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Can Baseline Characteristics be Used to Predict Liver Disease Outcomes in Pediatric Nonalcoholic Fatty Liver Disease?
Author(s) -
Orkin Sarah,
Yodoshi Toshifumi,
Sun Qin,
Fei Lin,
Meryum Syeda,
ArceClachar Ana Catalina,
Bramlage Kristin,
Beck Andrew F.,
Mouzaki Marialena
Publication year - 2021
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.22999
Subject(s) - medicine , nonalcoholic fatty liver disease , logistic regression , retrospective cohort study , liver disease , disease , cohort , fatty liver , cohort study , alanine aminotransferase
Objective Longitudinal studies on childhood predictors of nonalcoholic fatty liver disease (NAFLD) progression are lacking. The objective of this study was to determine whether baseline clinical or laboratory measures predict liver disease outcomes in a pediatric NAFLD cohort. Methods A retrospective study of patients with presumed NAFLD was conducted using baseline and follow‐up clinical and laboratory measures. Disease outcomes were defined using the mean serum alanine aminotransferase (ALT) levels from 24 to 36 months after the first visit. Logistic regression assessed the relationship between ALT progression/regression and predictor variables. Multivariable regression determined the best model for predicting the ALT outcome. Markov process modeling explored the likelihood for a patient to transition between ALT states. Results Of a total of 816 patients identified, 144 had sufficient data. Regression was seen in 26%, whereas 30% progressed. No baseline clinical or laboratory measurements had a significant effect on disease outcomes. Markov modeling demonstrated that subjects were more likely to either remain in their baseline ALT group or worsen rather than improve. Conclusions Routinely obtained baseline clinical or laboratory measures cannot help risk‐stratify youth with presumed NAFLD in terms of long‐term outcomes. Close clinical, radiographic, and histologic evaluation of patients is warranted to determine those at risk of progression.