A Nomogram for Predicting Non-Alcoholic Fatty Liver Disease in Obese Children
	    		
		   		
		   			
		   		
	    	
    	 
    	10.5223/pghn.2020.23.3.276
   		
        
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Ahlee KIM
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Hye Ran YANG
			        		
			        		;
		        		
		        		
		        		
			        		Jin Min CHO
			        		
			        		;
		        		
		        		
		        		
			        		Ju Young CHANG
			        		
			        		;
		        		
		        		
		        		
			        		Jin Soo MOON
			        		
			        		;
		        		
		        		
		        		
			        		Jae Sung KO
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Department of Pediatrics, Bundang Jasaeng General Hospital, Seongnam, Korea
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:Original Article
 
        	
        	
            
            
            	- From:Pediatric Gastroenterology, Hepatology & Nutrition
	            		
	            		 2020;23(3):276-285
	            	
            	
 
            
            
            	- CountryRepublic of Korea
 
            
            
            	- Language:English
 
            
            
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		        	Abstract:
			       	
			       		
				        
				        	 Purpose:Non-alcoholic fatty liver disease (NAFLD) ranges in severity from simple steatosis to steatohepatitis. Early detection of NAFLD is important for preventing the disease from progressing to become an irreversible end-stage liver disease. We developed a nomogram that allows for non-invasive screening for NAFLD in obese children. 
				        	
				        
				        	Methods:Anthropometric and laboratory data of 180 patients from our pediatric obesity clinic were collected. Diagnoses of NAFLD were based on abdominal ultrasonographic findings. The nomogram was constructed using predictors from a multivariate analysis of NAFLD risk factors. 
				        	
				        
				        	Results:The subjects were divided into non-NAFLD (n=67) and NAFLD groups (n=113). Factors, including sex, body mass index, abdominal circumference, blood pressure, insulin resistance, and levels of aspartate aminotransferase, alanine aminotransferase (ALT), γ-glutamyl transpeptidase (γGT), uric acid, triglycerides, and insulin, were significantly different between the two groups (all p<0.05) as determined using homeostatis model assessment of insulin resistance (HOMA-IR). In our multivariate logistic regression analysis, elevated serum ALT, γGT, and triglyceride levels were significantly related to NAFLD development. The nomogram was established using γGT, uric acid, triglycerides, HOMA-IR, and ALT as predictors of NAFLD probability. 
				        	
				        
				        	Conclusion:The newly developed nomogram may help predict NAFLD risk in obese children. The nomogram may also allow for early NAFLD diagnosis without the need for invasive liver biopsy or expensive liver imaging, and may also allow clinicians to intervene early to prevent the progression of NAFLD to become a more advanced liver disease.