Back to Search
Start Over
Comparison of diagnostic accuracy of screening tests ALT and ultrasound for pediatric non-alcoholic fatty liver disease.
- Source :
- European Journal of Pediatrics; Jun2019, Vol. 178 Issue 6, p863-870, 8p, 5 Charts, 1 Graph
- Publication Year :
- 2019
-
Abstract
- Alanine aminotransferase (ALT) and ultrasound (US) are the most commonly used tools for detecting non-alcoholic fatty liver disease (NAFLD). No direct comparison of these two modalities in children exists. We aimed to compare head-to-head the diagnostic accuracy of ALT and US and their combination for detecting NAFLD in children with obesity. Ninety-nine children with severe obesity underwent simultaneous serum-ALT and abdominal ultrasound (US steatosis score 0-3). Proton magnetic resonance spectroscopy was used as reference standard for detecting steatosis/NAFLD. ROC curve analyses were performed to determine diagnostic performance and to determine optimum screening cut-points aiming for a specificity ≥ 80%. The area under the ROC (AUROC) of ALT and US were not significantly different (0.74 and 0.70, respectively). At the optimal ALT threshold (≥40 IU/L), sensitivity was 44% and specificity was 89%. At the optimal US steatosis score (≥ 2), sensitivity was 51% and specificity was 80%. Combining ALT and US did not result in better accuracy than ALT or US alone.Conclusion: ALT and US have comparable and only moderate diagnostic accuracy for detecting hepatic steatosis in children with obesity. A stepwise screening strategy combining both methods does not improve diagnostic accuracy. What is Known: • Alanine aminotransferase (ALT) and ultrasound (US) are the most commonly used tools for detecting non-alcoholic fatty liver disease (NAFLD). • ALT and ultrasound have mediocre accuracy in detecting steatosis in children with obesity. What is New: • In a head-to-head comparison, the difference in diagnostic accuracy of ALT and ultrasound in detecting steatosis is not significant. • A stepwise screening strategy combining both methods does not improve diagnostic accuracy. [ABSTRACT FROM AUTHOR]
- Subjects :
- FATTY liver
PROTON magnetic resonance spectroscopy
CHILDHOOD obesity
ALANINE aminotransferase
COMPARATIVE studies
RESEARCH methodology
MEDICAL cooperation
NUCLEAR magnetic resonance spectroscopy
RESEARCH
ULTRASONIC imaging
EVALUATION research
PREDICTIVE tests
CROSS-sectional method
SEVERITY of illness index
RECEIVER operating characteristic curves
DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 03406199
- Volume :
- 178
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- European Journal of Pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 136404743
- Full Text :
- https://doi.org/10.1007/s00431-019-03362-3