Pediatric non-alcoholic fatty liver disease predicted by anthropometric values through transient elastography.

BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is the leading cause of pediatric chronic liver disease, which is highly associated with obesity. Transient elastography together with anthropometric values including waist-to-height ratio (WHtR) and body mass index (BMI) z-score prove to be a more precise diagnostic method of NAFLD than ultrasonography. Through transient elastography, we investigate principal anthropometric values associated with pediatric NAFLD. METHODS Healthy children between the ages of 6-18 years whose BMI are ≥85% of normal were recruited as the overweight-and-obese group, and children whose BMIs range between 5%-85% were recruited as the control group. NAFLD was evaluated via transient elastography. BMI z-score and WHtR were measured. RESULTS A total of 107 (58 overweight-and-obese, 49 control) children were recruited. As evaluated by transient elastography, children in the overweight-and-obese group had significantly higher controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) values than the control group. To detect fatty liver, WHtR with a cut-off point of 0.481 and BMI z-score with cut-off point of 1.075 had the best sensitivity and specificity. To identify liver stiffness or inflammation, WHtR with cut-off point of 0.514 and BMI z-score with cut-off point of 1.62 had the best sensitivity and specificity. Additionally, CAP demonstrates fair correlation with WHtR and BMI z-score, even in the normal range of these parameters. CONCLUSIONS Transient elastography together with anthropometric measurements demonstrate that pediatric NAFLD may develop earlier than expected. We hereby present principal anthropometric values associated with pediatric NAFLD.