ArticleWorld journal of clinical pediatrics2026
Ultrasound hepatic elastography: A non-invasive indicator of insulin resistance in the pediatric population: A systematic review.
Article in World journal of clinical pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundInsulin resistance (IR) plays a pivotal role in the pathogenesis of metabolic dysfunction-associated steatotic liver disease. While non-invasive imaging methods are increasingly used in pediatrics, the extent to which hepatic elastography reflects IR in children remains unclear.
aimTo evaluate the association between ultrasound-based hepatic elastography parameters and clinical indices of IR in the pediatric population.
methodsA systematic search of PubMed, Scopus, and Web of Science databases was conducted through October 2025. Studies assessing correlations between elastography parameters - controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) - and IR indices were included. Data were pooled using random-effects meta-analysis with correlation coefficients (
resultsSixteen studies, encompassing 2,032 children and adolescents, were included. The pooled correlation between hepatic elastography (CAP/LSM) and IR indices was
conclusionUltrasound-based hepatic elastography provides a reliable, non-invasive surrogate for systemic metabolic dysfunction in pediatric metabolic dysfunction-associated steatotic liver disease. CAP reflects early, reversible hepatic fat accumulation, while LSM reflects more advanced fibrosis and systemic IR, and identifies fibrotic progression driven by chronic IR. The strongest associations with adipose tissue-IR and metabolic score-IR highlight the systemic, multisite nature of pediatric IR. Elastography thus holds promise as an integrated biomarker for IR severity, early risk stratification, and therapeutic monitoring in children and adolescents with metabolic risk factors.
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