TY - JOUR
T1 - Accuracy of prediction scores and novel biomarkers for predicting nonalcoholic fatty liver disease in obese children.
AU - Koot, B.G.
AU - van der Baan Slootweg, O.H.
AU - Bohte, A.E.
AU - Nederveen, A.J.
AU - van Werven, J.R.
AU - Tamminga-Smeulders, C.I.
AU - Merkus, M.P.
AU - Schaap, F.G.
AU - Jansen, P.L.
AU - Stoker, J.
AU - Benninga, M.A.
PY - 2013/3
Y1 - 2013/3
N2 - 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.
AB - 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.
KW - GROWTH-FACTOR 21
KW - HEPATIC STEATOSIS
KW - DIAGNOSTIC-ACCURACY
KW - INSULIN-RESISTANCE
KW - NAFLD
KW - STEATOHEPATITIS
KW - SEVERITY
KW - FIBROSIS
KW - US
KW - ADOLESCENTS
U2 - 10.1002/oby.20173
DO - 10.1002/oby.20173
M3 - Article
SN - 1930-7381
VL - 21
SP - 583
EP - 590
JO - Obesity
JF - Obesity
IS - 3
ER -