ArticleEuropean journal of pediatrics2019
Comparison of diagnostic accuracy of screening tests ALT and ultrasound for pediatric non-alcoholic fatty liver disease.
Article in European journal of pediatrics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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Who cites it
33 citing papers in PubMed, 67 citations in OpenAlex.
- Updates on paediatric MASLD: insights from an endocrine lens.Diabetologia · 2026Review
- European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) steatotic liver disease special interest group position paper on screening, diagnosis and investigation of paediatric metabolic dysfunction-associated steatotic liver disease.Journal of pediatric gastroenterology and nutrition · 2026Article
- Screening and diagnosis of metabolic dysfunction-associated steatotic liver disease in children within public healthcare.Pediatric research · 2026Article
- Comparison of the diagnostic performance of alanine aminotransferase and ultrasonography for discrimination of liver biopsy proven metabolic associated steatotic liver disease: a ROC curve analysis.BMC endocrine disorders · 2026Article
- Hepatic steatosis in pediatric obesity: association with cardiometabolic profile and considerations regarding alanine aminotransferase screening.European journal of pediatrics · 2026Article
- Alanine Aminotransferase Elevation at Diagnosis of Youth-Onset Type 2 Diabetes: Prevalence, Predictors, and One-Year Outcomes.Endocrinology, diabetes & metabolism · 2026Article
- A Systematic Review and Meta-Analysis on the Diagnostic Test Accuracy of Hepatorenal Index in Pediatric Metabolic Dysfunction-Associated Steatotic Liver Disease.Diagnostics (Basel, Switzerland) · 2026Review
- Optimal cutoff values of alanine aminotransferase and its derived markers for pediatric MASLD.Frontiers in endocrinology · 2026Article
- Association of behavioral factors, liver function and NAFLD: Bayesian Mendelian randomization.Nutrition & metabolism · 2025Article
- Association of fatty liver with serum gamma-glutamyltransferase and uric acid in obese children in a tertiary care centre.BMC pediatrics · 2025Article
- [Research progress on dietary and exercise intervention for the prevention and treatment of non-alcoholic fatty liver disease in obese children].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025Review
- Article
- Yogurt Supplementation Can Ameliorate Fatty Liver Diseases and Metabolic Syndrome in High Fat-Induced Conditions in Mice.Food science & nutrition · 2025Article
- Converging Pathways between Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Diabetes in Children.International journal of molecular sciences · 2024Review
- Establish a noninvasive model to screen metabolic dysfunction-associated steatotic liver disease in children aged 6-14 years in China and its applications in high-obesity-risk countries and regions.The Lancet regional health. Western Pacific · 2024Article
- Development and validation of a novel non-invasive test for diagnosing nonalcoholic fatty liver disease in Chinese children.World journal of pediatrics : WJP · 2024Article
- Exploring the Role of Serum Osteonectin and Hsp27 in Pediatric MAFLD Diagnosis and Cardiometabolic Health.Nutrients · 2024Article
- Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) and Thyroid Function in Childhood Obesity: A Vicious Circle?Children (Basel, Switzerland) · 2024Review
- Nonalcoholic Fatty Liver Disease in Young Children with Obesity.Childhood obesity (Print) · 2023Article
- BMI Metrics Are Poor Predictors of Pediatric Nonalcoholic Fatty Liver Disease Severity.Childhood obesity (Print) · 2023Article
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Alanine aminotransferase (ALT) and ultrasound (US) are the most commonly used tools for detecting non-alcoholic fatty liver disease (NAFLD). No direct comparison of these two modalities in children exists. We aimed to compare head-to-head the diagnostic accuracy of ALT and US and their combination for detecting NAFLD in children with obesity. Ninety-nine children with severe obesity underwent simultaneous serum-ALT and abdominal ultrasound (US steatosis score 0-3). Proton magnetic resonance spectroscopy was used as reference standard for detecting steatosis/NAFLD. ROC curve analyses were performed to determine diagnostic performance and to determine optimum screening cut-points aiming for a specificity ≥ 80%. The area under the ROC (AUROC) of ALT and US were not significantly different (0.74 and 0.70, respectively). At the optimal ALT threshold (≥40 IU/L), sensitivity was 44% and specificity was 89%. At the optimal US steatosis score (≥ 2), sensitivity was 51% and specificity was 80%. Combining ALT and US did not result in better accuracy than ALT or US alone.Conclusion: ALT and US have comparable and only moderate diagnostic accuracy for detecting hepatic steatosis in children with obesity. A stepwise screening strategy combining both methods does not improve diagnostic accuracy. What is Known: • Alanine aminotransferase (ALT) and ultrasound (US) are the most commonly used tools for detecting non-alcoholic fatty liver disease (NAFLD). • ALT and ultrasound have mediocre accuracy in detecting steatosis in children with obesity. What is New: • In a head-to-head comparison, the difference in diagnostic accuracy of ALT and ultrasound in detecting steatosis is not significant. • A stepwise screening strategy combining both methods does not improve diagnostic accuracy.
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