Skip to main content
Erschienen in: Endocrine 1/2022

23.07.2021 | Original Article

Prospective assessment of liver stiffness by shear wave elastography in childhood obesity: a pilot study

verfasst von: Domenico Corica, Antonio Bottari, Tommaso Aversa, Letteria Anna Morabito, Selenia Curatola, Angela Alibrandi, Giorgio Ascenti, Malgorzata Wasniewska

Erschienen in: Endocrine | Ausgabe 1/2022

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The increased incidence of childhood obesity and related non-alcoholic fatty liver disease (NAFLD) has determined the need to identify a non-invasive technique to diagnose and monitor NAFLD. Two-dimensional shear wave elastography (2D-SWE) has emerged as a reliable, non-invasive, tool to evaluate liver tissue elasticity in clinical practice. Aims of this study were to longitudinally evaluate 2D-SWE changes in relation to weight loss, metabolic profile, and body composition modifications and to investigate the correlation between 2D-SWE variation and clinical and biochemical indices of cardio-metabolic risk in obese children.

Methods

Thirty-three children underwent anthropometric, bioimpedenziometric, fasting biochemical assessments, ultrasound, and SWE evaluations, at baseline (V0) and after a 12-months of follow-up (V12). Diet and physical activity programs have been prescribed to all patients according to European Society of Endocrinology and Pediatric Endocrine Society recommendations. Adherence to the prescribed diet and physical activity program was checked every 3 months during the 12-month of follow-up. Variation of all parameters was evaluated in intragroup and intergroup comparison analysis in children, who had not lost weight (Group A) and those who had lost weight (Group B) at V12. Study population was also analyzed dividing it into two groups with respect to 2D-SWE liver elasticity value ≤10.6 kPa or >10.6 kPa.

Results

A significant reduction of mean 2D-SWE value was demonstrated both in the entire cohort (p = 0.002) and in Group B children (p = 0.004). Intragroup comparison analysis, between V0 and V12, documented a significant decrease of 2D-SWE and BMI SDS and a significant improvement of metabolic profile (decrease of HOMA-IR, HbA1c, oral glucose tolerance test 120-min glucose and insulin, triglycerides, triglycerides/HDL-ratio, transaminases, uric acid, and increase of Matsuda-index and HDL) in children of Group B but not in those of Group A. Intergroup comparison analysis showed significant differences for BMI, BMI SDS, transaminases and several parameters of glucose and lipid metabolism, between Group A and Group B children after 12-months of follow-up. No significant differences were documented with regard to clinical and biochemical variables by dividing the population in accordance with the 2D-SWE cut-off of 10.6 kPa.

