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KMID : 1038820200230030276
Pediatric Gastroenterology, Hepatology & Nutrition
2020 Volume.23 No. 3 p.276 ~ p.285
A Nomogram for Predicting Non-Alcoholic Fatty Liver Disease in Obese Children
Kim Ah-Lee

Yang Hye-Ran
Cho Jin-Min
Chang Ju-Young
Moon Jin-Soo
Ko Jae-Sung
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), ¥ã-glutamyl transpeptidase (¥ãGT), 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, ¥ãGT, and triglyceride levels were significantly related to NAFLD development. The nomogram was established using ¥ãGT, 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.
KEYWORD
Obesity, Non-alcoholic fatty liver disease, Nomograms, Children
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