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World J Gastroenterol. Dec 28, 2006; 12(48): 7821-7825
Published online Dec 28, 2006. doi: 10.3748/wjg.v12.i48.7821
Non invasive evaluation of liver fibrosis in paediatric patients with nonalcoholic steatohepatitis
Angelo Iacobellis, Matilde Marcellini, Angelo Andriulli, Francesco Perri, Gioacchino Leandro, Rita Devito, Valerio Nobili
Angelo Iacobellis, Angelo Andriulli, Francesco Perri, Division of Gastroenterology, Hospital “Casa Sollievo della Sofferenza”, IRCCS, San Giovanni Rotondo, Italy
Matilde Marcellini, Valerio Nobili, Liver Unit, Bambino Gesu’ Children’s Hospital, Rome, Italy
Gioacchino Leandro, Division of Gastroenterology, “De Bellis” Hospital, IRCCS, Castellana Grotte, Italy
Rita Devito, Pathology Department Bambino Gesu’ Children’s Hospital, Rome, Italy
Correspondence to: Dr. Valerio Nobili, Liver Unit, Bambino Gesu’ Children’s Hospital, Rome, Italy. nobili66@yahoo.it
Telephone: +39-6-68592243 Fax: +39-6-68592192
Received: September 17, 2006
Revised: September 28, 2006
Accepted: November 30, 2006
Published online: December 28, 2006
Abstract

AIM: To identify the independent predictors of hepatic fibrosis in 69 children with nonalcoholic steatohepatitis (NASH) due to nonalcoholic fatty liver disease (NAFLD).

METHODS: All patients with clinically suspected NASH underwent liver biopsy as a confirmatory test. The following clinical and biochemical variables at baseline were examined as likely predictors of fibrosis at histology: age, body mass index (BMI), systolic blood pressure (SBP), dyastolic blood pressure (DBP), fasting glucose, fasting insulin, homeostatic model assessment for insulin resistence (HOMA-IR), cholesterol, tryglicerides, alanine aminotransferase (ALT), aspartate aminotransferase (AST), AST/ALT ratio, gamma glutamil transferase (GT), platelet count, prothrombin time (PT).

RESULTS: At histology 28 (40.6%) patients had no fibrosis and 41 (59.4%) had mild to bridging fibrosis. At multivariate analysis, BMI > 26.3 was the only independent predictor of fibrosis (OR = 5.85, 95% CI = 1.6-21).

CONCLUSION: BMI helps identify children with NASH who might have fibrotic deposition in the liver.

Keywords: Nonalcoholic steatohepatitis, Obesity, Body mass index, Liver fibrosis, Non invasive diagnosis