title: Importance of the liver ultrasound scores in pubertal obese children with nonalcoholic fatty liver disease.
abstract: OBJECTIVE
  The purpose of our study was to determine the relationship between liver ultrasound scores and insulin sensitivity in a population of obese children with nonalcoholic fatty liver disease (NAFLD) and the relationships between other metabolic features and ultrasound scores.
  
  
  METHODS
  One hundred sixty-nine obese adolescents, 96 girls, and 73 boys (mean age: 12.7 ± 1.3 years, mean body mass index: 26.3 ± 4.6) were enrolled the study. The obese subjects were divided into 2 groups based on their pubertal status. Ultrasonography findings were scored in this study included hepatorenal echo contrast, liver brightness, deep attenuation, and vascular blurring. Scores ranged from 0 to 6 points, and NAFLD was defined if ultrasound score was ≥ 1. Insulin resistance was evaluated by homeostasis model assessment (HOMA-IR) from fasting samples.
  
  
  RESULTS
  Prevalence of NAFLD in pubertal children (61.9%) had significantly higher than pre-pubertal children (40.8%) (P=.008). Transaminases ratio was significantly correlated in both prepubertal (r=0.231; P=.03) and pubertal (r=0.628, P=0.017) groups. HOMA-IR values were elevated in both groups; however, liver ultrasound score was positively correlated with HOMA-IR (r=0.735, P=.014) in pubertal children.
  
  
  CONCLUSIONS
  NAFLD prevalence among obese children is quite high, especially pubertal adolescents than prepubertal children. We demonstrated an association between insulin resistance and NAFLD ultrasound scoring in pubertal obese children. We suggested that ultrasound examination of the liver be included in the routine check-up of the pubertal obese children with insulin resistance to allow the detection of NAFLD at an early stage.
authors.affiliation: Department of Pediatric Gastroenterology, Hepatology and Nutrition, S.Demirel University, Faculty of Medicine, Isparta, Turkey. makcam@med.sdu.edu.tr
authors.forename: Mustafa
authors.initials: M
authors.lastname: Akcam
authors.forename: Aslihan
authors.initials: A
authors.lastname: Boyaci
authors.forename: Ozgur
authors.initials: O
authors.lastname: Pirgon
authors.forename: Mert
authors.initials: M
authors.lastname: Koroglu
authors.forename: Bumin N
authors.initials: BN
authors.lastname: Dundar
mesh_terms: D000293:Adolescent; D000465:Algorithms; D002648:Child; D015897:Comorbidity; D005234:Fatty Liver / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D015994:Incidence; D007333:Insulin Resistance; D008099:Liver / Q000000981:diagnostic imaging*; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease; D009765:Obesity / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D011627:Puberty; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014421:Turkey / Q000453:epidemiology; D014463:Ultrasonography / Q000379:methods / Q000706:statistics & numerical data*