Skip to main content
Journal cover image

Clinical correlates of histopathology in pediatric nonalcoholic steatohepatitis.

Publication ,  Journal Article
Patton, HM; Lavine, JE; Van Natta, ML; Schwimmer, JB; Kleiner, D; Molleston, J; Nonalcoholic Steatohepatitis Clinical Research Network,
Published in: Gastroenterology
December 2008

BACKGROUND & AIMS: Nonalcoholic fatty liver disease (NAFLD) is the most prevalent liver disease in American children. Noninvasive means to discriminate between NAFLD and nonalcoholic steatohepatitis (NASH) might diminish the requirement for liver biopsy or predict those at increased risk for progression. METHODS: Data obtained prospectively from children (age, 6-17 y) enrolled in the NASH Clinical Research Network were analyzed to identify clinical-pathologic correlates of pediatric NAFLD. All participants underwent liver biopsy within 6 months of clinical data that were reviewed by a central pathology committee. RESULTS: A total of 176 children (mean age, 12.4 y; 77% male) were eligible for inclusion. By using ordinal logistic regression analysis, increasing aspartate aminotransferase (AST) level (odds ratio [OR], 1.017 per U/L; 95% confidence interval [CI], 1.004-1.031) and gamma-glutamyltransferase level (OR, 1.016 per U/L; 95% CI, 1.000-1.033) were associated independently with increasing severity of NASH. Increasing AST level (OR, 1.015 per U/L; 95% CI, 1.006-1.024), increasing white blood cell count (OR, 1.22 per 1000/mm(3); 95% CI, 1.07-1.38), and decreasing hematocrit (OR, 0.87 per %; 95% CI, 0.79-0.96) were associated independently with increasing severity of fibrosis. Area under the receiver operator characteristic curve for a model with AST and alanine aminotransferase was 0.75 (95% CI, 0.66-0.84) and 0.74 (95% CI, 0.63-0.85) for distinguishing steatosis from more advanced forms of NASH and bridging fibrosis from lesser degrees of fibrosis, respectively. CONCLUSIONS: Certain components of routine laboratory tests are predictive of NAFLD pattern and fibrosis severity, but do not have adequate discriminate power to replace liver biopsy in evaluating pediatric NAFLD.

Duke Scholars

Published In

Gastroenterology

DOI

EISSN

1528-0012

Publication Date

December 2008

Volume

135

Issue

6

Start / End Page

1961 / 1971.e2

Location

United States

Related Subject Headings

  • Vitamin E
  • Severity of Illness Index
  • ROC Curve
  • Prospective Studies
  • Prognosis
  • Prevalence
  • Predictive Value of Tests
  • Metformin
  • Male
  • Liver
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Patton, H. M., Lavine, J. E., Van Natta, M. L., Schwimmer, J. B., Kleiner, D., Molleston, J., & Nonalcoholic Steatohepatitis Clinical Research Network, . (2008). Clinical correlates of histopathology in pediatric nonalcoholic steatohepatitis. Gastroenterology, 135(6), 1961-1971.e2. https://doi.org/10.1053/j.gastro.2008.08.050
Patton, Heather M., Joel E. Lavine, Mark L. Van Natta, Jeffrey B. Schwimmer, David Kleiner, Jean Molleston, and Jean Nonalcoholic Steatohepatitis Clinical Research Network. “Clinical correlates of histopathology in pediatric nonalcoholic steatohepatitis.Gastroenterology 135, no. 6 (December 2008): 1961-1971.e2. https://doi.org/10.1053/j.gastro.2008.08.050.
Patton HM, Lavine JE, Van Natta ML, Schwimmer JB, Kleiner D, Molleston J, et al. Clinical correlates of histopathology in pediatric nonalcoholic steatohepatitis. Gastroenterology. 2008 Dec;135(6):1961-1971.e2.
Patton, Heather M., et al. “Clinical correlates of histopathology in pediatric nonalcoholic steatohepatitis.Gastroenterology, vol. 135, no. 6, Dec. 2008, pp. 1961-1971.e2. Pubmed, doi:10.1053/j.gastro.2008.08.050.
Patton HM, Lavine JE, Van Natta ML, Schwimmer JB, Kleiner D, Molleston J, Nonalcoholic Steatohepatitis Clinical Research Network. Clinical correlates of histopathology in pediatric nonalcoholic steatohepatitis. Gastroenterology. 2008 Dec;135(6):1961-1971.e2.
Journal cover image

Published In

Gastroenterology

DOI

EISSN

1528-0012

Publication Date

December 2008

Volume

135

Issue

6

Start / End Page

1961 / 1971.e2

Location

United States

Related Subject Headings

  • Vitamin E
  • Severity of Illness Index
  • ROC Curve
  • Prospective Studies
  • Prognosis
  • Prevalence
  • Predictive Value of Tests
  • Metformin
  • Male
  • Liver