INVESTIGATION IN TO THE STUDY OF DIAGNOSIS NAFLD BY ANTHEROPOMETRIC PARAMETRS, DEXA, ULTRASOUND WITH FIBRO SCAN IN CHILDREN, AND DEFINING THE TOPOGRAPHY OF NAFLD

Background and Aim: Non- alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease which can contribute in simple steatosis to cirrhosis and also hepatocellular carcinoma. Early diagnosis of disease in clinic is important. Our aims is compare of accuracy of diagnosis methods: Anthropometric, ultrasound, Densitometry (DEXA) and Fibro scan in Children and determine of topography in adult NAFLD. Methods: This cross sectional study consisted of 70 child with overweight up 85th percentile and 370 adult in Mashhad. Anthropometric parameters were measured with handle and body analyzer device. Hepatic steatosis and fibrosis was determined by Transient Elastography and compared with Ultrasound and DEXA in children. The sensitivity and specificity and also its optimal cutoff point was determined by receiver operating characteristic analysis. Determined topography in NAFLD by machine learning.The waist circumference was the more Roc curve with 0.754 in diagnosis of hepatic steatosis in children and its optimal cutoff point was 94.5 (sensitivity =0.931, specificity =0.696). The optimal cutoff points of stomach circumference were 96.5 (sensitivity = 0.901, specificity = 0.513). The accuracy other diagnosis methods were ultrasound with Roc curve 0.692 (sensitivity = 0.892, specificity = 0.657), DEXA with cutoff 1.75 and AUROC 0.578 (sensitivity= 0.725, specificity= 0.392), ALT with optimal cutoff point 22.5 and AUROC 0.888 (sensitivity= 0.778, specificity= 0.411), AST cutoff point 22.5 and AUROC curve 0.426 (sensitivity= 0.617, specificity= 0.250), GGT with cutoff point 18.5 and AUROC curve 0.342 (sensitivity= 0.642, specificity= 0.250). The patients with more weight, neck, waist, stomach and mid arm circumference were more grade of steatosis and fibrosis.Conclusion: Anthropometric parameters: BMI, waist, stomach, neck and Mid Arm Circumference (MAC) is the most accuracy and sensitivity for diagnosis of liver Steatosis and Fibrosis in compare with Ultrasound and Densitometry (DEXA). Serum liver function test is less accuracy and sensitivity for diagnosis of liver steatosis and fibrosis. Topography was like of samovar or sham pain glasses. We predict steatosis grade by excel program.

Keywords:

NAFLD , Hepatic steatosis , Hepatic fibrosis , Fibro Scan , Anthropometric Parameters