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A Nomogram for Predicting Non-Alcoholic Fatty Liver Disease in Obese Children

김아리, 양혜란, 조진민, 장주영, 문진수, 고재성,
소속 상세정보
김아리 ( Kim Ah-Lee ) - Bundang Jasaeng General Hospital Department of Pediatrics
양혜란 ( Yang Hye-Ran ) - Seoul National University Bundang Hospital Department of Pediatrics
조진민 ( Cho Jin-Min ) - Seoul National University Bundang Hospital Department of Pediatrics
장주영 ( Chang Ju-Young ) - Seoul National University College of Medicine Department of Pediatrics
문진수 ( Moon Jin-Soo ) - Seoul National University College of Medicine Department of Pediatrics
고재성 ( Ko Jae-Sung ) - Seoul National University College of Medicine Department of Pediatrics

Abstract


Purpose: Non-alcoholic fatty liver disease (NAFLD) ranges in severity from simple steatosis to steatohepatitis. Early detection of NAFLD is important for preventing the disease from progressing to become an irreversible end-stage liver disease. We developed a nomogram that allows for non-invasive screening for NAFLD in obese children.

Methods: Anthropometric and laboratory data of 180 patients from our pediatric obesity clinic were collected. Diagnoses of NAFLD were based on abdominal ultrasonographic findings. The nomogram was constructed using predictors from a multivariate analysis of NAFLD risk factors.

Results: The subjects were divided into non-NAFLD (n=67) and NAFLD groups (n=113). Factors, including sex, body mass index, abdominal circumference, blood pressure, insulin resistance, and levels of aspartate aminotransferase, alanine aminotransferase (ALT), γ-glutamyl transpeptidase (γGT), uric acid, triglycerides, and insulin, were significantly different between the two groups (all p<0.05) as determined using homeostatis model assessment of insulin resistance (HOMA-IR). In our multivariate logistic regression analysis, elevated serum ALT, γGT, and triglyceride levels were significantly related to NAFLD development. The nomogram was established using γGT, uric acid, triglycerides, HOMA-IR, and ALT as predictors of NAFLD probability.

Conclusion: The newly developed nomogram may help predict NAFLD risk in obese children. The nomogram may also allow for early NAFLD diagnosis without the need for invasive liver biopsy or expensive liver imaging, and may also allow clinicians to intervene early to prevent the progression of NAFLD to become a more advanced liver disease.

키워드

Obesity; Non-alcoholic fatty liver disease; Nomograms; Children

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