Diagnostic accuracy of a noninvasive hepatic ultrasound score for non-alcoholic fatty liver disease (NAFLD) in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Abstract

CONTEXT AND OBJECTIVE: Noninvasive strategies for evaluating non-alcoholic fatty liver disease (NAFLD) have been investigated over the last few decades. Our aim was to evaluate the diagnostic accuracy of a new hepatic ultrasound score for NAFLD in the ELSA-Brasil study. DESIGN AND SETTINGS: Diagnostic accuracy study conducted in the ELSA center, in the hospital of a public university. METHODS: Among the 15,105 participants of the ELSA study who were evaluated for NAFLD, 195 individuals were included in this sub-study. Hepatic ultrasound was performed (deep beam attenuation, hepatorenal index and anteroposterior diameter of the right hepatic lobe) and compared with the hepatic steatosis findings from 64-channel high-resolution computed tomography (CT). We also evaluated two clinical indices relating to NAFLD: the fatty liver index (FLI) and the hepatic steatosis index (HSI). RESULTS: Among the 195 participants, the NAFLD frequency was 34.4%. High body mass index, high waist circumference, diabetes and hypertriglyceridemia were associated with high hepatic attenuation and large anteroposterior diameter of the right hepatic lobe, but not with the hepatorenal index. The hepatic ultrasound score, based on hepatic attenuation and the anteroposterior diameter of the right hepatic lobe, presented the best performance for NAFLD screening at the cutoff point

Prevalence of Fatty Liver and Its Association With High Total Cholesterol in People of Tumkur, India

“…Severity of fatty liver was classified according to the following modified scoring system: brightness compared to kidneys (0 -3), blurring of gall bladder wall (0-3), blurring of hepatic veins (0 -3), blurring of portal vein (0 -3), far gain attenuation (0 -3). Severity was defined as mild (total scores of 2-6), moderate, (7)(8)(9)(10) and severe (11)(12)(13)(14)(15) fatty liver.…”

“…Among these criteria, deepbeam attenuation has presented better performance for diagnosing fatty liver disease. [6,7] A high Total Cholesterol (TC) level is associated with the risk of coronary heart disease [8,9] and abnormal glucose metabolism. [6] We investigated the prevalence of NAFLD in association with total cholesterol levels whether it is significantly associated with those with high total cholesterol levels.…”

Chronic kidney disease - determinants of progression and cardiovascular risk. PROGREDIR cohort study: design and methods

“…Liver images were obtained using standard equipment (Toshiba SSA-770A Aplio, Japan) and a broadband convex transducer (PVT-375BT) with a central frequency of 3.5 MHz (2.5-5.5 MHz). 16 The carotid-femoral pulse-wave velocity (PWV) was measured Carotid intimal-media thickness (IMT) was assessed in all patients in a standardized manner using a device (Aplio XG, Toshiba) with a 7.5 MHz linear transducer. The technique used for IMT measurement was as previously published.…”

Avaliação do desempenho do escore de hipertensão a curto prazo do \"Framingham Heart Study\" no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil)

“…horas. Todas as amostras são analisadas para exames-padrão e várias alíquotas ficam armazenadas em uma central de criobiologia para estudos posteriores(Pereira et al, 2013).Exames sonográficos foram feitos para determinação em artéria carótida comum do espessamento da camada médio intimal (Santos et al,2014) e para determinação de esteatose hepática(Goulart et al, 2015). Em São Paulo, realizou-se a determinação do escore de cálcio em território arterial coronariano(Pereira et al, 2016).A identificação de eventos nos participantes do ELSA-Brasil é realizada anualmente por contato telefônico, para permitir que se confirmem as seguintes situações: estado vital (vivo ou morto), doença coronariana, acidente vascular cerebral (AVC) e outras afecções cardiovasculares, cânceres e internações por causas diversas.…”

“…Análise do NRI (Net Reclassification Index) entre os escores ajustados de Framingham e ELSA-Brasil Como descrito anteriormente, os modelos de previsão têm limitações(20) (54). A maioria dos estudos foi realizada em coortes com outros objetivos.…”