It has been observed that nonalcoholic fatty liver disease (NAFLD) is the most frequently encountered chronic condition in developed countries among various obesity-related complications. Childhood obesity is growing as a real health problem worldwide, and the World Health Organization (WHO) revealed that over 40 million children are either overweight or obese. This NAFLD can advance into nonalcoholic steatohepatitis (NASH) with further liver fibrosis, cirrhosis, neoplasia or organ failure. Although hepatic biopsy is the gold-standard for the diagnosis of hepatic fibrosis, its role is still limited in children because it is an invasive method. Currently, non-invasive methods employed for the assessment of liver fibrosis are two dimensional shear wave elastography (2D SWE) technique and transient elastography (TE) .

The present study is aimed to evaluate liver stiffness values in children with obesity in contrast to healthy children on 2D-SWE and TE, considering different laboratory parameters. The investigators included 287 children aged between 3 to 18 years, which were categorized according to the body mass index (BMI) into two groups; the study group-77 children with obesity, and control group-210 children with normal weight. Both groups underwent anamnesis, clinical examination, laboratory parameters, ultrasound exam, and elastography. 

The results divulged that children with obesity had higher levels of platelets, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and AST/ALT ratio (AAR) than those of controls. Evidence of no remarkable differences was reported for AST to platelet ratio index (APRI) between the two groups. However, APRI value was higher in children with obesity. Furthermore, significant increase in values of liver stiffness was found in children with obesity on both 2D-SWE and TE. Additionally, the velocity values measured by 2D-SWE were also significantly raised in obese children. 

Thus, based on the significant higher values of platelets, transaminases, AAR, and liver stiffness in obese children, it can be assumed that both 2D-SWE and TE can serve as a beneficial non-invasive diagnostic tools for liver impairment associated to pediatric obesity.

Source: Sci Rep. 2019;9(1):19800. Published 2019 Dec 24.