Abstract
Purpose Controlled attenuation parameter (CAP) is a non-invasive method to
assess the presence of liver steatosis. It has been evaluated in children and
adults, mainly in either the obese or in subjects with suspected liver disease.
Our aim was to describe CAP in healthy non-obese subjects without suspected
liver steatosis and to suggest cutoff levels for steatosis.
Materials and Methods We prospectively recruited 187 individuals aged
8–70 years. All underwent clinical examination, including height and
weight measurement. Body mass index (BMI) was calculated and converted into
z-scores. To exclude liver pathology, B-mode ultrasound and liver stiffness
measurements were performed in all prior to CAP measurement. Blood was drawn for
liver biochemistry in adults.
Results CAP was associated with BMI z-score across all ages. CAP started
to rise alongside BMI z-score already in subjects with a BMI below average. CAP
values were higher in adults than in children (p<0.001), and higher in
adult males than adult females (p=0.014). CAP did not correlate with age
within the adult or pediatric cohorts. CAP was highly correlated with the fatty
liver index. 18 and 23% of subjects showed CAP above the suggested
cutoff value for children and adults, respectively.
Conclusion CAP was correlated with BMI z-score, even in individuals with a
below-average BMI . We found CAP above published cutoff values in a substantial
proportion of presumably healthy, non-obese children and adults, warranting
further research to clarify whether this represents non-obese non-alcoholic
fatty liver disease or if reference values need adjustment.
Key words
Controlled attenuation parameter - Fatty liver index - Liver stiffness - measurement - Non-alcoholic fatty liver disease - ultrasound, methods & techniques
