Measurement of Controlled Attenuation Parameter: A Surrogate Marker of Hepatic Steatosis in Patients of Nonalcoholic Fatty Liver Disease on Lifestyle Modification - A Prospective Follow-Up Study

Paul, Jayanta; Venugopal, Raj Vigna; Peter, Lorance; Shetty, Kula Naresh Kumar; Shetti, Mohit P

doi:10.1590/s0004-2803.201800000-07

Cited by 11 publications

(6 citation statements)

References 33 publications

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“…Reported factors that are commonly associated with CAP scores include insulin resistance indicators, e.g., levels of fasting C-peptide, fasting insulin, fasting glucose, glycated hemoglobin, and homeostasis model assessment of insulin resistance [27,28]. Furthermore, BMI and the total cholesterol level, which were found to be related in our study, are considered metabolic components that have been associated with the CAP score in many previous studies [9,21,29,30]. Although the serum albumin level has not been reported previously in association with the CAP score, it can be interpreted as a reflection of nutritional parameters of the metabolic component.…”

Section: Discussionsupporting

confidence: 62%

Correlation of the grade of hepatic steatosis between controlled attenuation parameter and ultrasound in patients with fatty liver: a multi-center retrospective cohort study

Yoo

Moon

et al. 2020

Korean J Intern Med

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Background/Aims: The controlled attenuation parameter (CAP), based on transient elastography, is widely used for noninvasive assessment of the degree of hepatic steatosis (HS). We investigated the correlation of the degree HS between CAP and ultrasound (US) in patients with HS. Methods: In total, 986 patients with US-based HS who underwent transient elastography within 1 month were evaluated. The US-based grade of HS was categorized as mild (grade 1), moderate (grade 2), or severe (grade 3). Results: The CAP was significantly correlated with the US-based grade of HS (r = 0.458, p < 0.001). The median CAP value of each US-based HS grade showed a positive correlation with grade (271.1, 303.7, and 326.7 dB/m for grades 1, 2, and 3). In a multivariate analysis, the US-based HS grade, body mass index, serum albumin, alanine aminotransferase, and total cholesterol, and liver stiffness were all significantly correlated with the CAP value (all p < 0.05). The areas under the receiver operating characteristic curves for grade 2 to 3 and grade 3 HS were 0.749 (95% confidence interval [CI], 0.714 to 0.784) and 0.738 (95% CI, 0.704 to 0.772). The optimal cutoff CAP values to maximize the sum of the sensitivity and specificity for grade 2 to 3 and grade 3 HS were 284.5 dB/m (sensitivity 78.6%, specificity 61.7%) and 298.5 dB/m (sensitivity 84.6%, specificity 55.6%). Conclusions: The correlation of the degree of HS between CAP and US was significantly high in patients with HS, and the optimal cutoff CAP values for grade 2 to 3 and grade 3 HS were 284.5 and 298.5 dB/m.

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Section: Discussionsupporting

confidence: 62%

Correlation of the grade of hepatic steatosis between controlled attenuation parameter and ultrasound in patients with fatty liver: a multi-center retrospective cohort study

Yoo

Moon

et al. 2020

Korean J Intern Med

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“…Moreover, the highest rate of ultrasound attenuation occurs in fatty tissues 25 . On the other hand, the attenuation in ultrasound decreases linearly when BMI is increased independent of the patient's sex 26 . Accordingly, the ketone fold rates increased in female patients (although they were administered low EL), most of whom had a high BMI.…”

Section: Discussionmentioning

confidence: 99%

By-products of lithotripsy: Are they related to abdominal fat and wave characteristics?

