Abstract
Background: To assess the clinical validity of controlled attenuation parameter (CAP) in the diagnosis of hepatic steatosis in a series of overweight or obese children by using the imperfect gold standard methodology. Methods: Consecutive children referred to our institution for auxological evaluation or obesity or minor elective surgery were prospectively enrolled. Anthropometric and biochemical parameters were recorded. Ultrasound (US) assessment of steatosis was carried out using ultrasound systems. CAP was obtained with the FibroScan 502 Touch device (Echosens, Paris, France). Pearson's or Spearman's rank correlation coefficient were used to test the association between two study variables. Optimal cutoff of CAP for detecting steatosis was 249dB/m. The diagnostic performance of dichotomized CAP, US, body mass indexes (BMI), fatty liver index (FLI) and hepatic steatosis index (HSI) was analyzed using the imperfect gold standard methodology. Results: Three hundred five pediatric patients were enrolled. The data of both US and CAP were available for 289 children. Steatosis was detected in 50/289 (17.3%) children by US and in 77/289 (26.6%) by CAP. A moderate to good correlation was detected between CAP and BMI (r=0.53), FLI (r=0.55) and HSI (r=0.56). In obese children a moderate to good correlation between CAP and insulin levels (r=0.54) and HOMA-IR (r=0.54) was also found. Dichotomized CAP showed a performance of 0.70 (sensitivity, 0.72 [0.64-0.79]; specificity, 0.98 [0.97-0.98], which was better than that of US (performance, 0.37; sensitivity, 0.46 [0.42-0.50]; specificity, 0.91 [0.89-0.92]), BMI (performance, 0.22; sensitivity, 0.75 [0.73-0.77]; specificity, 0.57 [0.55-0.60]) and FLI or HSI. Conclusions: For the evaluation of liver steatosis in children CAP performs better than US, which is the most widely used imaging technique for screening patients with a suspicion of liver steatosis. A cutoff value of CAP of 249dB/m rules in liver steatosis with a very high specificity.
| Original language | English |
|---|---|
| Article number | 61 |
| Journal | BMC Gastroenterology |
| Volume | 17 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - May 4 2017 |
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Keywords
- Controlled attenuation parameter
- Liver steatosis
- NAFLD
- Obesity
- Pediatric series
- Transient elastography
- Ultrasound
ASJC Scopus subject areas
- Gastroenterology
Cite this
Noninvasive assessment of liver steatosis in children : The clinical value of controlled attenuation parameter. / Ferraioli, Giovanna; Calcaterra, Valeria; Lissandrin, Raffaella; Guazzotti, Marinella; Maiocchi, Laura; Tinelli, Carmine; De Silvestri, Annalisa; Regalbuto, Corrado; Pelizzo, Gloria; Larizza, Daniela; Filice, Carlo.
In: BMC Gastroenterology, Vol. 17, No. 1, 61, 04.05.2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Noninvasive assessment of liver steatosis in children
T2 - The clinical value of controlled attenuation parameter
AU - Ferraioli, Giovanna
AU - Calcaterra, Valeria
AU - Lissandrin, Raffaella
AU - Guazzotti, Marinella
AU - Maiocchi, Laura
AU - Tinelli, Carmine
AU - De Silvestri, Annalisa
AU - Regalbuto, Corrado
AU - Pelizzo, Gloria
AU - Larizza, Daniela
AU - Filice, Carlo
PY - 2017/5/4
Y1 - 2017/5/4
N2 - Background: To assess the clinical validity of controlled attenuation parameter (CAP) in the diagnosis of hepatic steatosis in a series of overweight or obese children by using the imperfect gold standard methodology. Methods: Consecutive children referred to our institution for auxological evaluation or obesity or minor elective surgery were prospectively enrolled. Anthropometric and biochemical parameters were recorded. Ultrasound (US) assessment of steatosis was carried out using ultrasound systems. CAP was obtained with the FibroScan 502 Touch device (Echosens, Paris, France). Pearson's or Spearman's