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The efficacy of aspartate aminotransferase-to-platelet ratio index for assessing hepatic fibrosis in childhood nonalcoholic steatohepatitis for medical practice

 Earl Kim  ;  Yunkoo Kang  ;  Seungmin Hahn  ;  Mi Jung Lee  ;  Young Nyun Park  ;  Hong Koh 
 Korean Journal of Pediatrics, Vol.56(1) : 19-25, 2013 
Journal Title
 Korean Journal of Pediatrics 
Issue Date
APRI ; Child ; Hepatic fibrosis ; Nonalcoholic fatty liver disease
PURPOSE: Childhood obesity is associated with nonalcoholic fatty liver disease (NAFLD), and it has become one of the most common causes of childhood chronic liver diseases which significant as a cause of liver related mortality and morbidity in children in the United States. The development of simpler and easier clinical indices for medical practice is needed to identify advanced hepatic fibrosis in childhood NAFLD instead of invasive method like liver biopsy. FibroScan and aspartate aminotransferase (AST)-to-platelet ratio index (APRI) have been proposed as a simple and noninvasive predictor to evaluate hepatic fibrosis in several liver diseases. APRI could be a good alternative to detect pathologic change in childhood NAFLD. The purpose of this study is to validate the efficacy of APRI for assessing hepatic fibrosis in childhood NAFLD based on FibroScan. METHODS: This study included 23 children with NAFLD who underwent FibroScan. Clinical, laboratory and radiological evaluation including APRI was performed. To confirm the result of this study, 6 patients received liver biopsy. RESULTS: Factors associated with hepatic fibrosis (stiffness measurement >5.9 kPa Fibroscan) were triglyceride, AST, alanine aminotransferase, platelet count, APRI and collagen IV. In multivariate analysis, APRI were correlated with hepatic fibrosis (>5.9 kPa). In receiver operating characteristics curve, APRI of meaningful fibrosis (cutoff value, 0.4669; area under the receiver operating characteristics, 0.875) presented sensitivity of 94%, specificity of 66%, positive predictive value of 94%, and negative predictive value of 64%. CONCLUSION: APRI might be a noninvasive, simple, and readily available method for medical practice to predict hepatic fibrosis of childhood NAFLD.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Yunkoo(강윤구) ORCID logo https://orcid.org/0000-0003-1712-2138
Koh, Hong(고홍) ORCID logo https://orcid.org/0000-0002-3660-7483
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
Lee, Mi-Jung(이미정) ORCID logo https://orcid.org/0000-0003-3244-9171
Hahn, Seung Min(한승민) ORCID logo https://orcid.org/0000-0001-9832-6380
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