https://pubmed.ncbi.nlm.nih.gov/35899561/ NAFLD

Turk J Pediatr. 2022;64(3):482-489.
doi: 10.24953/turkjped.2022.41.

Urinary C-peptide creatinine ratio is a significant indicator of non-alcoholic fatty liver disease in children with obesity

Hekma Saad Farghaly 1, Kotb Abbass Metwalley 1, Yasser Gamal 1, Ghada Mohamed Saied 2, Yasser Yasser 1
Affiliations expand
PMID: 35899561

DOI: 10.24953/turkjped.2022.41
Free article

Abstract
Background: Nonalcoholic fatty liver disease (NAFLD) is the commonest etiology of chronic hepatic problems in children with obesity. This study aimed to assess whether urinary C-peptide creatinine ratio (UCPCR) might be a potential indicator of NAFLD in obese children.

Methods: The study included 240 children with simple obesity. Hepatic ultrasonic examination, anthropometric and laboratory measurements including fasting plasma glucose, fasting insulin, fasting C peptide, liver, renal profile, lipid profile, and UCPCR were obtained in all cases. According to the results of the hepatic ultrasonography, cases were classified into two categories, those with NAFLD (n=98) and without NAFLD (n= 142).

Results: In cases with NAFLD, UCPCR was significantly higher than those without NAFLD (P < 0.001). A significant positive correlation between UCPCR and waist circumference (WC SDS), triglyceride, fasting C-peptide, HOMA-IR and alanine aminotransferase (ALT) was found (P < 0.001 for each). Adjusting for other variables, UCPCR was the most significant predictor of NAFLD in children with obesity with higher odds ratio (OR = 3.26) than fasting C peptide (OR = 2.87), triglyceride (OR = 1.89), ALT (OR = 2.20), WC SDS (OR = 1.32) and age (OR=1.27) . UCPCR cut-off value of 0.755 nmol/mmol was able to discriminate cases with NAFLD from those without NAFLD with a sensitivity of 95%, a specificity of 87%.

Conclusions: We concluded that UCPCR is a useful, practical and non-invasive predictor of NAFLD in children with obesity with high sensitivity and specificity.