Conclusions

These results suggested a relation between weight loss, metabolic profile improvement and 2D-SWE value reduction. SWE could play a significant role in the non-invasive assessment of NAFLD in children and adolescents with obesity.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
11.
12.
Zurück zum Zitat I. Doycheva, J. Cui, P. Nguyen, E.A. Costa, J. Hooker, H. Hofflich, R. Bettencourt, S. Brouha, C.B. Sirlin, R. Loomba, Non-invasive screening of diabetics in primary care for NAFLD and advanced fibrosis by MRI and MRE. Aliment Pharmacol. Ther. 43(1), 83–95 (2016). https://doi.org/10.1111/apt.13405CrossRefPubMed I. Doycheva, J. Cui, P. Nguyen, E.A. Costa, J. Hooker, H. Hofflich, R. Bettencourt, S. Brouha, C.B. Sirlin, R. Loomba, Non-invasive screening of diabetics in primary care for NAFLD and advanced fibrosis by MRI and MRE. Aliment Pharmacol. Ther. 43(1), 83–95 (2016). https://​doi.​org/​10.​1111/​apt.​13405CrossRefPubMed
13.
Zurück zum Zitat P. Angulo, D.E. Kleiner, S. Dam-Larsen, L.A. Adams, E.S. Bjornsson, P. Charatcharoenwitthaya, P.R. Mills, J.C. Keach, H.D. Lafferty, A. Stahler, S. Haflidadottir, F. Bendtsen, Liver fibrosis, but no other histologic features, is associated with long-term outcomes of patients With nonalcoholic fatty liver disease. Gastroenterology 149(2), 389–397 (2015). https://doi.org/10.1053/j.gastro.2015.04.043CrossRefPubMed P. Angulo, D.E. Kleiner, S. Dam-Larsen, L.A. Adams, E.S. Bjornsson, P. Charatcharoenwitthaya, P.R. Mills, J.C. Keach, H.D. Lafferty, A. Stahler, S. Haflidadottir, F. Bendtsen, Liver fibrosis, but no other histologic features, is associated with long-term outcomes of patients With nonalcoholic fatty liver disease. Gastroenterology 149(2), 389–397 (2015). https://​doi.​org/​10.​1053/​j.​gastro.​2015.​04.​043CrossRefPubMed
21.
Zurück zum Zitat V. Nobili, F. Vizzutti, U. Arena, J.G. Abraldes, F. Marra, A. Pietrobattista, R. Fruhwirth, M. Marcellini, M. Pinzani, Accuracy and reproducibility of transient elastography for the diagnosis of fibrosis in pediatric nonalcoholic steatohepatitis. Hepatology 48(2), 442–448 (2008). https://doi.org/10.1002/hep.22376CrossRefPubMed V. Nobili, F. Vizzutti, U. Arena, J.G. Abraldes, F. Marra, A. Pietrobattista, R. Fruhwirth, M. Marcellini, M. Pinzani, Accuracy and reproducibility of transient elastography for the diagnosis of fibrosis in pediatric nonalcoholic steatohepatitis. Hepatology 48(2), 442–448 (2008). https://​doi.​org/​10.​1002/​hep.​22376CrossRefPubMed
22.
Zurück zum Zitat C.F. Dietrich, J. Bamber, A. Berzigotti, S. Bota, V. Cantisani, L. Castera, D. Cosgrove, G. Ferraioli, M. Friedrich-Rust, O.H. Gilja, R.S. Goertz, T. Karlas, R. de Knegt, V. de Ledinghen, F. Piscaglia, B. Procopet, A. Saftoiu, P.S. Sidhu, I. Sporea, M. Thiele, EFSUMB guidelines and recommendations on the clinical use of liver ultrasound elastography, update 2017 (Long Version). Ultraschall Med. 38(4), e16–e47 (2017). https://doi.org/10.1055/s-0043-103952CrossRefPubMed C.F. Dietrich, J. Bamber, A. Berzigotti, S. Bota, V. Cantisani, L. Castera, D. Cosgrove, G. Ferraioli, M. Friedrich-Rust, O.H. Gilja, R.S. Goertz, T. Karlas, R. de Knegt, V. de Ledinghen, F. Piscaglia, B. Procopet, A. Saftoiu, P.S. Sidhu, I. Sporea, M. Thiele, EFSUMB guidelines and recommendations on the clinical use of liver ultrasound elastography, update 2017 (Long Version). Ultraschall Med. 38(4), e16–e47 (2017). https://​doi.​org/​10.​1055/​s-0043-103952CrossRefPubMed
23.
27.
