Prediction of hepatic fibrosis using the aspartate transaminase-to-platelet ratio index in children and adolescents with non-alcoholic fatty liver disease

Kim Eun Young; Eu-Seon Noh; Yi Kyung Hee; Hwang Il Tae

P1-41

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ESPE Abstracts (2024) 98 P1-41

ESPE2024 Poster Category 1 Fat, Metabolism and Obesity 1 (10 abstracts)

Prediction of hepatic fibrosis using the aspartate transaminase-to-platelet ratio index in children and adolescents with non-alcoholic fatty liver disease

Eun Young Kim ¹ , Eu-Seon Noh ² , Kyung Hee Yi ³ & Il Tae Hwang ²

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¹Department of Pediatrics, Chosun University School of Medicine, Gwangju, South Korea. ²Department of Pediatrics, Kangdong Sacred Heart Hospital, Seoul, South Korea. ³Miracle Growth Clinic, Anyang-si, South Korea

Background: Aspartate transaminase-to-platelet ratio index (APRI) is an easy and useful predictor of hepatic fibrosis in patients with chronic hepatic disease, and it significantly correlates with the degree of hepatic fibrosis in adult patients with non-alcoholic fatty liver disease (NAFLD).

Objects: This study aimed to evaluate the use of APRI in assessing the severity of NAFLD in children and adolescents.

Methods: Medical records of 115 patients (males: 78; females: 37) with NAFLD were retrospectively reviewed. Their ages ranged between 7.3–18.8 years old. Patients with hepatitis B or C infections were excluded from the study. The APRI score was calculated, and transient elastography for liver stiffness measurement (LSM) was performed for all the patients.

Results: The mean APRI score was 0.46 ± 0.26, ranging between 0.16–1.57. The LSM values ranged between 2.94–7.72 kPa. Body mass index-standard deviation score, transaminase levels, and HbA1c levels were higher in a group with abnormal LSM when divided into two groups according to LSM. The APRI score was greater in the group with abnormal LSM (0.40 ± 0.17 vs. 0.64 ± 0.40, P <0.001). The APRI score was associated with LSM (r =0.354, P <0.001). Area under the curve of APRI for predicting abnormal LSM was 0.650 (95% confidence interval, 0.517–0.784) with a cutoff value of 0.74.

Conclusion: Aspartate transaminase-to-platelet ratio index was associated with LSM in pediatric NAFLD, and can be used as a screening tool to predict abnormal LSM.