New noninvasive liver fibrosis index reduces need for biopsies in children
A new non-invasive diagnostic index has been developed that may be used in tertiary care to rule in liver fibrosis in children with non-alcoholic fatty liver disease (NAFLD). The 'Pediatric NAFLD Fibrosis Index' (PNFI), described in the open access journal BMC Medicine, uses age, waist circumference and triglycerides to predict the presence of fibrosis.
Dr Valerio Nobili, from the Pediatric Hospital IRCCS "Bambino Gesů", Rome, worked a team of researchers including Dr Giorgio Bedogni and Professor Claudio Tiribelli to assess the factors that were associated with fibrosis in 203 children treated at the hospital's Liver Unit. Nobili said, "Diagnosis of liver fibrosis is currently based on liver biopsy. However, this is invasive and limited by the hazard and discomfort to the patient. Thus, there is a recognized need for less invasive strategies to identify the minority of NAFLD patients with liver fibrosis".
NAFLD is a highly prevalent and potentially very serious complication of childhood obesity. The early identification of fibrosis is particularly important in children as it may help prevent the development of liver disease in adulthood. The authors' evaluation of the ability of selected clinical features and laboratory exams to predict liver fibrosis in children with NAFLD revealed that by inputting a child's age, waist circumference and triglyceride levels into a relatively simple equation, it was possible to gain a useful indication of the likelihood of fibrosis.
Nobili concludes, "The use of non-invasive, reliable tests for this booming condition is important for children and adults and this is why we invested our expertise in the field of NAFLD into this original and important study".
More information: The pediatric NAFLD fibrosis index: a predictor of liver fibrosis in children with non-alcoholic fatty liver disease, Valerio Nobili, Anna Alisi, Andrea Vania, Claudio Tiribelli, Andrea Pietrobattista and Giorgio Bedogni, BMC Medicine (in press), www.biomedcentral.com/bmcmed/