Aspartate aminotransferase-platelet ratio index and body mass index in children with fatty liver
Abstract
Background Obesity in children is becoming a global epidemic.
Nonô€€·alcoholic fatty liver disease (NAFLD) is a highly prevalent
and potentially serious complication of childhood obesity. The
early identification of fibrosis is important in children v.ith NAFLD
in order to prevent the development of liver disease in adulthood.
One nonô€€·invasive procedure to predict liver fibrosis is the aspartate
aminotransferase (AST)ô€€·platelet ratio index (APRI).
Objective The purpose of our study was to assess a correlation
between APRI and body mass index (BMI) in obese children
with fatty liver.
Methods A crossô€€·sectional study was conducted from August to
September 2007. Subjects were obese children from one junior
high school in Semarang. Complete blood count, transaminase
enzyme measurement, and abdominal ultrasound (USG) were
performed on each subject. Only subjects with bright liver on
USG underwent APRI analysis. Spearman's correlation was used
for statistical analysis.
Results Of 3 7 obese children, 19 children had bright liver on USG.
Their mean APRI was 0.16 (SD 0.119). Only one obese subject
(1137) with bright liver had an APRI > 0.5. APRI was significantly
correlated to alanine amino transferase (ALT) levels (r = 0.62),
but not significantly correlated to weight and BMI.
Conclusion There was no correlation between APRI and BMI.
Only lout of 37 obese children with fatty liver had APRI levels
indicating the presence of liver fibrosis. [Paediatr Indones.
2012;52:181-4].
References
and childhood obesity. Indian) Pediatr. 2007;74AOl·7.
2. Nobili V, Alisi A, Vania A, Tiribelli C, Pietrobattista A,
Bedogni G. The pediatric NAFLD fibrosis index: a predictor
of liver fibrosis in children with non􀂾alcoholic fatty liver
disease. BMC Med. 2009;NI.
3. Karim MF, AI-Mahtab M, Rahman S, Khan M. NASH in
children : a short review. Kust Med J. 2010;2:24,6.
4. Pacifico L, Poggiogalle E, Canrisani V, Menichini G, Ricci
P, Ferraro F, et al. Pediatric nonalcoholic fatty liver disease:
a clinical and laboratory challenge. World J Hepatol.
2010;20275-88.
5. Mexitalia M. Faktor risiko obesitas pada remaja dikaji dari
sudut energi expenditure dan polimorfisme gen uncoupling
protein 2 dan 3 [dissertation}. [Semarang}: Diponegoro
University ; 2010.
6. Ashraf S. Non-invasive evaluation of liver fibrosis in patients
with chronic hepatitis B and C [dissertation]. [Pakistan]:
Baqai Medical University; 2006. Available from: hup:/Iprr.
hec.gov.pkffhes􀀩/33S·pdf
7. Sebastiani G, Alberti A Non􀂾invasive fibrosis biomarkers
reduce but not substitute the need for liver biopsy. World J
Gastroenterol. 2006;12,3682-94.
8. Friedman SL. Liver fibrosis􀂾from bench to bedside. J Hepatol.
2003 ;38,S38-53.
9. Kelleher TB, Afdhal N. Non-invasive assessment of liver
fibrosis. Clin Liver Dis. 2005;9,667-83.
to. Ndhal NH, Nunes D. Evaluation of liver fibrosis: a concise
review. Am J Gastroenterol. 2004;99,1160-74.
11. Wai cr, Greenson JK, Fontana RJ, Kalbfleisch JD, Marrero
JA, Conjeevaram HS, et al. A simple noninvasive index can
predict both significant fibrosis and cirrhosis in patients with
chronic hepatitis C. Hepatology. 2003;380518-26.
12. Hesham A􀂾Kader H. Nonalcoholic fatty liver disease in
children living in the obeseogenic society. World J Pediatr.
2009;5,245-54.
13. Rockey DC. Hepatic fibroSiS, stellate cells, and portal
hypertension. Clin Liver Dis. 2006; 10:459-79.
14. Canbay A, Friedman 5, Gores GJ. Apoptosis: the nexus of
liver injury and fibrosis. Hepato logy. 2004;39:273-78.
15. lacobellis A, Marcellini M, AndriuUi A, Perri F, Leandro G,
Devito R, et al. Non invasive evaluation of liver fibrosis in
paediatric patients with nonalcoholic steatohepatitis. World
J Gastroenterol. 2006;12,7821-5.
16. Siddiqi AI, Siddiqeh M, Mehmood A, Siddiqui AM. Alanin
aminotransferase/aspartate aminotransferase ratio reversal
and prolonged protrombin time: a specific indicator of hepatic
cirrhosis. J Ayub Med Call Abbottabad. 2007;19,22-4.
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Accepted 2016-08-30
Published 2012-06-30