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ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Gastroenterology, Hepatology and Nutrition
Volume 13 - 2025 |
doi: 10.3389/fped.2025.1527605
Association of Antinuclear Antibody Positivity with Liver Disease Severity in Pediatric Metabolic dysfunction-Associated Steatotic Liver Disease
Provisionally accepted
Hyun Jin Kim 1* Ju Young Kim 2* Yoo Min Lee 3* Yong Hee Hong 3*
Ben Kang 4 Byung-Ho Choe 4*
Dae Yong Yi 5
Eun Hye Lee 6
Soon Chul Kim 7 You Jin Choi 8*
Hyo-Jeong Jang 9
So Yoon Choi 10 So Yoon Choi 11*- 1 Department of Pediatrics, Chungnam National University Hospital, Daejeon, Republic of Korea
- 2 Department of Pediatrics, Eulji university hospital, Daejeon, Republic of Korea
- 3 Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
- 4 Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
- 5 Department of Pediatrics, Chung-Ang University Hospital, College of Medicine, Chung-Ang University,, Seoul, Republic of Korea
- 6 Department of Pediatrics, Nowon Eulji Medical Center, Eulji University School of medicine, Seoul, Republic of Korea
- 7 Department of Pediatrics, Jeonbuk National University Medical School and Hospital, Jeonju, Republic of Korea
- 8 Department of Pediatrics, Inje University, Ilsan Paik Hospital, Inje University College of Medicine, Ilsan, Republic of Korea
- 9 Department of Pediatrics, Keimyung University School of Medicine, Daegu, Republic of Korea
- 10 Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea, Busan, Republic of Korea
- 11 Department of Pediatrics, Kosin Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
Background: Although 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.Methods: We 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.Results: Out 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.Conclusions: ANA 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.
Keywords: Metabolic dysfunction-associated steatotic liver disease, Antinuclear antibody, aspartate aminotransferase, Alanine aminotransferase, pediatrics - children
Received: 13 Nov 2024; Accepted: 05 Feb 2025.
Copyright: © 2025 Kim, Kim, Lee, Hong, Kang, Choe, Yi, Lee, Kim, Choi, Jang, Choi and Choi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Hyun Jin Kim, Department of Pediatrics, Chungnam National University Hospital, Daejeon, Republic of Korea
Ju Young Kim, Department of Pediatrics, Eulji university hospital, Daejeon, Republic of Korea
Yoo Min Lee, Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
Yong Hee Hong, Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
Byung-Ho Choe, Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
You Jin Choi, Department of Pediatrics, Inje University, Ilsan Paik Hospital, Inje University College of Medicine, Ilsan, Republic of Korea
So Yoon Choi, Department of Pediatrics, Kosin Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea
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