Zurück zum Zitat D. Corica, L. Oreto, G. Pepe, M.P. Calabro, L. Longobardo, L. Morabito, G.B. Pajno, A. Alibrandi, T. Aversa, M. Wasniewska, Precocious preclinical cardiovascular sonographic markers in metabolically healthy and unhealthy childhood obesity. Front. Endocrinol. 11, 56 (2020). https://doi.org/10.3389/fendo.2020.00056CrossRef D. Corica, L. Oreto, G. Pepe, M.P. Calabro, L. Longobardo, L. Morabito, G.B. Pajno, A. Alibrandi, T. Aversa, M. Wasniewska, Precocious preclinical cardiovascular sonographic markers in metabolically healthy and unhealthy childhood obesity. Front. Endocrinol. 11, 56 (2020). https://​doi.​org/​10.​3389/​fendo.​2020.​00056CrossRef
28.
Zurück zum Zitat D. Corica, C. Zusi, F. Olivieri, M. Marigliano, C. Piona, E. Fornari, A. Morandi, M. Corradi, E. Miraglia Del Giudice, D. Gatti, M. Rossini, R.C. Bonadonna, C. Maffeis, Vitamin D affects insulin sensitivity and beta-cell function in obese non-diabetic youths. Eur. J. Endocrinol. 181(4), 439–450 (2019). https://doi.org/10.1530/EJE-19-0369CrossRefPubMed D. Corica, C. Zusi, F. Olivieri, M. Marigliano, C. Piona, E. Fornari, A. Morandi, M. Corradi, E. Miraglia Del Giudice, D. Gatti, M. Rossini, R.C. Bonadonna, C. Maffeis, Vitamin D affects insulin sensitivity and beta-cell function in obese non-diabetic youths. Eur. J. Endocrinol. 181(4), 439–450 (2019). https://​doi.​org/​10.​1530/​EJE-19-0369CrossRefPubMed
29.
Zurück zum Zitat B. Wang, M. Li, Z. Zhao, S. Wang, J. Lu, Y. Chen, M. Xu, W. Wang, G. Ning, Y. Bi, T. Wang, Y. Xu, Glycemic measures and development and resolution of nonalcoholic fatty liver disease in nondiabetic individuals. J. Clin. Endocrinol. Metab. 105(5), 1416–1426 (2020). https://doi.org/10.1210/clinem/dgaa112CrossRef B. Wang, M. Li, Z. Zhao, S. Wang, J. Lu, Y. Chen, M. Xu, W. Wang, G. Ning, Y. Bi, T. Wang, Y. Xu, Glycemic measures and development and resolution of nonalcoholic fatty liver disease in nondiabetic individuals. J. Clin. Endocrinol. Metab. 105(5), 1416–1426 (2020). https://​doi.​org/​10.​1210/​clinem/​dgaa112CrossRef
30.
Zurück zum Zitat S.H. Kim, J.M. Lee, J.H. Kim, K.G. Kim, J.K. Han, K.H. Lee, S.H. Park, N.J. Yi, K.S. Suh, S.K. An, Y.J. Kim, K.R. Son, H.S. Lee, B.I. Choi, Appropriateness of a donor liver with respect to macrosteatosis: application of artificial neural networks to US images–initial experience. Radiology 234(3), 793–803 (2005). https://doi.org/10.1148/radiol.2343040142CrossRefPubMed S.H. Kim, J.M. Lee, J.H. Kim, K.G. Kim, J.K. Han, K.H. Lee, S.H. Park, N.J. Yi, K.S. Suh, S.K. An, Y.J. Kim, K.R. Son, H.S. Lee, B.I. Choi, Appropriateness of a donor liver with respect to macrosteatosis: application of artificial neural networks to US images–initial experience. Radiology 234(3), 793–803 (2005). https://​doi.​org/​10.​1148/​radiol.​2343040142CrossRefPubMed
32.
Zurück zum Zitat A.B. Mjelle, A. Mulabecirovic, R.F. Havre, E.J. Olafsdottir, O.H. Gilja, M. Vesterhus, Liver elastography in healthy children using three different systems—how many measurements are necessary? Ultraschall. Med. (2020). https://doi.org/10.1055/a-1283-5906 A.B. Mjelle, A. Mulabecirovic, R.F. Havre, E.J. Olafsdottir, O.H. Gilja, M. Vesterhus, Liver elastography in healthy children using three different systems—how many measurements are necessary? Ultraschall. Med. (2020). https://​doi.​org/​10.​1055/​a-1283-5906
37.
