Clinical value of liver ultrasound for the diagnosis of nonalcoholic fatty liver disease in overweight and obese patients

Bril, Fernando; Ortiz-López, Carolina; Lomonaco, Romina; Orsak, Beverly; Freckleton, Michael W.; Chintapalli, Kedar N.; Hardies, Jean; Lai, Song; Estrada-Solano, Felipe; Tio, Fermin O.; Cusi, Kenneth

doi:10.1111/liv.12840

Cited by 190 publications

(139 citation statements)

References 32 publications

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“…The diagnosis of NAFLD was based on ultrasonography, which was generally considered not accurate enough. It is known that the sensitivity of liver ultrasonography (parenchymal echo alone) is not optimal for hepatic fat content <12.5%, However, using a combination of hepatic/renal ratio and hepatic attenuation index, liver ultrasonography showed significant improvements in diagnostic performance in both sensitivity and specificity. Another limitation of the present study was that the telomere length was determined in peripheral blood leukocytes, but not in the liver.…”

Section: Discussionmentioning

confidence: 75%

Deoxyribonucleic acid telomere length shortening can predict the incidence of non‐alcoholic fatty liver disease in patients with type 2 diabetes mellitus

Ping

Li²,

et al. 2016

J of Diabetes Invest

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Aims/IntroductionTo investigate the effect of telomere shortening and other predictive factors of non‐alcoholic fatty liver disease (NAFLD) in type 2 diabetes mellitus patients in a 6‐year prospective cohort study.Materials and MethodsA total of 70 type 2 diabetes mellitus (mean age 57.8 ± 6.7 years) patients without NAFLD were included in the study, and 64 of them were successfully followed up 6 years later, excluding four cases with significant alcohol consumption. NAFLD was diagnosed by the hepatorenal ratio obtained by a quantitative ultrasound method using NIH image analysis software. The 39 individuals that developed NAFLD were allocated to group A, and the 21 individuals that did not develop NAFLD were allocated to group B. Fluorescent real‐time quantitative polymerase chain reaction was used to measure telomere length.ResultsThere was no significant difference between the two groups in baseline telomere length; however, at the end of the 6th year, telomere length had become shorter in group A compared with group B. There were significant differences between these two groups in baseline body mass index, waistline, systolic blood pressure, glycated hemoglobin and fasting C‐peptide level. In addition, the estimated indices of baseline insulin resistance increased in group A. Fasting insulin level, body mass index, systolic blood pressure at baseline and the shortening of telomere length were independent risk factors of NAFLD in type 2 diabetes mellitus patients.ConclusionsTelomere length became shorter in type 2 diabetes mellitus patients who developed NAFLD over the course of 6 years. Type 2 diabetes mellitus patients who developed NAFLD had more serious insulin resistance compared with those who did not develop NAFLD a long time ago.

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Section: Discussionmentioning

confidence: 75%

Deoxyribonucleic acid telomere length shortening can predict the incidence of non‐alcoholic fatty liver disease in patients with type 2 diabetes mellitus

Ping

Li²,

et al. 2016

J of Diabetes Invest

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show abstract

“…Published data regarding the role of NAFLD in predicting the development of incident T2D appear to be fully consistent in our study, given that they span over a small interval of RRs (ranging from 1.58 for AST to 1.97 for ALT), irrespective of the diagnostic criterion for NAFLD. This is of clinical importance in as much as serum liver enzyme levels are deemed to have a relatively poor sensitivity and specificity in the diagnosis of NAFLD, while US is deemed to have a sensitivity threshold for hepatic steatosis on histology as low as ≤ 20% . In other words, our results suggest that the presence of NAFLD per se , irrespective of severity of fatty liver infiltration, may be a risk factor increasing of up to two‐fold the risk of developing T2D over a median period of 5 years.…”

Section: Discussionmentioning

confidence: 76%

Nonalcoholic fatty liver disease is associated with an almost twofold increased risk of incident type 2 diabetes and metabolic syndrome. Evidence from a systematic review and meta‐analysis

Ballestri

Zona

Targher

et al. 2016

J of Gastro and Hepatol

594

465

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Background and Aim:: The magnitude of the risk of incident type 2 diabetes (T2D) and metabolic syndrome (MetS) among patients with nonalcoholic fatty liver disease (NAFLD) is poorly known. We gauged the risk of developing T2D and MetS in patients with NAFLD diagnosed by either serum liver enzymes (aminotransferases or gamma-glutamyltransferase [GGT]) or ultrasonography. Methods:: Pertinent prospective studies were identified through extensive electronic database research, and studies fulfilling enrolment criteria were included in the meta-analysis. Results: Overall, in a pooled population of 117020 patients (from 20 studies), who were followed-up for a median period of 5years (range: 3-14.7years), NAFLD was associated with an increased risk of incident T2D with a pooled relative risk of 1.97 (95% confidence interval [CI], 1.80-2.15) for alanine aminotransferase, 1.58 (95% CI, 1.43-1.74) for aspartate aminotransferase, 1.86 (95% CI, 1.71-2.03) for GGT (last vs first quartile or quintile), and 1.86 (95% CI, 1.76-1.95) for ultrasonography, respectively. Overall, in a pooled population of 81411 patients (from eight studies) who were followed-up for a median period of 4.5years (range: 3-11years), NAFLD was associated with an increased risk of incident MetS with a pooled relative risk of 1.80 (95% CI, 1.72-1.89) for alanine aminotransferase (last vs first quartile or quintile), 1.98 (95% CI, 1.89-2.07) for GGT, and 3.22 (95% CI, 3.05-3.41) for ultrasonography, respectively. Conclusions:: Nonalcoholic fatty liver disease, as diagnosed by either liver enzymes or ultrasonography, significantly increases the risk of incident T2D and MetS over a median 5-year follow-up

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“…After more than 10 years since its original description, this cut‐off point still remains widely accepted when defining NAFLD by liver 1 H‐MRS and is frequently used by our group and others . However, whether this population‐based cut‐off point reflects the threshold of IHTG content associated with metabolic and/or histological changes in patients with NAFLD remains unclear.…”

mentioning

confidence: 99%

Metabolic and histological implications of intrahepatic triglyceride content in nonalcoholic fatty liver disease

et al. 2017

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IHTG accumulation is strongly associated with adipose tissue insulin resistance (IR), supporting the current theory of lipotoxicity as a driver of IHTG accumulation. Once IHTG accumulation reaches ∼6 ± 2%, skeletal muscle IR, hypertriglyceridemia, and low HDL-C become fully established. Histological activity appears to have an early threshold and is not significantly influenced by increasing amounts of IHTG accumulation. (Hepatology 2017;65:1132-1144).

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Clinical value of liver ultrasound for the diagnosis of nonalcoholic fatty liver disease in overweight and obese patients

Cited by 190 publications

References 32 publications

Deoxyribonucleic acid telomere length shortening can predict the incidence of non‐alcoholic fatty liver disease in patients with type 2 diabetes mellitus

Deoxyribonucleic acid telomere length shortening can predict the incidence of non‐alcoholic fatty liver disease in patients with type 2 diabetes mellitus

Nonalcoholic fatty liver disease is associated with an almost twofold increased risk of incident type 2 diabetes and metabolic syndrome. Evidence from a systematic review and meta‐analysis

Metabolic and histological implications of intrahepatic triglyceride content in nonalcoholic fatty liver disease

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