Al-Naemi

Aldosky

Shukri

2019

Journal of Taibah University Medical Sciences

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Objectives This study aimed to evaluate the correlations between by-products of extracorporeal shock wave lithotripsy (ESWL) and some physical parameters such as abdominal fat, energy levels, and shock wave pulses. Methods A total of 40 patients (20 men and 20 women), aged 37.18 ± 10.64 years, with renal or ureteral stones were recruited. All patients were treated with ESWL, and their abdominal fat was measured using an Omron body fat monitor and the body mass index (BMI). Parameters such as the levels of malondialdehyde (MDA), ketones, and protein in urine were measured before and after ESWL using a Bio Doctor Analyzer. The wave characteristics of the lithotripsy procedure and the wave pulses were determined. Results The mean levels of urinary MDA and ketones showed statistically significant increases in post-ESWL compared with pre-ESWL values. The results showed significant elevations in MDA and ketones in both male and female patients. In addition, there was a significant correlation between MDA/ketones and energy levels and between ketones and BMI in female patients. The analysis also revealed that the shock wave pulse had an insignificant impact on the by-product parameters. Conclusion An energy level of ≤4 J is recommended for overweight and obese patients undergoing ESWL. In addition, measurement of the post-ESWL MDA urinary level should be performed as a routine test, especially in obese male patients.

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“…The mean (±SD) CAP value of 127 NAFLD patients enrolled in this study was 271.53 (±50.69) dB/m which corresponds to S2 steatosis. Paul et al also reported the mean CAP value of 278.57 (±49.13) dB/m in NAFLD patients during the first consultation [ 17 ]. Interestingly, 26 (20.5%) patients diagnosed to have NAFLD by USG were unable to be diagnosed with fatty liver in accordance with the standard of CAP value by FibroScan.…”

Section: Discussionmentioning

confidence: 99%

Estimation of Liver Fat by FibroScan in Patients With Nonalcoholic Fatty Liver Disease

Shrestha¹,

Kc²,

Thapa³

et al. 2021

Cureus

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BackgroundAssessment of nonalcoholic fatty liver disease (NAFLD) includes estimation of liver fat (steatosis).Controlled attenuation parameter (CAP) value obtained by FibroScan ® (Echosens, Paris, France) is an alternative to liver biopsy for diagnosing and estimating steatosis (S). This study aimed to estimate the liver fat by CAP in NAFLD patients. MethodsAn observational cross-sectional study was conducted at the Liver Unit of Bir Hospital, from January 2021 to May 2021 after ethical clearance from the Institutional Review Board of the National Academy of Medical Sciences. A convenient sampling method was used. Data were analyzed with descriptive and inferential statistics involving bivariate and multivariate analysis. ResultsA total of 127 NAFLD patients were enrolled. The mean (±SD) CAP value was 271.53 (±50.69) dB/m. Total cholesterol, triglyceride, and body mass index (BMI) correlated positively (p<0.05) while systolic blood pressure correlated negatively with CAP value (p=0.031). On multivariate analysis, patients with BMI ≥25 kg/m 2 were found 3.7 times more likely to have CAP ≥291 dB/m (S3, severe steatosis) than those with BMI <25 kg/m 2 (p=0.048, 95% CI 1.01, 13.50). The mean (±SD) CAP values were 276.19 (±49.93) and 246.60 (±48.50) dB/m among those with BMI ≥25 kg/m 2 and <25 kg/m 2 , respectively (p=0.016, using independent ttest). CAP steatosis grading correlated positively with both the ultrasound grading (p<0.001) and fibrosis grading by liver stiffness measurement (p=0.004). ConclusionIn this observational cross-sectional study of NAFLD patients, the mean (±SD) CAP value was 271.53 (±50.69) dB/m, which corresponds to moderate steatosis (S2). Obese NAFLD patients with ≥25 kg/m 2 were 3.7 times more likely to have severe steatosis (S3) than nonobese NAFLD patients with BMI <25 kg/m 2 .

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Measurement of Controlled Attenuation Parameter: A Surrogate Marker of Hepatic Steatosis in Patients of Nonalcoholic Fatty Liver Disease on Lifestyle Modification - A Prospective Follow-Up Study

Cited by 11 publications

References 33 publications

Correlation of the grade of hepatic steatosis between controlled attenuation parameter and ultrasound in patients with fatty liver: a multi-center retrospective cohort study

Correlation of the grade of hepatic steatosis between controlled attenuation parameter and ultrasound in patients with fatty liver: a multi-center retrospective cohort study

By-products of lithotripsy: Are they related to abdominal fat and wave characteristics?

Estimation of Liver Fat by FibroScan in Patients With Nonalcoholic Fatty Liver Disease

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