Short Communication | DOI: https://doi.org/10.31579/2641-5194/009
Pediatric Gastroenterology, Cleveland Clinic Main Campus, Cleveland, OH. E-mail: kabbanm@ccf.org
*Corresponding Author: Mohammad Nasser Kabany, Pediatric Gastroenterology, Cleveland Clinic Main Campus, Cleveland, OH. E-mail: kabbanm@ccf.org
Citation: Mohammad Nasser Kabany, Comparing Two Strategies for Pediatric Nonalcoholic Fatty Liver Disease(NAFLD) Screening, J. Gastroenterology Pancreatology and Hepatobilary Disorders, 3(1): DOI: 10.31579/2641-5194/009
Copyright: © 2019 Mohammad Nasser Kabany. This is an open-access article distributed under the terms of The Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 30 September 2019 | Accepted: 05 November 2019 | Published: 22 November 2019
Keywords: nonalcoholic fatty liver disease; insulin resistance; cirrhosis
Nonalcoholic fatty liver disease (NAFLD) is a growing disease globally. It is strongly related to obesity and insulin resistance. NAFLD poses a public health issue because it may progress to NASH and subsequently to cirrhosis [1]. Currently, NASH cirrhosis is going to be the second most common cause for chronic liver disease in adult patients awaiting transplantation [2]. There is evidence that its prevalence is also increasing in children which creates an urgent need to identify patients with NAFLD and intervene early.
Nonalcoholic fatty liver disease (NAFLD) is a growing disease globally. It is strongly related to obesity and insulin resistance. NAFLD poses a public health issue because it may progress to NASH and subsequently to cirrhosis [1]. Currently, NASH cirrhosis is going to be the second most common cause for chronic liver disease in adult patients awaiting transplantation [2]. There is evidence that its prevalence is also increasing in children which creates an urgent need to identify patients with NAFLD and intervene early.
Typically the gold standard for diagnosis for NAFLD is liver biopsy. However it is an invasive procedure and carries the risk of complications including death [3]. So it is reasonable to look for alternative tools especially for screening. Screening test should have the following qualities: high sensitivity/specificity, readily available at a low cost and non-invasive if possible. Unfortunately, no screening tool meets the above criteria in pediatric NAFLD. While American Association for the Study of Liver Diseases (AASLD) had no formal recommendations to screen for pediatric NAFLD [4], the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) recommend using alanine aminotransferase (ALT) as a screening tool in overweight children with risk factors and obese children [5]. On the other hand the European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) recommended using ALT and ultrasound [6]. The purpose of our recently published study is to evaluate the difference between both guidelines in detecting NAFLD in at-risk children.
In this retrospective study we included overweight children with risk factors for metabolic syndrome as well as obese children seen at a weight management program at a tertiary medical center (Cleveland Clinic Children’s, Cleveland, OH). We found that NAFLD prevalence in this population was 58.4
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