Gastroenterology
Volume 136, Issue 1 , Pages 160-167 , January 2009

Performance of ELF Serum Markers in Predicting Fibrosis Stage in Pediatric Non-Alcoholic Fatty Liver Disease

  • Valerio Nobili

      Affiliations

    • Liver Unit, “Bambino Gesù” Children's Hospital and Research Institute, Rome, Italy
    • Corresponding Author InformationAddress requests for reprints to: Valerio Nobili, Liver Unit, Research Institute, Bambino Gesù Children's Hospital Piazza S. Onofrio, 4, 00165 Rome, Italy. fax: +39 0668592192
    • ,
  • Julie Parkes

      Affiliations

    • Public Health Sciences and Medical Statistics, University of Southampton, United Kingdom
    • ,
  • Gianfranco Bottazzo

      Affiliations

    • Direzione Scientifica “Bambino Gesù” Children's Hospital and Research Institute, Rome, Italy
    • ,
  • Matilde Marcellini

      Affiliations

    • Liver Unit, “Bambino Gesù” Children's Hospital and Research Institute, Rome, Italy
    • ,
  • Richard Cross

      Affiliations

    • iQur Limited, United Kingdom
    • ,
  • Daniel Newman

      Affiliations

    • Public Health Sciences and Medical Statistics, University of Southampton, United Kingdom
    • iQur Limited, United Kingdom
    • ,
  • Francesco Vizzutti

      Affiliations

    • Department of Internal Medicine, Higher Education and Transfer DENOThe, University of Florence, Italy
    • ,
  • Massimo Pinzani

      Affiliations

    • Department of Internal Medicine, Higher Education and Transfer DENOThe, University of Florence, Italy
    • Center for Research, Higher Education and Transfer DENOThe, University of Florence, Italy
    • ,
  • William M. Rosenberg

      Affiliations

    • Institute of Hepatology, University College London, United Kingdom

Received 23 April 2008 ,Accepted 11 September 2008.

