Prevalence of liver steatosis and stiffness by transient elastography and serum markers in Japanese early adolescents.

Abstract

Background: The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) is projected to increase in the Asian pediatric population. However, data regarding its prevalence in the general pediatric population are limited. We aimed to determine the prevalence of liver steatosis and liver stiffness, measured by controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), respectively, using FibroScan^® in the general pediatric population, and to assess their associations with sex, BMI, abdominal circumference (AC), and serum parameters.

Methods: The CAP and LSM were measured in 1,435 children aged 9-12 years in the Aichi Regional Adjunct Study of the Japan Environment and Children's Study. Elevated CAP and LSM values were defined by age-specific CAP and LSM cutoffs (11-12 and 9-10 years: CAP >225 and >220 dB/m and LSM >6.5 and >5.8 kPa, respectively). Multivariate logistic regression, adjusted for sex, BMI, AC, HDL-Chol, non-HDL-Chol, TG, and ALT levels, was performed.

Results: At 11-12 years, the prevalence of elevated CAP and LSM was 12.6% and 2.9%, respectively. Children with higher CAP exhibited significantly higher BMI and AC. TG and ALT levels were significantly associated with higher CAP, whereas lower non-HDL-Chol levels were significantly associated with higher LSM. At 9-10 years, higher LSM was more prevalent in males.

Conclusion: This study reports the prevalence of elevated CAP and LSM values and their association with biomarkers in a large cohort of the general pediatric population in Japan. This partially contributes to the understanding of the epidemiology of MASLD and supports the development of early prevention and risk-stratification approaches.