rank correlation coefficient were used to test the association between two study variables. Optimal cutoff of CAP for detecting steatosis was 249dB/m. The diagnostic performance of dichotomized CAP, US, body mass indexes (BMI), fatty liver index (FLI) and hepatic steatosis index (HSI) was analyzed using the imperfect gold standard methodology. Results: Three hundred five pediatric patients were enrolled. The data of both US and CAP were available for 289 children. Steatosis was detected in 50/289 (17.3%) children by US and in 77/289 (26.6%) by CAP. A moderate to good correlation was detected between CAP and BMI (r=0.53), FLI (r=0.55) and HSI (r=0.56). In obese children a moderate to good correlation between CAP and insulin levels (r=0.54) and HOMA-IR (r=0.54) was also found. Dichotomized CAP showed a performance of 0.70 (sensitivity, 0.72 [0.64-0.79]; specificity, 0.98 [0.97-0.98], which was better than that of US (performance, 0.37; sensitivity, 0.46 [0.42-0.50]; specificity, 0.91 [0.89-0.92]), BMI (performance, 0.22; sensitivity, 0.75 [0.73-0.77]; specificity, 0.57 [0.55-0.60]) and FLI or HSI. Conclusions: For the evaluation of liver steatosis in children CAP performs better than US, which is the most widely used imaging technique for screening patients with a suspicion of liver steatosis. A cutoff value of CAP of 249dB/m rules in liver steatosis with a very high specificity.
AB - Background: To assess the clinical validity of controlled attenuation parameter (CAP) in the diagnosis of hepatic steatosis in a series of overweight or obese children by using the imperfect gold standard methodology. Methods: Consecutive children referred to our institution for auxological evaluation or obesity or minor elective surgery were prospectively enrolled. Anthropometric and biochemical parameters were recorded. Ultrasound (US) assessment of steatosis was carried out using ultrasound systems. CAP was obtained with the FibroScan 502 Touch device (Echosens, Paris, France). Pearson's or Spearman's rank correlation coefficient were used to test the association between two study variables. Optimal cutoff of CAP for detecting steatosis was 249dB/m. The diagnostic performance of dichotomized CAP, US, body mass indexes (BMI), fatty liver index (FLI) and hepatic steatosis index (HSI) was analyzed using the imperfect gold standard methodology. Results: Three hundred five pediatric patients were enrolled. The data of both US and CAP were available for 289 children. Steatosis was detected in 50/289 (17.3%) children by US and in 77/289 (26.6%) by CAP. A moderate to good correlation was detected between CAP and BMI (r=0.53), FLI (r=0.55) and HSI (r=0.56). In obese children a moderate to good correlation between CAP and insulin levels (r=0.54) and HOMA-IR (r=0.54) was also found. Dichotomized CAP showed a performance of 0.70 (sensitivity, 0.72 [0.64-0.79]; specificity, 0.98 [0.97-0.98], which was better than that of US (performance, 0.37; sensitivity, 0.46 [0.42-0.50]; specificity, 0.91 [0.89-0.92]), BMI (performance, 0.22; sensitivity, 0.75 [0.73-0.77]; specificity, 0.57 [0.55-0.60]) and FLI or HSI. Conclusions: For the evaluation of liver steatosis in children CAP performs better than US, which is the most widely used imaging technique for screening patients with a suspicion of liver steatosis. A cutoff value of CAP of 249dB/m rules in liver steatosis with a very high specificity.
KW - Controlled attenuation parameter
KW - Liver steatosis
KW - NAFLD
KW - Obesity
KW - Pediatric series
KW - Transient elastography
KW - Ultrasound
UR - http://www.scopus.com/inward/record.url?scp=85019159744&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85019159744&partnerID=8YFLogxK
U2 - 10.1186/s12876-017-0617-6
DO - 10.1186/s12876-017-0617-6
M3 - Article
AN - SCOPUS:85019159744
VL - 17
JO - BMC Gastroenterology
JF - BMC Gastroenterology
SN - 1471-230X
IS - 1
M1 - 61
ER -