Association of antinuclear antibody positivity with liver disease severity in pediatric metabolic dysfunction-associated steatotic liver disease
BackgroundAlthough antinuclear antibody (ANA) is frequently observed in patients with metabolic dysfunction-associated steatotic liver disease (MASLD), its clinical significance in children remains unclear and controversial. In this study, we investigated the prevalence of ANA positivity and the fac...
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Frontiers Media S.A.
2025-02-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2025.1527605/full |
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| author | Hyun Jin Kim Ju Young Kim Yoo Min Lee Yong Hee Hong Ben Kang Byung-Ho Choe Dae Yong Yi Eun Hye Lee Soon Chul Kim You Jin Choi Hyo-Jeong Jang So Yoon Choi |
| author_facet | Hyun Jin Kim Ju Young Kim Yoo Min Lee Yong Hee Hong Ben Kang Byung-Ho Choe Dae Yong Yi Eun Hye Lee Soon Chul Kim You Jin Choi Hyo-Jeong Jang So Yoon Choi |
| author_sort | Hyun Jin Kim |
| collection | DOAJ |
| description | BackgroundAlthough antinuclear antibody (ANA) is frequently observed in patients with metabolic dysfunction-associated steatotic liver disease (MASLD), its clinical significance in children remains unclear and controversial. In this study, we investigated the prevalence of ANA positivity and the factors associated with it in pediatric MASLD patients without concurrent autoimmune hepatitis.MethodsWe retrospectively reviewed the medical records of patients aged 4–18 years diagnosed with MASLD and tested for ANA from January 2015 to December 2020 at 10 hospitals in Korea. All statistical analyses were carried out using SPSS 26.0 and P-values <0.05 were considered statistically significant.ResultsOut of the 439 patients included, ANAs were present in 89 (20.3%); 51 (57.3%) patients had ANA titer <1:80; 22 (24.7%), <1:160; 10 (11.2%), <1:320; and 6 (6.7%), <1:640. Compared to ANA-negative patients, aspartate aminotransferase (AST, P = 0.003) and alanine aminotransferase (ALT, P = 0.007) levels were significantly higher in ANA-positive patients. The ALT to Platelet Ratio Index (APRI) score was also associated with the ANA-positive patients (P = 0.005). To predict ANA positivity using APRI, the area under receiver operating characteristic (AUROC) curve was 0.597 (p = 0.004), and the APRI cutoff value of >0.893 could predict ANA, with sensitivity and specificity of 42.7% and 72.9%, respectively.ConclusionsANA positivity in pediatric MASLD is associated with greater liver enzyme elevation and increased risk of fibrosis, highlighting the need for careful monitoring in ANA-positive patients. |
| format | Article |
| id | doaj-art-17d5acd055714ab3bbede91a59c6cc8c |
| institution | DOAJ |
| issn | 2296-2360 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj-art-17d5acd055714ab3bbede91a59c6cc8c2025-08-20T03:06:04ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-02-011310.3389/fped.2025.15276051527605Association of antinuclear antibody positivity with liver disease severity in pediatric metabolic dysfunction-associated steatotic liver diseaseHyun Jin Kim0Ju Young Kim1Yoo Min Lee2Yong Hee Hong3Ben Kang4Byung-Ho Choe5Dae Yong Yi6Eun Hye Lee7Soon Chul Kim8You Jin Choi9Hyo-Jeong Jang10So Yoon Choi11Department of Pediatrics, Chungnam National University Hospital, College of Medicine, Chungnam National University, Daejeon, Republic of KoreaDepartment of Pediatrics, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Republic of KoreaDepartment of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of KoreaDepartment of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of KoreaDepartment of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Republic of KoreaDepartment of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Republic of KoreaDepartment of Pediatrics, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Republic of KoreaDepartment of Pediatrics, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Republic of KoreaDepartment of Pediatrics, Jeonbuk National University Medical School and Hospital, Jeonju, Republic of KoreaDepartment of Pediatrics, Inje University, Ilsan Paik Hospital, Inje University College of Medicine, Ilsan, Republic of KoreaDepartment of Pediatrics, Keimyung University School of Medicine, Daegu, Republic of Korea0Department of Pediatrics, Kosin Gospel Hospital, Kosin University College of Medicine, Busan, Republic of KoreaBackgroundAlthough antinuclear antibody (ANA) is frequently observed in patients with metabolic dysfunction-associated steatotic liver disease (MASLD), its clinical significance in children remains unclear and controversial. In this study, we investigated the prevalence of ANA positivity and the factors associated with it in pediatric MASLD patients without concurrent autoimmune hepatitis.MethodsWe retrospectively reviewed the medical records of patients aged 4–18 years diagnosed with MASLD and tested for ANA from January 2015 to December 2020 at 10 hospitals in Korea. All statistical analyses were carried out using SPSS 26.0 and P-values <0.05 were considered statistically significant.ResultsOut of the 439 patients included, ANAs were present in 89 (20.3%); 51 (57.3%) patients had ANA titer <1:80; 22 (24.7%), <1:160; 10 (11.2%), <1:320; and 6 (6.7%), <1:640. Compared to ANA-negative patients, aspartate aminotransferase (AST, P = 0.003) and alanine aminotransferase (ALT, P = 0.007) levels were significantly higher in ANA-positive patients. The ALT to Platelet Ratio Index (APRI) score was also associated with the ANA-positive patients (P = 0.005). To predict ANA positivity using APRI, the area under receiver operating characteristic (AUROC) curve was 0.597 (p = 0.004), and the APRI cutoff value of >0.893 could predict ANA, with sensitivity and specificity of 42.7% and 72.9%, respectively.ConclusionsANA positivity in pediatric MASLD is associated with greater liver enzyme elevation and increased risk of fibrosis, highlighting the need for careful monitoring in ANA-positive patients.https://www.frontiersin.org/articles/10.3389/fped.2025.1527605/fullmetabolic dysfunction-associated steatotic liver diseaseantinuclear antibodyaspartate aminotransferasealanine aminotransferasepediatrics - children |
| spellingShingle | Hyun Jin Kim Ju Young Kim Yoo Min Lee Yong Hee Hong Ben Kang Byung-Ho Choe Dae Yong Yi Eun Hye Lee Soon Chul Kim You Jin Choi Hyo-Jeong Jang So Yoon Choi Association of antinuclear antibody positivity with liver disease severity in pediatric metabolic dysfunction-associated steatotic liver disease Frontiers in Pediatrics metabolic dysfunction-associated steatotic liver disease antinuclear antibody aspartate aminotransferase alanine aminotransferase pediatrics - children |
| title | Association of antinuclear antibody positivity with liver disease severity in pediatric metabolic dysfunction-associated steatotic liver disease |
| title_full | Association of antinuclear antibody positivity with liver disease severity in pediatric metabolic dysfunction-associated steatotic liver disease |
| title_fullStr | Association of antinuclear antibody positivity with liver disease severity in pediatric metabolic dysfunction-associated steatotic liver disease |
| title_full_unstemmed | Association of antinuclear antibody positivity with liver disease severity in pediatric metabolic dysfunction-associated steatotic liver disease |
| title_short | Association of antinuclear antibody positivity with liver disease severity in pediatric metabolic dysfunction-associated steatotic liver disease |
| title_sort | association of antinuclear antibody positivity with liver disease severity in pediatric metabolic dysfunction associated steatotic liver disease |
| topic | metabolic dysfunction-associated steatotic liver disease antinuclear antibody aspartate aminotransferase alanine aminotransferase pediatrics - children |
| url | https://www.frontiersin.org/articles/10.3389/fped.2025.1527605/full |
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