References 

  1. Reilly JJ. Obesity in childhood and adolescence: evidence-based clinical and public health perspectives. Postgrad Med J. 2006;82:429–437
  2. Roberts E. Pediatric non-alcoholic fatty liver disease (NAFLD): a “growing” problem?. J Hepatol. 2007;46:1133–1142
  3. Tominaga K, Kurata JH, Chen YK, et al. Prevalence of fatty liver in Japanese children and relationship to obesity (An epidemiological ultrasonographic survey). Dig Dis Sci. 1995;40:2002–2009
  4. Franzese A, Vajro P, Argenziano A, et al. Liver involvement in obese children (Ultrasonography and liver enzymes levels at diagnosis and during follow-up in an Italian population). Dig Dis Sci. 1997;42:1428–1432
  5. Schwimmer JB, Deutsch R, Kahen T, et al. Prevalence of fatty liver in children and adolescents. Pediatrics. 2006;118:1388–1393
  6. Chan DF, Li AM, Chu WC, et al. Hepatic steatosis in obese Chinese children. Int J Obes Relat Metab Disord. 2004;28:1257–1263
  7. Adams LA, Lymp JF, St. Sauver J, et al. The natural history of non-alcoholic fatty liver disease: a population-based cohort study. Gastroenterology. 2005;129:113–121
  8. Ekstedt M, Franzen LE, Mathiensen UI, et al. Long-term follow-up of patients with NAFLD and elevated liver enzymes. Hepatology. 2006;44:865–873
  9. Bugianesi E, Leone N, Vanni E, et al. Expanding the natural history of non-alcoholic steatohepatitis: from cryptogenic cirrhosis to hepatocellular carcinoma. Gastroenterology. 2002;123:134–140
  10. Kinugasa A, Tsunamoto K, Furukawa N, et al. Fatty liver and its fibrous changes found in simple obesity of children. J Pediatr Gatroenterol Nutr. 1984;3:408–414
  11. Jankowska I, Socha P, Pawlowska J, et al. Recurrence of non-alcoholic steatohepatitis after liver transplantation in a 13-yr-old boy. Pediatr Transplant. 2007;11:796–798
  12. Nobili V, Marcellini M, Devito R. NAFLD in children: a prospective clinical-pathological study and effect of lifestyle advice. Hepatology. 2006;44:458–465
  13. Molleston JP, White F, Teckman J, et al. Obese children with steatohepatitis can develop cirrhosis in childhood. Am J Gastroenterol. 2002;97:2460–2462
  14. Adams LA, Sanderson S, Lindor KD, et al. The histological course of non-alcoholic fatty liver disease: a longitudinally study of 103 patients with sequential liver biopsies. J Hepatol. 2005;42:132–138
  15. Pinzani M, Vizzutti F, Arena U, et al. Technology insight: non-invasive assessment of liver fibrosis by biochemical scores and elastography. Nat Clin Pract Gastroenterol Hepatol. 2008;5:95–106
  16. Guha IN, Parkes J, Roderick P, et al. Noninvasive markers of fibrosis in non-alcoholic fatty liver disease: validating the European Liver Fibrosis Panel and exploring simple markers. Hepatology. 2008;47:455–460
  17. Rosenberg WM, Voelker M, Thiel R, et al. Serum markers detect the presence of liver fibrosis: a cohort study. Gastroenterology. 2004;127:1704–1713
  18. Matthews DR, Hosker JP, Rudenski AS, et al. Homeostatic model assessment: insulin resistance and beta-cell function from fasting glucose and insulin concentration in man. Diabetologia. 1985;28:412–419
  19. Matsuda M, De Fronzo R. Insulin sensitivity indices obtained from oral glucose tolerance testing. Diabetes Care. 1999;22:1462–1470
  20. Sharma P, MacDonald GB, Banaji M. The risk of bleeding after percutaneous liver biopsy: relation to platelet count. J Clin Gastroenterol. 1982;4:451–453
  21. Cassiman D, Jaeken J. NASH may be trash. Gut. 2008;57:141–143
  22. Nobili V, Comparcola D, Sartorelli MR, et al. Blind and ultrasound-guided percutaneous liver biopsy in children. Pediatr Radiol. 2003;33:772–775
  23. Brunt EM, Janney CG, Di Bisceglie AM, et al. Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions. Am J Gastroenterol. 1999;94:2467–2474
  24. Kleiner DE, Brunt EM, Van Natta M, et al. Design and validation of a histological scoring system for non-alcoholic fatty liver disease. Hepatology. 2005;41:1313–1321
  25. Parkes J, Bialek SR, Bell BP, et al. ELF serum markers accurately distinguish fibrosis severity in chronic hepatitis C: an external validation study. Hepatology. 2006;44(Suppl 1):321
  26. Roberts EA. Pediatric nonalcoholic fatty liver disease (NAFLD): a “growing” problem?. J Hepatol. 2007;46:1133–1142
  27. American Academy of Pediatrics. Committee on Nutrition. American Academy of Pediatrics. Committee on Nutrition. Cholesterol in childhood. Pediatrics. 1998;101:141–147
  28. Schulpis K, Karikas GA. Serum cholesterol and triglyceride distribution in 7767 school-aged Greek children. Pediatrics. 1998;101:861–864
  29. Baranova A, Younossi Z. The future is around the corner: non-invasive diagnosis of progressive non-alcoholic steatohepatitis. Hepatology. 2008;47:373–375
  30. Schwimmer JB, Behling C, Newbury R, et al. Histopathology of pediatric non-alcoholic fatty liver disease. Hepatology. 2005;42:641–649
  31. Ashcroft GS, Horan MA, Ferguson MW. Aging is associated with reduced deposition of specific extracellular matrix components, an upregulation of angiogenesis, and an altered inflammatory response in a murine incisional wound healing model. J Invest Dermatol. 1997;108:430–437
  32. Ashcroft GS, Horan MA, Herrick SE, et al. Age-related differences in the temporal and spatial regulation of matrix metalloproteinases (MMPs) in normal skin and acute cutaneous wounds of healthy humans. Cell Tissue Res. 1997;290:581–591
  33. Ashcroft GS, Herrick SE, Tarnuzzer RW, et al. Human ageing impairs injury-induced in vivo expression of tissue inhibitor of matrix metalloproteinases (TIMP)-1 and -2 proteins and mRNA. J Pathol. 1997;183:169–176
  34. Schwimmer JB. Definitive diagnosis and assessment of risk for non-alcoholic fatty liver disease in children and adolescents. Semin Liver Dis. 2007;27:312–318
  35. Nobili V, Manco M, Devito R, et al. Lifestyle intervention and antioxidants in children with nonalcoholic fatty liver disease: a randomized, controlled trial. Hepatology. 2008;48:113–128
  36. Angulo P, Hui JM, Marchesini G, et al. The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology. 2007;45:846–854
  37. Nobili V, Vizzutti F, Arena U, et al. Accuracy and reproducibility of transient elastography for the diagnosis of fibrosis in pediatric non-alcoholic steatohepatitis. Hepatology. 2008;48:442–448

 The authors are indebted to all the patients and their legal guardians who participated in this study.

 The authors disclose the following: Dr Richard Cross is an employee of iQur Limited; Prof. William M. Rosenberg is founder and holds stock in iQur Limited. M.P. and W.M.R. contributed equally to this paper.

PII: S0016-5085(08)01678-8

doi: 10.1053/j.gastro.2008.09.013

Gastroenterology
Volume 136, Issue 1 , Pages 160-167 , January 2009

Article Tools

* Image Usage & Resolution