The prevalence of liver fibrosis according to non-invasive tools in a pediatric home parenteral nutrition cohort

Autor: Laura G. Draijer, Bart G. P. Koot, Sjoerd C. J. Nagelkerke, Merit M. Tabbers, Marc A. Benninga
Přispěvatelé: Graduate School, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam Reproduction & Development (AR&D), Paediatric Gastroenterology
Jazyk: angličtina
Rok vydání: 2021
Předmět:
0301 basic medicine
Liver Cirrhosis
Male
Intestinal failure-associated liver disease
medicine.medical_specialty
Enhanced liver fibrosis score
Transient elastography
Cross-sectional study
Liver fibrosis
030209 endocrinology & metabolism
Critical Care and Intensive Care Medicine
Gastroenterology
Risk Assessment
Statistics
Nonparametric
03 medical and health sciences
Liver disease
0302 clinical medicine
Liver Function Tests
Fibrosis
Risk Factors
Internal medicine
Prevalence
Medicine
Humans
Aspartate Aminotransferases
Child
030109 nutrition & dietetics
Nutrition and Dietetics
medicine.diagnostic_test
business.industry
Platelet Count
medicine.disease
Parenteral nutrition
Chronic intestinal failure
Intestinal Diseases
Cross-Sectional Studies
Liver
Liver biopsy
Cohort
Chronic Disease
Elasticity Imaging Techniques
Female
business
Parenteral Nutrition
Home
Zdroj: Clinical nutrition (Edinburgh, Scotland), 40(2), 460-466. Churchill Livingstone
ISSN: 0261-5614
Popis: Summary Background & aims Liver biopsy is no viable tool to routinely screen for liver fibrosis in children suffering from chronic intestinal failure (IF). We aim to assess the prevalence of liver fibrosis in a cohort of children with chronic IF by non-invasive tests: transient elastography (TE), aspartate-aminotransferase-to-platelet-ratio-index (APRI) and enhanced liver fibrosis (ELF) score. Methods Cross sectional study where patients with chronic IF, receiving parenteral nutrition (PN) for at least 3 months, were enrolled. TE, APRI and ELF score were measured. Using Spearman's rank correlation coefficient and Kruskal–Wallis H test, the correlation between transient elastography, APRI, ELF score and known risk factors for development of intestinal failure associated liver disease (IFALD) were calculated. Results 32 patients were included (50% female), median age was 8 years and 4 months, median PN duration was 45 months. Six patients (21%) had TE ≥ 6.5 kPa, indicating significant fibrosis. Twelve patients (38%) had APRI≥.5, indicating fibrosis. ELF score indicated moderate fibrosis in 17 patients (63%) and significant fibrosis in 10 patients (37%). TE and APRI correlated significantly with known risk factors for intestinal failure associated liver disease (IFALD), but ELF showed poor correlation with known risk factors for IFALD. Conclusion In a cohort of pediatric patients suffering from chronic IF, TE measurement, APRI and ELF test, assessing liver fibrosis show a varying, but substantial proportion of subjects with fibrosis. The diagnostic value of these tests and their role in the management of pediatric IF must be determined in larger cohorts with liver biopsy as reference standard. Trial Registration Academic Medical Center medical ethics committee number: METC 2017_185.
Databáze: OpenAIRE
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