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RESEARCH PRODUCT

Transient Elastography-Based Liver Stiffness Age-Dependently Increases in Children

Haruo ShintakuYuki ChoDaisuke Tokuhara

subject

MalePercentilePhysiologylcsh:MedicineSocial SciencesOverweightAdolescentsPediatricsGastroenterologyLiver disease0302 clinical medicineSociologyReference ValuesRisk FactorsMedicine and Health Sciences030212 general & internal medicinelcsh:ScienceChildSchoolsMultidisciplinaryLiver DiseasesFatty liverLiverPhysiological ParametersChild PreschoolElasticity Imaging TechniquesLiver FibrosisFemale030211 gastroenterology & hepatologymedicine.symptomResearch Articlemedicine.medical_specialtyChildhood ObesityAdolescentGastroenterology and HepatologyChildhood obesityEducation03 medical and health sciencesLiver stiffnessInternal medicinemedicineHumansObesitybusiness.industrylcsh:RBody WeightInfantBiology and Life SciencesEchogenicitymedicine.diseaseFatty LiverAge GroupsPeople and Placeslcsh:QPopulation GroupingsTransient elastographybusiness

description

Background and Aims Pediatric use of liver transient elastography (TE) is attractive for its non-invasiveness, but reference values have not been established. We aimed to determine reference values for TE in children. Methods In pediatric patients (1 to 18 years), TE (FibroScan®) with an M probe was used for both liver stiffness measurement (LSM) and measurement of hepatic fat deposition by using a controlled attenuation parameter (CAP). The patients were divided into three relevant age groups: preschoolers (1 to 5 years), elementary school children (6 to 11 years), and adolescents (12 to 18 years). Overweight or obese patients or those with known liver disease, elevated serum liver enzymes, or hepatic echogenic abnormality were excluded from the study. Results Among 139 children, 123 (88.5%; 62 male; median age, 11.7 years; age range, 1.3 to 17.2 years) were successfully subjected to M-probe TE without anesthesia. Median LSM increased with age: it was 3.4 kPa (2.3 to 4.6 kPa, 5th to 95th percentiles) at ages 1 to 5 years; 3.8 (2.5 to 6.1) kPa at ages 6 to 11; and 4.1 (3.3 to 7.9) kPa at ages 12 to 18 (P = 0.001). Median CAP was not age dependent: it was 183 (112 to 242) for ages 1 to 18 years. Conclusions M-probe TE is suitable in a wide age range of children from age 1 year up. In children without evidence of liver disease, LSM has an age-dependent increase, whereas CAP does not differ between ages 1 and 18.

https://doi.org/10.1371/journal.pone.0166683