ESPE Abstracts

Background: Triglyceride glucose (TyG) index combined with body mass index (BMI) were reported to be superior to TyG index alone in predicting non-alcoholic fatty liver disease (NAFLD) in youths. Transient elastography (TE) uses pulsed echo ultrasound to measure the hardness of the liver, showing excellent accuracy in the assessment of fibrosis, and is considered a useful test in NAFLD. Objects: This study aims to investigate the association between TyG-BMI and TE and to evaluate its usefulness in NAFLD.

Methods: Alanine aminotransferase (ALT) was used as the screening method for NAFLD (>26IU/L in boys and >22IU/L in girls), and US-FLI was performed on children who met these criteria. The US-FLI is a scoring system ranging 2-8 that evaluates based on intensity of liver/kidney contrast, posterior attenuation of ultrasound beam, vessel blurring, difficult visualization of gallbladder wall, difficult visualization of the diaphragm and areas of focal sparing. NAFLD is diagnosed by the minimum score ≥2. TE was used to evaluate liver fibrosis in terms of liver stiffness measurement (LSM).

Results: A total of 130 NAFLD patients (90 boys and 40 girls) included in this study, with mean age of 11.5±2.29 years. The control group consisted of a total of 28 subjects (17 boys and 11 girls) with mean age of 8.39±1.60 years. The mean TE values of the NAFLD group and the control group were 4.40±0.91 kPa and 3.77±0.29 kPa, respectively, showing a statistically significant difference (P<0.001). The TE was significantly correlated with AST (r= 0.322, P=0.001), ALT (r= 0.330, P=0.001), BMI (r= 0.330, P=0.001), US-FLI (r= 0.203, P=0.047), and TyG-BMI (r= 0.356, P<0.001) after controlling for sex and age. Multiple linear regression analysis showed that TE were significantly associated with TyG-BMI (β=0.359, P=0.001) after adjusting for confounders. In the receiver operating characteristic analysis, TE showed a superior ability to detect NASH (area under the curve [AUC]=0.831, P<0.001) than its ability to detect NAFLD (AUC=0.738, P<0.001). Conclusions: TE was significantly associated with TyG-BMI and showed better detection ability in severe NAFLD, suggesting that it could be useful in the evaluation of NASH in children and adolescents.