Non-invasive diagnosis: non-alcoholic fatty liver disease and alcoholic liver disease

Altamirano, José; Qi, Qiaochu; Choudhry, Sabina; Abdallah, Mohamed; Singal, Ashwani K.; Humar, Abhinav; Bataller, Ramón; Borhani, Amir A.; Duarte‐Rojo, Andrés

doi:10.21037/tgh.2019.11.14

Cited by 34 publications

(37 citation statements)

References 97 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The chosen diagnostic method can lead to over-or underestimation of the disease. Abdominal US, computerized tomography, magnetic resonance imaging (MRI), controlled attenuation parameter (CAP) by transient elastography (TE), and MRI-derived proton density fat fraction (PDFF-MRI) are the noninvasive imaging methods for prediction of hepatic steatosis (22)(23)(24). Although abdominal US has low sensitivity of, it is still routinely and widely used in daily clinical practice due to its availability and cost-effectiveness (25).…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Metabolic Associated Fatty Liver Disease in The Turkish Population: A Multicenter Study

Yılmaz¹

2021

Hepatology Forum

View full text Add to dashboard Cite

Background and Aim:The aim of the present study was to investigate the prevalence of metabolic associated fatty liver disease (MAFLD) in patients with dyspepsia. Methods:Between January 2019 and December 2019, a total of 909 consecutive patients with complaint of dyspepsia were included.Results: Their median age was 47 years. Among them, 30.3% of the patients were obese, 18.8% had type 2 diabetes mellitus, 35.1% had metabolic syndrome, 84.8% had dyslipidemia, and 23.9% had hypertension.The prevalence of MAFLD was found to be 45.5%. Among those patients with MAFLD prevalence of obesity, type 2 diabetes mellitus, metabolic syndrome, dyslipidemia, and hypertension were 43.3%, 24.9%, 52.5%, 92.3% and 31.9%, respectively. MAFLD was significantly associated with all the metabolic comorbidities (p<0.001). The median FIB-4 score of the MAFLD patients was 0.88 [0.1-9.5]. Of note, 53 patients with hepatic steatosis did not meet the MAFLD criteria.In Conclusion, based on the results of the present study, the prevalence of MAFLD is found to be significantly high in daily clinical practice in Turkey. Early diagnosis and prevention efforts should be aimed to reduce disease progression, which highlight application of a region based implementation strategy in our country.

show abstract

Section: Discussionmentioning

confidence: 99%

The Prevalence of Metabolic Associated Fatty Liver Disease in The Turkish Population: A Multicenter Study

Yılmaz¹

2021

Hepatology Forum

View full text Add to dashboard Cite

show abstract

“…Although liver biopsy is recommended as the gold standard for the diagnosis and staging of fibrosis, due to its invasive nature and other disadvantages, indirect assessments of liver fibrosis have been developed and are widely used. These include blood-based biomarkers (APRI, FIB-4, enhanced liver fibrosis, Fibro Test) and image-based techniques (US, transient elastography, shear wave elastography, Magnetic resonance elastography) as well as innovative methods that uses combined modalities including advanced magnetic resonance imaging sequences like diffusion-weighted magnetic resonance imaging and genetic testing[ 41 , 42 ].…”

