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Usefulness of Controlled Attenuation Parameter for Identification and Grading of Nonalcoholic Fatty Liver Disease in Adolescents with Obesity

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Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objective

To identify controlled attenuation parameter (CAP) based cutoffs for diagnosing and grading hepatic steatosis in adolescents with overweight/obesity, using magnetic resonance imaging-proton density fat fraction (MRI-PDFF) as the reference method.

Methods

Adolescents with overweight/obesity were included. Fasting glucose, insulin, aspartate aminotransferase, and alanine aminotransferase were estimated. Hepatic steatosis (S) was assessed by MRI-PDFF, and graded as S0, S1, S2, and S3 with fat fraction cutoffs of < 6.0%, ≥ 6.0% to < 17.5%, ≥ 17.5% to < 23.3%, and ≥ 23.3%, respectively. CAP and liver stiffness measure (LSM) were assessed using FibroScan. Receiver operating characteristic (ROC) curves were used to estimate the CAP scores predicting various grades of hepatic steatosis.

Results

A total of 108 adolescents aged 12.4 ± 1.9 y, with mean BMI of 26.7 ± 4.9 kg/m2 were included. S0, S1, S2, and S3 steatosis by MRI-PDFF was identified in 15, 70, 13, and 10 adolescents, respectively. A moderate positive correlation was observed between CAP score and MRI-estimated hepatic fat (r = 0.528, p < 0.001). The optimal CAP cutoffs for identifying ≥ S1, ≥ S2, and S3 steatosis were 271 [area under ROC (AUROC) 0.745 (0.630–0.859)], 296 [AUROC 0.820 (0.728–0.911)], and 309 dB/m [AUROC 0.836 (0.729–0.944)], respectively.

Conclusion

CAP score had a good discriminative ability to diagnose fatty liver in adolescents with overweight or obesity.

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Funding

This work was supported under a National Task Force project by Indian Council of Medical Research, New Delhi (Grant ID No. 5/4/3–2-2017-NCD-II, to VJ).

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Authors and Affiliations

  1. Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India

    Abhinav Anand &  Shalimar

  2. Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India

    Manisha Jana & Devasenathipathy Kandasamy

  3. Division of Pediatric Endocrinology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India

    Brijesh Kumar, Gajendra Singh & Vandana Jain

Authors
  1. Abhinav Anand
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  2. Shalimar
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  3. Manisha Jana
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  4. Devasenathipathy Kandasamy
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  5. Brijesh Kumar
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  6. Gajendra Singh
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  7. Vandana Jain
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Contributions

AA: Manuscript writing, revision, statistical analysis; S: Manuscript writing, study concept; MJ, DK, BK, and GS: Data collection; VJ: Study concept, design, manuscript writing and revision. VJ is the guarantor of this paper.

Corresponding author

Correspondence to Vandana Jain.

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Ethics Committee Approval

Study was conducted after approval from the Ethics Committee of All India Institute of Medical Sciences, New Delhi.

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Written voluntary informed consent was taken from parents and assent from the adolescents.

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Supplementary Information

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12098_2021_3842_MOESM1_ESM.tiff

Supplementary file1: Supplementary Fig. S1 (a) Scatter plots showing a moderate positive correlation between CAP and MRI-PDFF (r = 0.528, p < 0.001). (b) Scatter-plots showing a weak positive correlation between body fat percentage and CAP (r = 0.308, p = 0.003) (TIFF 116 KB)

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Anand, A., Shalimar, Jana, M. et al. Usefulness of Controlled Attenuation Parameter for Identification and Grading of Nonalcoholic Fatty Liver Disease in Adolescents with Obesity. Indian J Pediatr 89, 52–58 (2022). https://doi.org/10.1007/s12098-021-03842-1

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  • DOI: https://doi.org/10.1007/s12098-021-03842-1

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