Transient elastography (TE) is a non-invasive, cost-efficient, and observer-independent approach to reliably detect fibrosis and steatosis. To estimate liver fibrosis, TE uses Liver Stiffness Measurement (LSM), while Controlled Attenuation Parameter (CAP) is used to assess the percentage of liver fat.
This study aims to provide reference values for both LSM and CAP from healthy children and adolescents to both facilitate and improve early detection of abnormal liver function in paediatric patients. It also examined the potential effects of age, sex, puberty and body mass index (BMI-SDS) on CAP and LSM.
LSM is both age and sex-dependent: older children, particularly older boys, had higher LSM values. In contrast, no association between CAP, age and sex was found.
Weight status (BMI-SDS) was positively correlated with both LSM and CAP. This was particularly true when BMI-SDS >1.28. For BMI measures above 1.28, the association with both LSM and CAP remained positive, but only reached statistical significance for CAP. This association between BMI-SDS and CAP was also significantly stronger in younger children.
An association between puberty and LSM values, but not CAP values, was also found. This association could in part be explained by the increasing hepatic insulin resistance occurring during puberty.