Improvement of BMI after Lifestyle Intervention Is Associated with Normalisation of Elevated ELF Score and Liver Stiffness in Obese Children.
BACKGROUND
Noninvasive tools to diagnose nonalcoholic fatty liver disease (NAFLD), including transient elastography (TE) and enhanced liver fibrosis panel (ELF), have only been evaluated in children with biopsy-proven NAFLD. We evaluated the prevalence of ELF and TE abnormalities in obese children without clinical liver disease and examined the effects of BMI stabilization on ELF and TE in a longitudinal approach.


METHODS
39 obese children (17 m, age 12.3 (7.6-17.4) years) who participated in a 12-month lifestyle-intervention program underwent TE and ELF testing at baseline and at completion of the program. Results were compared with data from a nonobese paediatric cohort.


RESULTS
TE and ELF at baseline were significantly elevated compared to controls (TE: 5.9 (3.4-8.3) kPa versus 4.45 (2.45-8.85) kPa, P < 0.01; ELF: 9.0 (7.87-9.60) versus 8.6 (7.33-11.52), P = 0.033). All children with elevated TE and ELF results had normal transaminases. After the program, ELF and TE normalized. Reduction of ELF and TE was associated with a decrease in BMI centile.


CONCLUSIONS
Abnormal TE and ELF results in obese children suggest presence of NAFLD even when transaminases are normal. TE and ELF might be used as monitoring tools for NAFLD. BMI stabilisation normalizes TE and ELF, underlining the impact of lifestyle intervention.
Paediatric Gastroenterology and Hepatology, Children's Hospital, Hannover Medical School, 39625 Hannover, Germany.
Imeke
I
Goldschmidt
Paediatric Gastroenterology and Hepatology, Children's Hospital, Hannover Medical School, 39625 Hannover, Germany.
André
A
Di Nanni
Paediatric Gastroenterology and Hepatology, Children's Hospital, Hannover Medical School, 39625 Hannover, Germany.
Carolin
C
Streckenbach
Children's Hospital "Auf der Bult", 30173 Hannover, Germany.
Kerstin
K
Schnell
Children's Hospital "Auf der Bult", 30173 Hannover, Germany.
Thomas
T
Danne
Paediatric Gastroenterology and Hepatology, Children's Hospital, Hannover Medical School, 39625 Hannover, Germany.
Ulrich
U
Baumann
D000293:Adolescent; D001706:Biopsy / Q000379:methods; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D054459:Elasticity Imaging Techniques / Q000379:methods; D005260:Female; D006801:Humans; D008019:Life Style; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease / Q000473:pathology; D009765:Obesity / Q000473:pathology*