Section: Discussionmentioning

confidence: 99%

Longitudinal decrease in platelet counts as a surrogate marker of liver fibrosis

Gotlieb¹,

Schwartz²,

Zelber‐Sagi³

et al. 2020

WJG

View full text Add to dashboard Cite

BACKGROUND Liver cirrhosis is a significant source of morbidity and mortality worldwide. The disease is usually indolent and asymptomatic early in its course while many cirrhotic patients are diagnosed late when severe complications occur. A major challenge is to diagnose advanced fibrosis as early as possible, using simple and non-invasive diagnostics tools. Thrombocytopenia represents advanced fibrosis and portal hypertension (HTN) and most non-invasive scores that predict liver fibrosis incorporate platelets as a strong risk factor. However, little is known about the association between longitudinal changes in platelet counts (PTC), when still within the normal range, and the risk of cirrhosis. AIM To explore whether platelet counts trajectories over time, can predict advanced liver fibrosis across the different etiologies of liver diseases. METHODS A nested case-control study utilizing a large computerized database. Cirrhosis cases ( n = 5258) were compared to controls ( n = 15744) matched for age and sex at a ratio of 1:3. All participants had multiple laboratory measurements prior to enrollment. We calculated the trends of PTC, liver enzymes, bilirubin, international normalized ratio, albumin and fibrosis scores (fibrosis-4 and aspartate transaminase-to-platelet ratio index) throughout the preceding 20 years prior to cirrhosis diagnosis compared to healthy controls. The association between PTC, cirrhosis complications and fibrosis scores prior to cirrhosis diagnosis was investigated. RESULTS The mean age in both groups was 56 (SD 15.8). Cirrhotic patients were more likely to be smokers, diabetic with chronic kidney disease and had a higher prevalence of HTN. The leading cirrhosis etiologies were viral, alcoholic and fatty liver disease. The mean PTC decreased from 240000/μL to 190000/μL up to 15 years prior to cirrhosis diagnosis compared to controls who’s PTC remained stable around the values of 240000/μL. This trend was consistent regardless of sex, cirrhosis etiology and was more pronounced in patients who developed varices and ascites. Compared to controls whose values remained in the normal range, in the cirrhosis group aspartate aminotransferase and alanine aminotransferase, increased from 40 U/L to 75 U/L and FIB-4 increased gradually from 1.3 to 3 prior to cirrhosis diagnosis. In multivariable regression analysis, a decrease of 50 units in PTC was associated with 1.3 times odds of cirrhosis (95%CI 1.25-1.35). CONCLUSION In the preceding years before the diagnosis of cirrhosis, there is a progressive decline in PTC, within the normal range, matched to a gradual increase in fibrosis scores.

show abstract

“…The steatosis degree can be graded as mild, moderate and severe [61]. Importantly, some clinical variables as race, BMI, and T2D are known to affect this image-based method and further adjustments are needed to improve its accuracy [74]. In addition, TE is a valuable tool for detection of fibrosis, an important prognostic marker of liver disease.…”

Section: Multistep Approach For Nafld Diagnosis and Follow-upmentioning

confidence: 99%

“…The high cost and lack of availability are limitations of these methods. MRE may be recommended in selected cases, when the TE has lower accuracy, for instance in patients with ascites or severe obesity [74].…”

Section: Multistep Approach For Nafld Diagnosis and Follow-upmentioning

confidence: 99%

NAFLD as a continuum: from obesity to metabolic syndrome and diabetes

Godoy-Matos

Júnior

Valério

2020

Diabetol Metab Syndr

414

287

View full text Add to dashboard Cite

Background: The prevalence of non-alcoholic fatty liver disease (NAFLD) has been increasing rapidly. It is nowadays recognized as the most frequent liver disease, affecting a quarter of global population and regularly coexisting with metabolic disorders such as type 2 diabetes, hypertension, obesity, and cardiovascular disease. In a more simplistic view, NAFLD could be defined as an increase in liver fat content, in the absence of secondary cause of steatosis. In fact, the clinical onset of the disease is a much more complex process, closely related to insulin resistance, limited expandability and dysfunctionality of adipose tissue. A fatty liver is a main driver for a new recognized liver-pancreatic α-cell axis and increased glucagon, contributing to diabetes pathophysiology. Main text: This review will focus on the clinical and pathophysiological connections between NAFLD, insulin resistance and type 2 diabetes. We reviewed non-invasive methods and several scoring systems for estimative of steatosis and fibrosis, proposing a multistep process for NAFLD evaluation. We will also discuss treatment options with a more comprehensive view, focusing on the current available therapies for obesity and/or type 2 diabetes that impact each stage of NAFLD. Conclusion: The proper understanding of NAFLD spectrum-as a continuum from obesity to metabolic syndrome and diabetes-may contribute to the early identification and for establishment of targeted treatment.

show abstract

Non-invasive diagnosis: non-alcoholic fatty liver disease and alcoholic liver disease

Cited by 34 publications

References 97 publications

The Prevalence of Metabolic Associated Fatty Liver Disease in The Turkish Population: A Multicenter Study

The Prevalence of Metabolic Associated Fatty Liver Disease in The Turkish Population: A Multicenter Study

Longitudinal decrease in platelet counts as a surrogate marker of liver fibrosis

NAFLD as a continuum: from obesity to metabolic syndrome and diabetes

Contact Info

Product

Resources

About