Introduction: Non-alcoholic fatty liver disease (NAFLD) may progress to steatohepatitis, cirrhosis and complicated hepatocellular carcinoma with defined differential symptoms and manifestations.Objective: To evaluate the fatty liver status by several validated approaches and to compare imaging techniques, lipidomic and routine blood markers with magnetic resonance imaging in adults subjects with non-alcoholic fatty liver disease.Materials and methods: A total of 127 overweight/obese with NAFLD, were parallelly assessed by Magnetic Resonance Imaging (MRI), ultrasonography, transient elastography and a validated metabolomic designed test to diagnose NAFLD in this cross-sectional study. Body composition (DXA), hepatic related biochemical measurements as well as the Fatty Liver Index (FLI) were evaluated. This study was registered as FLiO: Fatty Liver in Obesity study; NCT03183193.Results: The subjects with more severe liver disease were found to have worse metabolic parameters. Positive associations between MRI with inflammatory and insulin biomarkers were found. A linear regression model including ALT, RBP4 and HOMA-IR was able to explain 40.9% of the variability in fat content by MRI. In ROC analyses a combination panel formed of ALT, HOMA-IR and RBP4 followed by ultrasonography, ALT and metabolomic test showed the major predictive ability (77.3%, 74.6%, 74.3% and 71.1%, respectively) for liver fat content.Conclusions: A panel combination including routine blood markers linked to insulin resistance showed highest associations with MRI considered as a gold standard for determining liver fat content. This combination of tests can facilitate the diagnosis of early stages of non-alcoholic liver disease thereby avoiding other invasive and expensive methods.
Palabras clave. Tuberculosis. Epidemiología. Tuberculosis multirresistente.
Validation of DVWR for use in nursing clinical practice is supported. Early detection of predictive variables could help to identify DVWR and facilitate the diagnosis in the clinical practice.
Neck circumference (NC) and its relationship to height (NHtR) and weight (NWtR) appear to be good candidates for the non-invasive management of non-alcoholic fatty liver disease (NAFLD). This study aimed to evaluate the ability of routine variables to assess and manage NAFLD in 98 obese subjects with NAFLD included in a 2-year nutritional intervention program. Different measurements were performed at baseline, 6, 12 and 24 months. The nutritional intervention significantly improved the anthropometric, metabolic and imaging variables. NC was significantly associated with the steatosis degree at baseline (r = 0.29), 6 m (r = 0.22), 12 m (r = 0.25), and 24 m (r = 0.39) (all p < 0.05). NC was also significantly associated with visceral adipose tissue at all the study time-points (basal r = 0.78; 6 m r = 0.65; 12 m r = 0.71; 24 m r = 0.77; all p < 0.05). NC and neck ratios combined with ALT levels and HOMA-IR showed a good prediction ability for hepatic fat content and hepatic steatosis (at all time-points) in a ROC analysis. The model improved when weight loss was included in the panel (NC-ROC: 0.982 for steatosis degree). NC and ratios combined with ALT and HOMA-IR showed a good prediction ability for hepatic fat during the intervention. Thus, their application in clinical practice could improve the prevention and management of NAFLD.
Introducción: América Latina a cinco décadas de seguir las políticas económicas y fiscales del Fondo Monetario Internacional y del Banco Mundial, que la llevarían al crecimiento y desarrollo y en las que los Estados-gobiernos se centraron para construir la democracia, sin tener el efecto deseado, al contrario, la región está viviendo en la violencia más profunda y creciente, sumado al reto de la COVID-19. Objetivo: Conocer las causas que originaron esta situación, que afecta a la población vulnerable, que sufre la violencia en varios entornos y con efectos diversos. Metodología: Cualitativa (1970-2020); en lo histórico, económico, social, de desarrollo, de crecimiento y bienestar en la región, siguiendo los postulados de Amartya Sen del año 2000 con relación al ejercicio de las libertades de la población y su bienestar. Se prefirieron las revisiones, estados del arte, estudios y análisis. Resultados: Se encontró que el modelo económico colapsó desde 1980 pues fundamentó su base económica solo en los recursos naturales. Continuó la dependencia externa. Las políticas económicas, fiscales y asistenciales tampoco fueron efectivas. La población se quedó sin educación y empleo, generando migración creciente, pobreza extrema y vulnerabilidad. Centroamérica es la zona más golpeada ya que sus habitantes son mayoritariamente rurales e indígenas. Actualmente se sigue el mismo modelo. Regresó la violencia de las fuerzas policiales y esta se detonó también en la población como mecanismo de defensa y sobrevivencia. Conclusiones: Los hallazgos demuestran el fracaso del modelo; las políticas nunca consideraron la capacidad contributiva real, ni las demandas de educación, empleo, seguridad y bienestar. Finalmente, los efectos de la pandemia en la región, corroboran lo endeble del sistema de salud, la fragilidad de las economías y a nivel social, el inminente incremento de población vulnerable con futuro incierto.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.