Accuracy of prediction scores and novel biomarkers for predicting nonalcoholic fatty liver disease in obese children.

BACKGROUND: Accurate prediction scores for liver steatosis are demanded clinicians to noninvasively screen for nonalcoholic fatty liver disease Several prediction scores have been developed, however external lacking. OBJECTIVE: The aim was to determine the diagnostic accuracy of existing prediction scores in severely obese children, to develop a new prediction score using novel biomarkers and to compare these results to performance of ultrasonography. DESIGN AND RESULTS: Liver steatosis was using proton magnetic resonance spectroscopy in 119 severely obese age 14.3 +/- 2.1 years, BMI z-score 3.35 +/- 0.35). Prevalence of 47%. The four existing predictions scores ("NAFLD liver fat score," index," "hepatic steatosis index," and the pediatric prediction score) moderate diagnostic accuracy in this cohort (positive predictive value 61, 61, 69% and negative predictive value (NPV) 77, 69, 68, 75%, new prediction score was built using anthropometry, routine biochemistry novel biomarkers (leptin, adiponectin, TNF-alpha, IL-6, CK-18, FGF-21, adiponutrin polymorphisms). The final model included ALT, HOMA, sex, and This equation (PPV 79% and NPV 80%) did not perform substantially better four other equations and did not outperform ultrasonography for (NPV 82%). CONCLUSION: The conclusion is in severely obese children and adolescents existing prediction scores and the tested novel biomarkers insufficient diagnostic accuracy for diagnosing or excluding NAFLD.