BackgroundNonalcoholic fatty liver disease (NAFLD) is among the most common chronic diseases of the modern world with a wide variety of factors including genetic, environmental and metabolic. The aim of this study was to verify the association between the degrees of hepatic steatosis at the abdominal ultrasound and the values of aminotransferases (aspartate aminotransferase (AST) and alanine transferase (ALT)), gamma glutamyl transpeptidase (GGT) and homeostasis model assessment-insulin resistance (HOMA-IR) index.MethodsA prospective, descriptive survey study, using a quantitative analytical examination, was conducted from July 2013 to July 2014. In the statistical analysis, values were expressed as median, first and third quartiles. We used the nonparametric Kruskal-Wallis test to compare the medians between the degrees of steatosis, adopted a statistical significance of 5% (P ≤ 0.05) and used the statistical program SPSS 22.0.ResultsWe diagnosed 233/800 (29.1%) patients with hepatic steatosis on routine ultrasound, and 65.7% were female. Regarding degrees, 119 had grade 1 (51.0%), 94 grade 2 (40.4%) and 20 grade 3 (8.6%). The median age of the patients with grade 1, 2 or 3 did not vary significantly (P > 0.05). The median body mass index (BMI), although clinically important because of its elevation, did not differ significantly (P > 0.05). ALT levels increased as the degree of hepatic steatosis has advanced as well as the levels of AST, GGT and HOMA-IR. AST values showed a greater association with the severity of fatty liver (P = 0.0001) than the ALT (P = 0.001).ConclusionsALT, AST, GGT and HOMA-IR are associated to the degrees of hepatic steatosis on ultrasound and can help in the selection of patients for the liver histological evaluation.
1. The portal blood flow was bigger in patients that the serum level of GGT was bigger; 2. the gamma-glutamil transferase is the variable of the hepatic screening evaluation more representative of the portal flow influence in hepatic functional activity in patients with hepatosplenic schistosomiasis, and 3. probably, the different surgeries through hemodynamics modifications, are beneficial in to diminish the degree of cholestasis or in decrease the microssomal induction.
ObjectiveTo estimate the prevalence and evaluate sonographic findings compatible with changes consistent with hepatic steatosis in patients referred for abdominal ultrasonography at four reference centers in Aracaju, SE, Brazil.Materials and MethodsProspective, descriptive survey, with analytical and quantitative approach, comprising abdominal ultrasonography scans performed with a convex, dynamic 3.75 MHz transducer. Liver dimensions and parenchymal echotexture were evaluated, classifying hepatic steatosis into grades (1, 2 or 3). The SPSS® 22.0 software was used for statistical analysis, adopting p < 0.05 as significance level.ResultsA total of 800 individuals (561 women and 239 men) were evaluated. The prevalence of steatosis was 29.1%, and the male patients were most affected, presenting with more advanced grades of disease (p = 0.021), as follows: 119 grade 1 (51.0%); 94 grade 2 (40.4%); and 20 grade 3 (8.6%). The median age patients' was 46 years.ConclusionIn the present study sample, the prevalence of hepatic steatosis was high, particularly in the male patients. Ultrasonography is suggested as a first choice for the diagnosis of this condition, considering its wide availability, low cost and absence of side effects or risks to the patient.
BACKGROUND: Non-alcoholic fatty liver disease is characterized by deposition of lipids in the hepatic parenchyma exceeding 5% of liver weight in the absence of other conditions, such as viral or alcoholic hepatitis and metabolic disease. Non-alcoholic fatty liver disease is the most common form of chronic liver disease in several countries. In addition to liver complications, recent studies have shown a relation between liver fat and sarcopenia. OBJECTIVE: Determine the association between sarcopenia and the severity of non-alcoholic hepatic steatosis diagnosed by abdominal ultrasonography. METHODS: A clinical, cross-sectional study was conducted with a sample of male and female adults (18 to 70 years of age) submitted to ultrasonography for the investigation of non-alcoholic hepatic steatosis. Evaluations were also performed for the determination of upper and lower limb muscle strength. Data analysis was performed with the aid of the SPSS 22.0 program and involved ANCOVA and the Bonferroni post hoc test, with P-value <0.05 considered indicative of statistical significance. RESULTS: One hundred two patients were submitted to abdominal ultrasonography, 57.8% of whom presented some degree of non-alcoholic hepatic steatosis. The presence and degree of fatty liver infiltration were significantly associated with the sarcopenic index, determined by the ratio between upper and lower limb strength and BMI (P=0.009 and post-test P=0.028 for upper limbs; P=0.006 and post-test P=0.013 for lower limbs). CONCLUSION: In the present study, an association was found between the sarcopenic index and non-alcoholic hepatic steatosis, with an inversely proportional relation between this index and the severity of fatty infiltration. This finding offers further evidence of the metabolic interaction of the liver, adipose tissue and muscle.
Objetivo: Avaliar o perfil metabólico e antropométrico dos pacientes obesos e não obesos portadores de esteatose hepática não alcoólica diagnosticados pela ultrassonografia abdominal. Métodos: Estudo clínico e prospectivo realizado no período entre abril de 2019 a fevereiro de 2020 em um centro de referência em ultrassonografia em Aracaju - SE. Foram avaliados índice de massa corporal, circunferência abdominal e dosados glicemia de jejum, colesterol total, lipoproteínas de alta densidade, lipoproteínas de baixa densidade, lipoproteínas de muito baixa densidade e triglicerídeos de todos os pacientes. Resultados: Foram estudados 85 pacientes portadores de esteatose hepática (45 não obesos e 40 obesos). Deles, 43 pacientes corresponderam ao grau leve e 42 ao grau moderado/severo. Com relação as condições clinicas, 78 pacientes apresentaram dislipidemia, 13 tinham diabetes mellitus tipo 2, 27 tinham hipertensão arterial sistêmica, 40 apresentaram síndrome metabólica e 65 pacientes foram portadores de obesidade central. Houve associação estatisticamente significativa no grupo dos pacientes obesos para triglicerídeos e circunferência abdominal em relação a gravidade da infiltração gordurosa. Entretanto, não houve esta associação no grupo dos pacientes não obesos. Conclusão: A obesidade e as suas condições metabólicas são fatores de risco para a gravidade da esteatose hepática não alcóolica.
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