Liver Fat Scores for Noninvasive Diagnosis and Monitoring of Nonalcoholic Fatty Liver Disease in Epidemiological and Clinical Studies

Abstract

Nonalcoholic fatty liver disease (NAFLD) is strongly associated with the metabolic syndrome and type 2 diabetes and independently contributes to long-term complications. Being often asymptomatic but reversible, it would require population-wide screening, but direct diagnostics are either too invasive (liver biopsy), costly (MRI) or depending on the examiner’s expertise (ultrasonography). Hepatosteatosis is usually accommodated by features of the metabolic syndrome (e.g. obesity, disturbances in triglyceride and glucose metabolism), and signs of hepatocellular damage, all of which are reflected by biomarkers, which poorly predict NAFLD as single item, but provide a cheap diagnostic alternative when integrated into composite liver fat indices. Fatty liver index, NAFLD LFS, and hepatic steatosis index are common and accurate indices for NAFLD prediction, but show limited accuracy for liver fat quantification. Other indices are rarely used. Hepatic fibrosis scores are commonly used in clinical practice, but their mandatory reflection of fibrotic reorganization, hepatic injury or systemic sequelae reduces sensitivity for the diagnosis of simple steatosis. Diet-induced liver fat changes are poorly reflected by liver fat indices, depending on the intervention and its specific impact of weight loss on NAFLD. This limited validity in longitudinal settings stimulates research for new equations. Adipokines, hepatokines, markers of cellular integrity, genetic variants but also simple and inexpensive routine parameters might be potential components. Currently, liver fat indices lack precision for NAFLD prediction or monitoring in individual patients, but in large cohorts they may substitute nonexistent imaging data and serve as a compound biomarker of metabolic syndrome and its cardiometabolic sequelae.

Hybrid Quantum Image Classification and Federated Learning for Hepatic Steatosis Diagnosis

“…Although noninvasive systems for diagnosis and staging of NALFD are being studied and tested [ 78 ], the visual analysis of histological sections on liver tissue samples obtained by biopsy or resection is still considered the gold standard. The histological analysis of steatosis is performed routinely to diagnose NAFLD or to decide about the suitability of liver grafts for transplantation.…”

Soluble CD46 as a diagnostic marker of hepatic steatosis

“… 15 , 16 Although these clinical scores are widely used in research and routine practice, it would be ideal to find a single, easily interpretable blood marker with a high discriminatory capacity that could be cost-effectively used for diagnosis, screening or monitoring treatment responses. 17 , 18…”

The Association Between Neutrophil/High-Density Lipoprotein Cholesterol Ratio and Non-Alcoholic Fatty Liver Disease in a Healthy Population

“…Liver biopsy, an invasive test, is usually not accepted by patients. 9 To fill these gaps, we explored the relationship between NHR and NAFLD in a healthy population and constructed a new model to predict NAFLD.…”