Zurück zum Zitat P. Di Bonito, G. Valerio, M.R. Licenziati, E. Miraglia Del Giudice, M.G. Baroni, A. Morandi, C. Maffeis, G. Campana, M.R. Spreghini, A. Di Sessa, G. Morino, A. Crino, C. Chiesa, L. Pacifico, M. Manco, High uric acid, reduced glomerular filtration rate and non-alcoholic fatty liver in young people with obesity. J. Endocrinol. Invest. 43(4), 461–468 (2020). https://doi.org/10.1007/s40618-019-01130-6CrossRefPubMed P. Di Bonito, G. Valerio, M.R. Licenziati, E. Miraglia Del Giudice, M.G. Baroni, A. Morandi, C. Maffeis, G. Campana, M.R. Spreghini, A. Di Sessa, G. Morino, A. Crino, C. Chiesa, L. Pacifico, M. Manco, High uric acid, reduced glomerular filtration rate and non-alcoholic fatty liver in young people with obesity. J. Endocrinol. Invest. 43(4), 461–468 (2020). https://​doi.​org/​10.​1007/​s40618-019-01130-6CrossRefPubMed
40.
43.
Zurück zum Zitat C. Cassinotto, J. Boursier, V. de Ledinghen, J. Lebigot, B. Lapuyade, P. Cales, J.B. Hiriart, S. Michalak, B.L. Bail, V. Cartier, A. Mouries, F. Oberti, I. Fouchard-Hubert, J. Vergniol, C. Aube, Liver stiffness in nonalcoholic fatty liver disease: a comparison of supersonic shear imaging, FibroScan, and ARFI with liver biopsy. Hepatology 63(6), 1817–1827 (2016). https://doi.org/10.1002/hep.28394CrossRefPubMed C. Cassinotto, J. Boursier, V. de Ledinghen, J. Lebigot, B. Lapuyade, P. Cales, J.B. Hiriart, S. Michalak, B.L. Bail, V. Cartier, A. Mouries, F. Oberti, I. Fouchard-Hubert, J. Vergniol, C. Aube, Liver stiffness in nonalcoholic fatty liver disease: a comparison of supersonic shear imaging, FibroScan, and ARFI with liver biopsy. Hepatology 63(6), 1817–1827 (2016). https://​doi.​org/​10.​1002/​hep.​28394CrossRefPubMed
44.
Zurück zum Zitat F. Guzman-Aroca, M.D. Frutos-Bernal, A. Bas, J.A. Lujan-Mompean, M. Reus, D. Berna-Serna Jde, P. Parrilla, Detection of non-alcoholic steatohepatitis in patients with morbid obesity before bariatric surgery: preliminary evaluation with acoustic radiation force impulse imaging. Eur. Radiol. 22(11), 2525–2532 (2012). https://doi.org/10.1007/s00330-012-2505-3CrossRefPubMed F. Guzman-Aroca, M.D. Frutos-Bernal, A. Bas, J.A. Lujan-Mompean, M. Reus, D. Berna-Serna Jde, P. Parrilla, Detection of non-alcoholic steatohepatitis in patients with morbid obesity before bariatric surgery: preliminary evaluation with acoustic radiation force impulse imaging. Eur. Radiol. 22(11), 2525–2532 (2012). https://​doi.​org/​10.​1007/​s00330-012-2505-3CrossRefPubMed
45.
Zurück zum Zitat V.W. Wong, J. Vergniol, G.L. Wong, J. Foucher, H.L. Chan, B. Le Bail, P.C. Choi, M. Kowo, A.W. Chan, W. Merrouche, J.J. Sung, V. de Ledinghen, Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease. Hepatology 51(2), 454–462 (2010). https://doi.org/10.1002/hep.23312CrossRefPubMed V.W. Wong, J. Vergniol, G.L. Wong, J. Foucher, H.L. Chan, B. Le Bail, P.C. Choi, M. Kowo, A.W. Chan, W. Merrouche, J.J. Sung, V. de Ledinghen, Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease. Hepatology 51(2), 454–462 (2010). https://​doi.​org/​10.​1002/​hep.​23312CrossRefPubMed
48.
Metadaten
Titel
Prospective assessment of liver stiffness by shear wave elastography in childhood obesity: a pilot study
verfasst von
Domenico Corica
Antonio Bottari
Tommaso Aversa
Letteria Anna Morabito
Selenia Curatola
Angela Alibrandi
Giorgio Ascenti
Malgorzata Wasniewska
Publikationsdatum
23.07.2021
Verlag
Springer US
Erschienen in
Endocrine / Ausgabe 1/2022
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-021-02828-5

Weitere Artikel der Ausgabe 1/2022

Endocrine 1/2022 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.