Diagnosis of Fatty Liver Complicated by Simple Obesity in Children: Serum ALT and Its Correlation with Abdominal CT and Liver Biopsy

소아의 단순성 비만증에 의한 지방간의 진단: ALT치와 복부 전산화단층촬영 및 간생검 소견간의 상관관계

  • Lee, Seong-Hee (Department of Pediatrics, Seoul Red Cross Hospital) ;
  • Kim, Hwa-Jung (Department of Pediatrics, Seoul Red Cross Hospital) ;
  • Oh, Jae-Cheol (Department of Pediatrics, Seoul Red Cross Hospital) ;
  • Han, Hae-Jeong (Department of Pediatrics, Seoul Red Cross Hospital) ;
  • Kim, Hee-Sup (Department of Pediatrics, Seoul Red Cross Hospital) ;
  • Tchah, Hann (Department of Pediatrics, Seoul Red Cross Hospital) ;
  • Park, Ho-Jin (Department of Pediatrics, Seoul Red Cross Hospital) ;
  • Shin, Mi-Keong (Department of Pathology, Seoul Red Cross Hospital) ;
  • Lee, Min-Jin (Department of Radiology, Seoul Red Cross Hospital) ;
  • Lee, Sang-Chun (Department of Radiology, Seoul Red Cross Hospital)
  • 이성희 (서울적십자병원 소아과) ;
  • 김화중 (서울적십자병원 소아과) ;
  • 오재철 (서울적십자병원 소아과) ;
  • 한혜정 (서울적십자병원 소아과) ;
  • 김희섭 (서울적십자병원 소아과) ;
  • 차한 (서울적십자병원 소아과) ;
  • 박호진 (서울적십자병원 소아과) ;
  • 신미경 (서울적십자병원 해부병리과) ;
  • 이민진 (서울적십자병원 진단방사선과) ;
  • 이상천 (서울적십자병원 진단방사선과)
  • Received : 1999.06.30
  • Accepted : 1999.09.07
  • Published : 1999.09.30

Abstract

Purpose: The purpose of our study is to provide useful information for diagnostic methods of fatty liver by childhood simple obesity and to provide correlation between serum alanine aminotransferase (ALT) for screening test and abdominal computerized tomography (CT) and liver biopsy for confirmative diagnostic methods of fatty liver. Methods: Among 78 obese childrens who visited our hospital, CT was carried out in 26 childrens. Of these, liver biopsy was carried out in 15 childrens who had high obesity index or severe elevated ALT. Based on the level of serum ALT, 26 cases were classified into 3 groups, and compared with physical measurements and degree of fatty infiltration on CT and liver biopsy. Results: 1) Correlation between ALT and physical measurements: Of 26 obese children, ALT was abnormally elevated (>30 IU/L) in 17 cases (67.4%) but there was no significant correlation between ALT and physical measurements (p>0.05). 2) Correlation between degree of fatty infiltration on CT and ALT: Of 26 cases, 13 cases (50%) revealed fatty liver on CT. The degree of fatty liver on CT had significant correlation with elevation of ALT (p<0.05). 3) Correlation between the degree of fatty infiltration on liver biopsy and ALT: Liver biopsy was performed in 15 cases of which 14 cases revealed fatty liver. But one case had normal hepatic histology with severe obesity and normal ALT. Fourteen fatty liver cases on liver biopsy were classified into 3 groups by the degree of fatty infiltration and analysed with obesity index and ALT. The histologic hepatic steatosis had no significant correlation with obesity index (p>0.05), but significant correlation with ALT (p<0.05). 4) Correlation between CT and liver biopsy finding: Both CT and liver biopsy were performed in 15 cases of which 6 cases revealed normal finding on CT and 9 cases manifested fatty liver. There was significant correlation between CT and liver biopsy findings (r=0.6094). Conclusion: The results of our study suggest that abdominal CT and liver biopsy are useful and accurate methods of estimating fatty liver in the childhood obesity. But biochemical abnormalities of routine liver function tests dot not correlate well with severity of the fatty liver and liver injury.