Performance and limitations of steatosis biomarkers in patients with nonalcoholic fatty liver disease

Fedchuk, Larysa; Nascimbeni, Fabio; Pais, R.; Charlotte, Frédéric; Housset, Chantal; Ratziu, Vlad

doi:10.1111/apt.12963

Cited by 386 publications

(383 citation statements)

References 57 publications

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“…All these biomarkers could diagnose steatosis and were correlated with insulin resistance. 17 However, they are confounded by fibrosis and inflammation and did not accurately quantify steatosis. The prognostic value of CAP needs to be evaluated and compared with FLI.…”

Section: Discussionmentioning

confidence: 99%

Controlled attenuation parameter for the diagnosis of steatosis in non‐alcoholic fatty liver disease

Lédinghen

Wong

Vergniol

et al. 2016

J of Gastro and Hepatol

160

130

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Background and Aim: Controlled attenuation parameter (CAP) evaluated with transient elastography (FibroScan) is a recent method for non-invasive assessment of steatosis. Its usefulness in non-alcoholic fatty liver disease (NAFLD) is unknown. We prospectively investigated the performance of CAP for the diagnosis of steatosis in NAFLD, factors associated with discordances between CAP and steatosis grades, and relationships between CAP and clinical or biological parameters. Methods: All CAP examinations performed in NAFLD patients with a liver biopsy performed within 1 week of CAP measurement were included. Liver biopsies were assessed for activity and fibrosis stage, NAFLD activity score, and steatosis graded as follows: S0, steatosis < 5%; S1, 5-33%; S2, 34-66%; S3, >66%. Results: Two hundred sixty-one patients (59% male, age 56 years) from two ethnic groups were included. No patient had steatosis < 5%. The area under the receiver-operating characteristics curve of CAP for steatosis ≥S2 and S3 was 0.80 and 0.66, respectively. At a cutoff value of 310 dB/m, the sensitivity, specificity, and positive and negative predictive values for ≥S2 steatosis were 79%, 71%, 86%, and 71%, respectively. Discordance of at least one grade between CAP and steatosis was observed in 81 patients. By multivariate analysis, only steatosis S2S3 was associated with no discordance. By multivariate analysis, only BMI ≥ 30 kg/m 2 was significantly associated with CAP > 310 dB/m. Conclusion: The association of CAP with steatosis, especially in patients with nonalcoholic steatohepatitis, and with elevated BMI could be useful for the diagnosis and follow-up of NAFLD patients.

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Section: Discussionmentioning

confidence: 99%

Controlled attenuation parameter for the diagnosis of steatosis in non‐alcoholic fatty liver disease

Lédinghen

Wong

Vergniol

et al. 2016

J of Gastro and Hepatol

160

130

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“…It has been shown that stage 2 fibrosis has highest misclassification rate on noninvasive techniques. 7,26,27 In spite of this till today LB is used in suspected cases of autoimmune hepatitis, primary sclerosing cholangitis, primary biliary cholangitis, NASH, cryptogenic cirrhosis, infections such as CMV or EBV, and liver tumors not well defined by imaging techniques. 6 With this reference, a study was planned to determine utility of LB in day-to-day hepatology practice.…”

Section: Discussionmentioning

confidence: 99%

Indications of Liver Biopsy in the Era of Noninvasive Assessment of Liver Fibrosis

Amarapurkar

Amarapurkar²

2015

Journal of Clinical and Experimental Hepatology

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Background: Liver biopsy (LB) has been used as diagnostic modality in liver diseases (LD). Over last two decades, there has been remarkable improvement in understanding of natural history, molecular diagnostics of viral hepatitis, genetic of LD, and also limitations of LB. There is current trend in avoiding LB in the management of various LDs. Aim: To determine utility of LB in clinical practice. Material and Methods: In a prospective study, 2413 patients of LD were followed up, 219 (9%) were acute, and remaining 2194 (90.9%) were chronic LD. Patients were evaluated by biochemical parameters, virological studies, and imaging endoscopy as and when required. LB was performed in 176 (7.2%) patients when no conclusion could be drawn from the noninvasive workup. Patients with platelet count <50,000/cm 2 , ascites, and overt bleeding were excluded. Patients with international normalization ratio (INR) more than 1.5 were not excluded. No prophylactic use of fresh frozen plasma and platelet transfusion was done. There was no major complication related to the procedure. Indications for LB were as follows: cryptogenic LD 38 cases, hepatitis B infection 35, suspected autoimmune hepatitis 30, mass lesion in the liver and lymphoma 29, evaluation of portal hypertension 15, elevated liver enzymes 11, hepatitis C infection 9, and drug-induced LD 4, and miscellaneous 5 cases which were primary biliary cholangitis, primary sclerosing cholangitis, cholestatic LD, sarcoidosis, and amyloidosis. Results: LB changed the diagnosis in 55 (31.2%). These were cryptogenic LD in 24 cases, portal hypertension 15, elevated liver enzymes 11, and 5 others. In remaining, LB confirmed clinical diagnosis and helped in making management decisions. Conclusion: LB was required in 7.2% of patients with chronic LD. In 31.2% cases, LB changed the diagnosis. LB was a safe procedure even in presence of low platelet count and abnormal INR. ( J CLIN EXP HEPATOL 2015;5:314-319)

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“…Têm a vantagem de prever também o aparecimento de complicações metabólicas, hepáticas e cardiovasculares. 26 No entanto, têm mais aplicabilidade em estudos populacionais/epidemiológicos, pois, considerando o indivíduo, a esteatose deve ser identificada preferencialmente por ecografia.…”

Section: Diagnósticounclassified

Fígado Gordo Não Alcoólico: Revisão da Literatura

Matos

2017

Gaz Med

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RESUMO:O fígado gordo não alcoólico é uma situação extremamente frequente na prática clínica, e rapidamente se está a tornar uma epidemia do mundo desenvolvido. Pode ser uma doença evolutiva, causadora de cirrose e insuficiência hepática terminal, ocupando já em alguns países um lugar destacado como causa de transplante hepático. Pretende-se fazer uma revisão da literatura e apresentar sucintamente os conceitos de gordo/esteato-hepatite, rever os meios e estratégias diagnósticas, a evolução e o prognóstico, e as formas de tratamento atuais e previsíveis num futuro próximo. PALAVRAS-CHAVE: Hepatopatia Gordurosa não Alcoólica ABSTRACT: Non-alcoholic fatty liver disease is a very common finding in clinical practice, and it is quickly becoming a developed world epidemic. It may progress to cirrhosis and terminal liver failure, and in some countries it is already a major indication for liver transplantation.We aim to do a literature review and briefly present the concepts of fatty liver / steatohepatitis, to review diagnosis methods, disease evolution and prognosis, and to approach current treatment strategies and the foreseeable ones in near future.

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Performance and limitations of steatosis biomarkers in patients with nonalcoholic fatty liver disease

Cited by 386 publications

References 57 publications

Controlled attenuation parameter for the diagnosis of steatosis in non‐alcoholic fatty liver disease

Controlled attenuation parameter for the diagnosis of steatosis in non‐alcoholic fatty liver disease

Indications of Liver Biopsy in the Era of Noninvasive Assessment of Liver Fibrosis

Fígado Gordo Não Alcoólico: Revisão da Literatura

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