Noninvasive Parameters and hepatic fibrosis scores in children with nonalcoholic fatty liver disease

AIM:To evaluate the noninvasive parameters and hepatic fibrosis scores in obese children with nonalcoholic fatty liver disease(NAFLD).METHODS:A total of 77 children diagnosed with NAFLD via liver biopsy were included and divided into 2 subgroups according to the histopathologic staging of hepatic fibrosis:mild(stage 0-1)vs significant fibrosis(stage 2-4).Clinical and laboratory parameters were evaluated in each patient.The aspartate aminotransferase(AST)/alanine aminotransferase(ALT)ratio,AST/platelet ratio index(APRI),PGA index,Forns index,FIB-4,NAFLD fibrosis score,and pediatric NAFLD fibrosis index(PNFI)were calculated.RESULTS:No clinical or biochemical parameter exhibited a significant difference between patients with mild and significant fibrosis.Among noninvasive hepatic fibrosis scores,only APRI and FIB4 revealed a significant difference between patients with mild and significant fibrosis(APRI:0.67±0.54 vs 0.78±0.38,P=0.032 and FIB4:0.24±0.12 vs 0.31±0.21,P=0.010).The area under the receiving operating characteristic curve of FIB4 was 0.81,followed by Forns index(0.73),APRI(0.70),NAFLD fibrosis score(0.58),AST/ALT ratio(0.53),PGA score(0.45),and PNFI(0.41).CONCLUSION:APRI and FIB4 might be useful noninvasive hepatic fibrosis scores for predicting hepatic fibrosis in children with NAFLD.