Radiologic Imaging in Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis

Esterson, Yonah B.; Grimaldi, Gregory

doi:10.1016/j.cld.2017.08.005

Cited by 40 publications

(22 citation statements)

References 61 publications

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“…The sensitivity of ultrasound has been reported to range from 53% to 100% and its specificity from 77% to 98%[32]. Higher diagnostic sensitivities and specificities are achieved during the evaluation of moderate to severe hepatic steatosis cases, whereas lower values are noted during all grades of hepatic steatosis[32]. The accurate diagnosis of NASH and cirrhosis can be conducted by liver biopsy.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of non-alcoholic fatty liver disease in Chinese adult hypopituitary patients

Yuan¹,

Zhu²,

Pan³

et al. 2019

WJG

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BACKGROUND Patients with hypothalamic-pituitary disease have the feature of central obesity, insulin resistance, and dyslipidemia, and there is increased prevalence of liver dysfunction consistent with non-alcoholic fatty liver disease (NAFLD) in this population. The causes of hypopituitarism in the reported studies varied and combined pituitary hormone deficiency including central diabetes insipidus is much common in this population. This retrospective cross-sectional study was performed to analyze the clinical characteristics and related factors with NAFLD and cirrhosis in Chinese adult hypopituitary/panhypopituitary patients. AIM To analyze the clinical characteristics of and related risk factors for NAFLD in Chinese adult hypopituitary patients. METHODS Adult Chinese patients with hypopituitarism and/or panhypopituitarism were enrolled at the Pituitary Center of Peking Union Medical College Hospital between August 2012 and April 2018. According to abdominal ultrasonography, these patients were divided into an NAFLD (-) group and an NAFLD (+) group, and the latter was further divided into an NAFLD group and a cirrhotic group. The data, such as patient characteristics, diagnosis, and treatment, were extracted from medical records, and statistical analysis was performed. RESULTS A total of 36 male and 14 female adult Chinese patients with hypopituitarism were included in this retrospective study; 43 (87.0%) of these patients exhibited growth hormone (GH) deficiency, and 39 (78.3%) had diabetes insipidus. A total of 27 (54.0%) patients were diagnosed with NAFLD, while seven patients were cirrhotic. No significant differences were noted in serum GH or insulin-like growth factor 1 among patients with cirrhosis, subjects with NAFLD, and those without NAFLD. However, plasma osmolality and serum sodium concentration of the cirrhotic patients were 314.9 mOsm/kgH 2 O and 151.0 mmol/L, respectively, which were significantly higher than those of the NAFLD patients ( P = 0.036 and 0.042, respectively). Overweight/obesity and insulin resistance were common metabolic disorders in this population. The body mass index (BMI) and homeostasis model assessment of insulin resistance parameters of the cirrhotic patients were 27.7 kg/m 2 and 9.57, respectively, which were significantly higher than those of the patients without NAFLD ( P = 0.011 and 0.044, respectively). A correlation analysis was performed, and fasting insulin concentration was positively associated with plasma osmolality in patients with NAFLD, after adjusting for gender, age, and BMI ( r = 0.540, P = 0.046), but no correlation was noted in patients without NAFLD. CONCLUSION NAFLD is common in patients with hypopituitarism. Plasma osmolality and serum sodium levels of hypopitu...

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics of non-alcoholic fatty liver disease in Chinese adult hypopituitary patients

Yuan¹,

Zhu²,

Pan³

et al. 2019

WJG

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“…Among them, imaging examinations, including ultrasound, CT, and MR, play important roles. Recently, Esterson et al [5] reviewed and discussed the sensitivity, specificity, advantages and limitations of the above examinations, which may not be suitable for large-scale epidemiological studies due to their characteristics, including required time and cost. Fortunately, serum ALT is cheaper and more accessible, and in numerous national guidelines, the use of ALT is recommended to screen for NAFLD in children [23, 24].…”

Section: Discussionmentioning

confidence: 99%

“…In fact, abdominal ultrasound was used to diagnose NAFLD in our study, but the results showed that NAFLD was not discovered. As ultrasound is not ideal for detecting the early stages of NAFLD [5], a more accurate method should be used to assess histologic severity in the liver in the future.…”

Section: Discussionmentioning

confidence: 99%

“…Various diagnostic tools, including ultrasound, computed tomography (CT), and magnetic resonance (MR), can be used to evaluate NAFLD but may not be suitable for large-scale epidemiologic studies due to time consumption and cost [4, 5]. As a common and useful indicator of hepatocyte injury, elevated serum alanine aminotransferase (ALT) level is a valuable way to screen for NAFLD that reflects liver histological progression [6–9].…”

Section: Introductionmentioning

confidence: 99%

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Association between Alanine Aminotransferase and Growth Hormone: A Retrospective Cohort Study of Short Children and Adolescents

Zhang

Zhao

et al. 2019

BioMed Research International

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Objective. This study aimed to examine the relationship between serum alanine aminotransferase (ALT) and growth hormone (GH) in children and adolescents with short stature. Methods. In this retrospective cohort study, 670 Chinese children and adolescents with short stature were included, and 253 of them received recombinant human GH (rhGH) therapy. Anthropometric and biochemical indicators were measured. GH peak levels were assessed after provocation tests with L-dopa and insulin. The subjects were divided into 3 groups according to the GH peak level. The association between the GH peak and ALT was analyzed. The change of ALT during rhGH therapy was assessed by a generalized additive mixed model. Results. Serum ALT and incidence of ALT elevation were both decreased across the GH tertiles (P = 0.002, 0.012, respectively). A univariate analysis showed that the GH peak was negatively associated with ALT (β: -0.12; 95%CI: -0.22, -0.02; P = 0.023). Furthermore, multiple linear stepwise regression analysis demonstrated that the GH peak was independently related to ALT after adjusting for other confounding variables (β: -0.12; 95%CI: -0.24, -0.00; P = 0.042). Besides, mean values of the change in ALT from baseline displayed that, during the early stages of rhGH treatment, serum ALT level indicated a temporary upward trend, but it subsequently gradually decreased (β: -0.16; 95%CI: -0.23, -0.09; P < 0.001). Conclusions. GH secretion level was strongly negatively correlated with ALT in short children and adolescents. And rhGH therapy could reduce ALT level over time.

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“…Ultrasound abdomen is recommended as an initial investigation for screening of NAFLD as it is non-invasive, easy to perform, cheap and readily available (28,31).…”

Section: Screeningmentioning

confidence: 99%

Non-alcoholic fatty liver disease – 2019

in-chief

2019

Sri Lanka J. Diabetes Endocrinol. Metab.

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Radiologic Imaging in Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis

Cited by 40 publications

References 61 publications

Clinical characteristics of non-alcoholic fatty liver disease in Chinese adult hypopituitary patients

Clinical characteristics of non-alcoholic fatty liver disease in Chinese adult hypopituitary patients

Association between Alanine Aminotransferase and Growth Hormone: A Retrospective Cohort Study of Short Children and Adolescents

Non-alcoholic fatty liver disease – 2019

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