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Enhanced liver fibrosis (ELF) test in obese children with ultrasound-proven liver steatosis.

Neuro endocrinology letters · 2015 · No effect · Low evidence

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No effectLow evidencePaper 2972

Among 58 obese children, those with ultrasound-proven liver steatosis had higher AST, ALT, LDH, and GGT, and also a higher ELF test value (8.98 vs 8.49). However, no combination of measured parameters including ELF improved diagnostic differentiation between …

Study snapshot

PublicationNeuro endocrinology letters · 2015
Study typecross_sectional
Reported directionNo effect
Evidence ratingLow

Abstract

OBJECTIVE: Non-alcoholic fatty liver disease (NAFLD) in obese children is a diagnostic challenge. The enhanced liver fibrosis test (ELF) based on the combination of serum concentration of hyaluronic acid (HA), aminoterminal propeptide of type III procollagen (PIIINP), tissue inhibitor of matrix metalloproteinase type 1 (TIMP-1) was developed as a noninvasive diagnostic tool for estimation of degree of liver fibrosis. The aim of our study was to investigate the performance of ELF test in obese children with ultrasound-proven steatosis in order assess the possibility of early detection of fibrotic changes in liver structure. MATERIAL AND METHODS: 58 obese (BMI >95th percentile) children, 27 male (mean age 13.9±2.65 years) and 31 female (mean age 13.82±2.64 years). Based on the liver ultrasound (US) examination results two groups of obese children were studied: group with steatosis (N=20, 8/12 M/F, mean age 14.2±1.90 years, BMI 32.9±5.60 kg/m2) and group with normal liver US (n=38, 19/19 M/F, mean age 13.7±2.94 years, BMI 30.4±4.67 kg/m2). Serum activity of aminotransferases (AST, ALT) and lactate dehydrogenase (LDH), and γ-glutamyl transpeptidase (GGT), and ELF test (HA, PIIINP, and TIMP-1 were analyzed. RESULTS: Children with liver steatosis presented with significantly higher AST (34.1 vs. 25.6 U/L), ALT (43.4 vs. 32 U/L), LDH (427.5 vs. 361.3 U/L), GGT (30.7 vs. 18.9 U/L). The ELF test value was also significantly higher in that group (8.98 vs. 8.49). Nevertheless no combination of measured parameters with ELF test value show better diagnostic value for differentiation between children with and without steaotosis. CONCLUSION: ELF test cannot be used for assessment of steatosis in obese children.

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AI evidence extraction

Structured fields below were generated from the paper’s abstract and metadata to make the evidence easier to inspect. Automated extraction may be incomplete or incorrect; verify important details against the original paper.

Study typecross_sectional
Effect directionno_effect
PopulationObese children (BMI >95th percentile) with and without ultrasound-proven liver steatosis
Sample size58
ExposureNot supplied
Evidence strengthLowConfidence: 74% · Peer reviewed: yes

Main findings

Among 58 obese children, those with ultrasound-proven liver steatosis had higher AST, ALT, LDH, and GGT, and also a higher ELF test value (8.98 vs 8.49). However, no combination of measured parameters including ELF improved diagnostic differentiation between children with and without steatosis; the authors conclude ELF cannot be used to assess steatosis in obese children.

Outcomes measured

  • Enhanced liver fibrosis (ELF) test (HA, PIIINP, TIMP-1)
  • Liver steatosis status by ultrasound
  • AST
  • ALT
  • LDH
  • GGT

Limitations

  • No EMF exposure assessed (study is not about electromagnetic fields)
  • Ultrasound-based grouping; no liver biopsy mentioned
  • Sample size for steatosis group is small (N=20)
View raw extracted JSON
{
  "study_type": "cross_sectional",
  "exposure": {
    "band": null,
    "source": null,
    "frequency_mhz": null,
    "sar_wkg": null,
    "duration": null
  },
  "population": "Obese children (BMI >95th percentile) with and without ultrasound-proven liver steatosis",
  "sample_size": 58,
  "outcomes": [
    "Enhanced liver fibrosis (ELF) test (HA, PIIINP, TIMP-1)",
    "Liver steatosis status by ultrasound",
    "AST",
    "ALT",
    "LDH",
    "GGT"
  ],
  "main_findings": "Among 58 obese children, those with ultrasound-proven liver steatosis had higher AST, ALT, LDH, and GGT, and also a higher ELF test value (8.98 vs 8.49). However, no combination of measured parameters including ELF improved diagnostic differentiation between children with and without steatosis; the authors conclude ELF cannot be used to assess steatosis in obese children.",
  "effect_direction": "no_effect",
  "limitations": [
    "No EMF exposure assessed (study is not about electromagnetic fields)",
    "Ultrasound-based grouping; no liver biopsy mentioned",
    "Sample size for steatosis group is small (N=20)"
  ],
  "evidence_strength": "low",
  "confidence": 0.74,
  "peer_reviewed_likely": "yes",
  "keywords": [
    "non-alcoholic fatty liver disease",
    "NAFLD",
    "obese children",
    "ultrasound",
    "liver steatosis",
    "enhanced liver fibrosis test",
    "ELF",
    "hyaluronic acid",
    "PIIINP",
    "TIMP-1",
    "AST",
    "ALT",
    "GGT",
    "LDH"
  ],
  "suggested_hubs": []
}
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AI-extracted fields are generated from the abstract and metadata and may be incomplete or incorrect. This material is for informational purposes and is not medical advice.

Identifiers and source

DOI: Not supplied
PubMed: 26859594

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