Lead Researcher – Dr Jake Mann
Establishment – University of Cambridge
Dr Jake Mann provides an update on his research study and what it means for the future of testing for paediatric fatty liver disease.
Fatty liver (also known as NAFLD) is the most common cause of abnormal liver blood tests in children in the UK. The majority of children do not have severe fatty liver but a small proportion might get liver inflammation or scarring (fibrosis) due to the build-up of fat. Currently the main way to test if there is scarring in children with fatty liver would be by doing a liver biopsy. However, this is quite a big procedure so we would like to find more simple tests that can avoid needing a biopsy.
In this research we aimed to use several different blood tests to see if they could give us the same information as a biopsy. We used two specialist research tests: ‘lipidomics’, which measures hundreds of different fats in the blood; and the ‘ELF test’, which tests three specific chemicals in the blood. We also used several genetic tests that have been said to be important in adults with fatty liver.
We used blood samples from over 300 children, some of whom had fatty liver and some whom didn’t have liver disease and ran the lipidomics tests. We found that some patterns of fats did seem to be linked to more severe liver disease. This is an important finding as it gives hope that a test like this could be used instead of performing biopsies.
Whereas the ELF test did not seem to work so well in showing who had fibrosis and who didn’t, from the samples we had.
We also found that the majority of the genetic changes that are linked to severe fatty liver in adults are also linked to more severe fatty liver in children. This is really important for our general understanding of fatty liver in children.
Two scientific papers have been published as a result of this study with two further papers currently under review.
The next step will be to check that the same results can be found in a separate group of children with fatty liver, ideally by a separate group of researchers. This ‘validation’ is really important to make sure the results are accurate. We hope to set up a big study across Europe to help us do this.