 1.6-21).


CONCLUSIONS
BMI helps identify children with NASH who might have fibrotic deposition in the liver.
Iacobellis
Angelo
A
Division of Gastroenterology, Hospital Casa Sollievo della Sofferenza, IRCCS, San Giovanni Rotondo, Italy.
Marcellini
Matilde
M
Andriulli
Angelo
A
Perri
Francesco
F
Leandro
Gioacchino
G
Devito
Rita
R
Nobili
Valerio
V
D000293:Adolescent; D001706:Biopsy; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D002648:Child; D018450:Disease Progression; D005234:Fatty Liver / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008099:Liver / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012307:Risk Factors
D005947:Glucose