Diagnostic criteria for fatty infiltration of the liver on contrast-enhanced helical CT.

Jacobs, Jill E.; Birnbaum, Bernard A.; Shapiro, M A; Langlotz, Curtis P.; Slosman, F; Rubesin, S E; Horii, Steven C.

doi:10.2214/ajr.171.3.9725292

Cited by 164 publications

(91 citation statements)

References 15 publications

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“…With splenic attenuation acting as a control or reference value, the liver attenuation index (LAI), defined as the difference between mean hepatic attenuation and mean splenic attenuation, was used as an indicator of the degree of hepatic steatosis. Fatty liver disease was defined as a LAI below 5 HU on the unenhanced hepatic CT image at screening (21) and as an LAI below 218.5 HU on the contrastenhanced CT image (22). LAI in all subjects who underwent contrast-enhanced CT (n = 6) was evaluated between 80 and 120 s after injection of a contrast bolus.…”

Section: Ct Imagingmentioning

confidence: 99%

Improvement of Nonalcoholic Fatty Liver Disease With Carnitine-Orotate Complex in Type 2 Diabetes (CORONA): A Randomized Controlled Trial

et al. 2015

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OBJECTIVEWe aimed to evaluate the effects of carnitine-orotate complex in patients with nonalcoholic fatty liver disease (NAFLD) and diabetes. RESEARCH DESIGN AND METHODSEight hospitals in Korea participated in this randomized, controlled, double-blind trial of patients with diabetes and NAFLD. Seventy-eight patients were randomly assigned in a 1:1 ratio to receive carnitine-orotate complex (824 mg, three times daily) or matching placebo. The primary study outcome was decline in alanine aminotransferase (ALT) to the normal range. Secondary study outcomes were change in ALT, radiological hepatic steatosis, parameters for anthropometry, liver function, lipid profiles, and glycemic control. Hepatic steatosis was assessed using Hounsfield units on noncontrast computed tomography (CT) imaging with hepatic attenuation. RESULTSAfter 12 weeks of treatment, compared with placebo group, carnitine-orotate complex-treated participants had a significantly higher rate of normalization of serum ALT level (17.9% vs. 89.7%, P < 0.001). On hepatic CT analysis, participants treated with carnitine-orotate complex showed an increased liver attenuation index (0.74 6 8.05 vs. 6.21 6 8.96, P < 0.008). A significant decrease in HbA 1c was observed in the carnitine-orotate complex group (20.33 6 0.82% [23.6 6 9.0 mmol/mol], P = 0.007), but no significant change was seen in the placebo group. CONCLUSIONSTreatment with carnitine-orotate complex improves serum ALT and may improve hepatic steatosis as assessed by CT in patients with diabetes and NAFLD. Further studies using more advanced magnetic resonance imaging and liver histology as an end point are needed to assess its efficacy in NAFLD.Ectopic fat accumulation in a visceral organ is associated with insulin resistance (1). As an example of such ectopic fat accumulation, nonalcoholic fatty liver disease (NAFLD) is now recognized as the hepatic component of metabolic syndrome and is even reportedly associated with insulin resistance independent of obesity and other metabolic components. Therefore, NAFLD can be a major determinant of insulin

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Section: Ct Imagingmentioning

confidence: 99%

Improvement of Nonalcoholic Fatty Liver Disease With Carnitine-Orotate Complex in Type 2 Diabetes (CORONA): A Randomized Controlled Trial

et al. 2015

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“…A liver minus spleen attenuation difference less than or equal to −10 Hounsfi eld Units (HU) is diagnostic for fatty liver, or a liver attenuation greater than or equal to spleen attenuation excludes fatty liver. [14][15][16] Carotid ultrasound examination was performed using a 8-MHz linear array transducer with an Acuson Sequoia 512 Imaging System (Siemens Medical Solutions, Mountain View, CA). A trained vascular technician located the carotid artery bifurcation and identifi ed the maximal wall thickening in the near and far wall.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Correlates of Diabetes in South Asian Indians in the United States: Findings From the Metabolic Syndrome and Atherosclerosis in South Asians Living in America Study and the Multi-Ethnic Study of Atherosclerosis

Kanaya

Wassel

Mathur

et al. 2010

Metabolic Syndrome and Related Disorders

125

105

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Background: Individuals from South Asia have high diabetes prevalence despite low body weight. We compared the prevalence of diabetes among South Asian Indians with other U.S. ethnic groups and explored correlates of diabetes. Methods: This was a cross-sectional study of 150 South Asian Indians (ages 45-79) in California, using similar methods to the Multi-Ethnic Study of Atherosclerosis (MESA). Type 2 diabetes was classifi ed by fasting plasma glucose (FPG) ≥126 mg/dL, 2-h postchallenge glucose ≥200 mg/dL, or use of hypoglycemic medication. Results: A total of 29% of Asian Indians had diabetes, 37% had prediabetes, and 34% had normal glucose tolerance. After full adjustment for covariates, Indians still had signifi cantly higher odds of diabetes compared to whites and Latinos, but not signifi cantly different from African Americans and Chinese Americans in MESA: Indians [odds ratio (OR), 1.0], whites [OR, 0.29; 95% confi dence interval (CI), 0.17-0.49], Latinos (OR, 0.59; CI, 0.34-1.00) African Americans (OR, 0.77; CI 0.45-1.32), Chinese Americans (OR, 0.78, CI, 0.45-1.32). Variables associated with prediabetes or diabetes among Indians included hypertension, fatty liver, visceral adiposity, microalbuminuria, carotid intima media thickness, and stronger traditional Indian beliefs. Conclusions: Indian immigrants may be more likely to have diabetes than other U.S. ethnic groups, and cultural factors may play a role, suggesting that this is a promising area of research.

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“…Unenhanced CT shows low attenuation of the steatotic liver in contrast to the spleen, and the severity of steatosis correlates with the liver-spleen attenuation ratio [18,19] . However, misdiagnosis can occur when other diffuse liver conditions are present, such as hemochromatosis [20] .…”

Section: Computed Tomographymentioning

confidence: 99%

Noninvasive imaging assessment of non-alcoholic fatty liver disease: Focus on liver scintigraphy

Tovo

Mattos

Coral

et al. 2015

WJG

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Diagnostic criteria for fatty infiltration of the liver on contrast-enhanced helical CT.

Cited by 164 publications

References 15 publications

Improvement of Nonalcoholic Fatty Liver Disease With Carnitine-Orotate Complex in Type 2 Diabetes (CORONA): A Randomized Controlled Trial

Improvement of Nonalcoholic Fatty Liver Disease With Carnitine-Orotate Complex in Type 2 Diabetes (CORONA): A Randomized Controlled Trial

Prevalence and Correlates of Diabetes in South Asian Indians in the United States: Findings From the Metabolic Syndrome and Atherosclerosis in South Asians Living in America Study and the Multi-Ethnic Study of Atherosclerosis

Noninvasive imaging assessment of non-alcoholic fatty liver disease: Focus on liver scintigraphy

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