34-PUB: Relevance of Elastographyin Children with Severe Obesity

Le résumé fourni par la source

Introduction and Objective: The literature reports that Mexican American children are at risk for diabetes, hypertension, renal dysfunction, cardiovascular and gallbladder disease, risk increases if the child has overweight or obesity. In 2005 we found that by the age of three 25% of boys and 15% of girls were either overweight or obese, but the numbers increased to 59% and 48 respectively by the time they were 18. OBJECTIVE: To determine if fibrosis is present in children with severe obesity. Methods: We established a protocol for children above normal weight for age according to the CDC growth chart, it included Complete metabolic and lipid panel, GGT, Insulin and Hgb A1C. We requested a liver ultrasound when laboratory tests reveal elevated liver enzymes. Over the years, ultrasound inconsistently identified fatty liver and hepatomegaly but never reported fibrosis. Recognizing these limitations, in 2023 we order liver elastography, on children with BMI > 99 percentile for age (Z-score 4) Results: A total of 89 studies were received, (graphic 1) of the 89 reports only 36% were in the normal range with no steatosis and 43% had more than two thirds of fatty infiltration (CAP in dB/m) (S1 & S3 respectively); liver stiffness (Fibrosis (LSM in kPa)) was reported in 35% of the studies with 6% of them being in the cirrhosis range (F4). Conclusion: Lack of insurance coverage leads to an expense for the family, and not all can afford it; but the reality is that fibrosis starts early in life. Disclosure F.J. Cervantes: None. M. Faz: None.

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