Non-invasive diagnosis of nonalcoholic fatty liver disease: impact of age and other risk factors

Bayrak, Muharrem

doi:10.1080/13685538.2020.1763293

Cited by 6 publications

(4 citation statements)

References 45 publications

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“…The prevalence of NAFLD varies widely; it affects approximately 25% of individuals across the globe (7,8). Its relatively high prevalence even in apparently healthy Turkish individuals underlines the importance of early recognition of MAFLD in daily clinical practice (9)(10)(11)(12). Unfortunately, early diagnosis of MAFLD constitutes a major clinical challenge owing to its usually asymptomatic presentation.…”

Section: Introductionmentioning

confidence: 99%

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

Yılmaz¹

2021

Hepatology Forum

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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.

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Section: Introductionmentioning

confidence: 99%

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

Yılmaz¹

2021

Hepatology Forum

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“…In addition, the AST/ALT ratio is a marker for chronic liver disease (NAFLD or HCV disease, etc.) ( 16 , 46 ). The risk of diabetes and prediabetes is related to some chronic liver diseases (NAFLD or HCV disease, etc.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have reported that the AST to ALT ratio (AST/ALT ratio) accurately identifies insulin resistance (IR) and is considered a potential biomarker (13). Furthermore, some researchers have revealed that the AST/ALT ratio may also be useful for assessing disease risks, such as NAFLD, diabetes mellitus, hyperinsulinemia, cardiovascular disease, and metabolic syndrome (14)(15)(16)(17). These findings all indicated the AST/ALT ratio is a good indicator of blood glucose metabolism.…”

Section: Introductionmentioning

confidence: 99%

Nonlinear relationship between aspartate aminotransferase to alanine aminotransferase ratio and the risk of prediabetes: A retrospective study based on chinese adults

Cao¹,

Zhang²,

Yuan

et al. 2022

Front. Endocrinol.

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ObjectiveRecent evidence has revealed that the aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT ratio) may be closely associated with metabolic syndrome and insulin resistance. However, it is unclear whether the AST/ALT ratio correlates with prediabetes risk. The aim of our study was to examine the association between AST/ALT ratios and the risk of prediabetes among a large cohort of Chinese subjects.MethodsThis retrospective cohort study recruited 75204 Chinese adults with normoglycemia at baseline who underwent physical examinations at the Rich Healthcare Group from 2010 to 2016. The AST/ALT ratio at baseline was the target independent variable, and the risk of developing prediabetes during follow-up was the dependent variable. Cox proportional-hazards regression was used to evaluate the independent association between the AST/ALT ratio and prediabetes. This study identified nonlinear relationships by applying a generalized additive model (GAM) and smooth curve fitting. In order to assess the robustness of this study, we performed a series of sensitivity analyses. Moreover, we performed a subgroup analysis to evaluate the consistency of the association in different subgroups. Data from this study have been updated on the DATADRYAD website.ResultsThe AST/ALT ratio was negatively and independently related to the prediabetes risk among Chinese adults (HR: 0.76, 95% CI: 0.75-0.84, P<0.0001) after adjusting demographic and biochemical covariates. Furthermore, a nonlinear relationship between the AST/ALT ratio and the risk of developing prediabetes was found at an inflection point of 1.50 for the AST/ALT ratio. When the AST/ALT ratio was to the left of the inflection point (AST/ALT ratio ≤ 1.50), the AST/ALT ratio was negatively related to the prediabetes risk (HR:0.70, 95%CI: 0.65-0.76, P<0.0001). In contrast, the relationship tended to be saturated when the AST/ALT ratio was more than 1.50 (HR: 1.01, 95%CI: 0.89-1.15, P=0.8976). Our findings remained robust across a range of sensitivity analyses. Subgroup analysis revealed that other variables did not alter the relationship between the AST/ALT ratio and prediabetes risk.ConclusionThis study revealed that AST/ALT ratio was negatively and independently associated with prediabetes risk among Chinese participants. The relationship between the AST/ALT ratio and prediabetes risk was nonlinear, and AST/ALT ratio ≤ 1.50 was strongly inversely correlated with prediabetes risk.

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“…Our study results show that the TyG index and the TG/HDL ratio, markers of IR, are useful for detecting NAFLD, with a diagnostic performance comparable to that of the HOMA-IR index. As IR plays a central pathogenic role in NAFLD development [ 32 ], indirect markers of IR could be the first step for early detection of this disease. Isokuortti et al reported that a cutoff point of 1.9 for the HOMA index had 87% sensitivity and 79% specificity to detect the presence of NAFLD [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Insulin Resistance Markers to Detect Nonalcoholic Fatty Liver Disease in a Male Hispanic Population

Pérez-Mayorga

López‐López

Chacon-Manosalva

et al. 2022

Canadian Journal of Gastroenterology and Hepatology

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Background. Nonalcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease and is closely associated with cardiometabolic disorders, being insulin resistance (IR) the common pathogenic mechanism. The triglycerides/glucose (TyG) index and triglycerides/HDL-c (TG/HDL) ratio are markers correlated with IR. We compared the capacity of these two indexes, alongside IR, to detect NAFLD. Methods. In a cross-sectional cohort study, we examined 263 active military personnel from the Colombian Air Force, aged between 29 and 54 years. Anthropometric measurements and biochemical determinations (glycemia, lipid profile, and insulin) were obtained, and ultrasound studies were performed to evaluate the presence of NAFLD. HOMA-IR index was calculated as (fasting insulin (µIU/mL) × fasting glucose (mmol/L)/22.5), the TyG index as Ln (triglycerides (mg/dL) × fasting glucose (mg/dL)/2), and the TG/HDL ratio as (triglycerides (mg/dL)/HDL-c (mg/dL)). Results. NAFLD ultrasound criteria were met in 70 individuals (26.6%). Subjects with NAFLD had significantly higher values of HOMA-IR (2.55 ± 1.36 vs. 1.51 ± 0.91), TyG (9.17 ± 0.53 vs. 8.7 ± 0.51), and TG/HDL (6.6 ± 4.54 vs. 3.52 ± 2.32) compared to those without NAFLD p < 0.001 . A TyG cutoff point of 8.92 showed an AUC of 0.731, while cutoff points of 3.83 for TG/HDL and 1.68 for HOMA-IR showed an AUC of 0.766 and 0.781, respectively. Conclusion. Our study shows that novel and lower-cost markers of IR are useful for detecting NALFD, with a performance comparable to the HOMA-IR index. These markers should be used as the first step when screening patients for NAFLD.

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Non-invasive diagnosis of nonalcoholic fatty liver disease: impact of age and other risk factors

Cited by 6 publications

References 45 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

Nonlinear relationship between aspartate aminotransferase to alanine aminotransferase ratio and the risk of prediabetes: A retrospective study based on chinese adults

Insulin Resistance Markers to Detect Nonalcoholic Fatty Liver Disease in a Male Hispanic Population

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