The Severity of Ultrasonographic Findings in Nonalcoholic Fatty Liver Disease Reflects the Metabolic Syndrome and Visceral Fat Accumulation

Hamaguchi, Masahide; Kojima, Takao; Itoh, Yoshito; Harano, Yuichi; Fujii, Kimio; Nakajima, Tomoaki; Kato, Takeshi; Takeda, Noriyuki; Okuda, Junichi; Ida, Kazunori; Kawahito, Yutaka; Yoshikawa, Toshikazu; Okanoue, Takeshi

doi:10.1111/j.1572-0241.2007.01526.x

Cited by 733 publications

(641 citation statements)

References 17 publications

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“…The first limitation is the use of ultrasound to assess liver fat content. However, the sensitivity (92%) and specificity (100%) of ultrasound to show increased fatty infiltration are very good, and its accuracy approaches 100% for patients with moderate to severe steatosis (34). The second limitation is that other covariants present in the food or some dietary habits (eg, drinking carbonated beverages facilitates the intake of fatty food such as pizza) may have played a role in the observed relationship between soft drink beverages and hepatic steatosis.…”

Section: Discussionmentioning

confidence: 99%

Soft Drink Consumption Linked with Fatty Liver in the Absence of Traditional Risk Factors

Assy

Nasser

Kamayse

et al. 2008

Canadian Journal of Gastroenterology

283

194

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BACKGROUND: Little is known about dietary habits and their relationships with liver disease in nonalcoholic fatty liver disease (NAFLD) patients, particularly in the absence of obesity, diabetes or hyperlipidemia. OBJECTIVE: To assess the association between soft drink consumption and the presence of fatty liver in NAFLD patients who do not have classic risk factors. METHODS: Three hundred ten patients with NAFLD diagnosed by ultrasound were assessed for 36 months in a cross-sectional manner. Thirty-one patients (10%) who had NAFLD without classic risk factors were compared with 30 healthy controls. Physical activity was assessed during the preceding week and year, and every six months for 36 months. Data on daily dietary intake of food and soft drink, and the source of added sugar were collected during two seven-day periods, at the beginning of the study, and within two weeks after the metabolic tests by using a validated food questionnaire given by a trained dietician. Insulin resistance and lipid peroxidation were assessed by homeostasis model assessment-insulin resistance index (HOMA-IRI) and malondialdehyde (MDA) levels, respectively. RESULTS: Eighty per cent of patients (25 of 31) consumed an excessive amount of soft drink beverages (more than 50 g/day of added sugar) for 36 months, compared with 20% in healthy controls (P<0.001). Twenty per cent of patients consumed one drink per day, 40% consumed two to three drinks per day, and 40% consumed more than four drinks per day for most days during 36 months. The most common soft drinks consumed were regular Coca-Cola (40% of patients), Diet Coke (40%) and flavoured fruit juices (20%). Ultrasound findings revealed mild fatty liver in 44% of cases (n=14), moderate fatty liver in 38% (n=12), and severe fatty liver in 18% (n=5). HOMA-IRI and MDA levels were significantly higher in patients with NAFLD than in healthy controls (HOMA-IRI, 3.7 versus 1.7, P<0.001; and MDA, 420±300 μmol/mL versus 200±100 μmol/mL; P<0.001). When controlled for other factors, including dietary composition and physical activity, soft drink beverage consumption was the only independent variable that was able to predict the presence of fatty liver in 82.5% of cases with a sensitivity of 100%, a specificity of 76%, a positive predictive value of 57% and a negative predictive value of 100%. CONCLUSION: The present study may add important insight into the role of sugar-sweetened beverage consumption as a cause of fatty liver in patients without risk factors. Patients are encouraged to change their long-standing drinking behaviour.

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Section: Discussionmentioning

confidence: 99%

Soft Drink Consumption Linked with Fatty Liver in the Absence of Traditional Risk Factors

Assy

Nasser

Kamayse

et al. 2008

Canadian Journal of Gastroenterology

283

194

View full text Add to dashboard Cite

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“…The specificity of this method could be increased up to 100% if known liver disease, drug use or alcohol consumption were ruled out. 89,90 However, US could not detect 7.4-8.8% of cases with NAFLD. However, the presence of fibrosis is not related to misdiagnosis.…”

Section: Ultrasonography (Us)mentioning

confidence: 99%

“…86,[88][89][90] Visceral fat measured by ultrasound might be a good predictor to identify risk for nonalcoholic fatty liver disease in obese adolescents. 21,23,89,90 Liver involvement assessed by means of US is as frequent as 42% among prepubertal children 6, higher than that revealed by measurement of serum liver enzymes. 13 Doppler sonography is used as noninvasive assessment of the hemodynamics of hepatic vascular flow.…”

Section: Ultrasonography (Us)mentioning

confidence: 99%

Nonalcoholic fatty liver disease: a challenge for pediatricians

Widhalm

Ghods

2010

Int J Obes

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Background: Nonalcoholic fatty liver disease (NAFLD) is the most common cause of pediatric liver disease. Its prevalence is related to the growing epidemic in childhood obesity during the past decades. At present, NAFLD and nonalcoholic steatohepatitis (NASH) are increasingly recognized worldwide. In spite of alarming trend in the epidemiology in pediatric field and growing risk of end stage liver disease, there is no significant advance in its diagnosis and treatment. Aim: To provide a detailed review for diagnosis and management of NAFLD and NASH. Methods: By using Pubmed to find review articles and relevant research. Results: The prevalence ranges from at least 3% in children overall to about 50% in obese children. The noninvasive biomarkers can be used to identify NAFLD/NASH patients. Diagnostic criteria based on biochemical and immunological indicators in the high-risk group of children could prevent about half of cases from receiving an invasive test. The pharmacological and surgical interventions have shown a growing role in pediatric NAFLD. Novel treatment modalities, such as probiotics, have hardly been studied. Conclusion: Early diagnosis by using noninvasive screening methods in high-risk groups is the most effective strategy against the NAFLD. The biology of early growth and development, including hepatic metabolism, may hold the key to pediatric NAFLD. Prevention of overweight children and childhood obesity is undoubtedly the best strategy for treating NAFLD.

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“…Scoring system described by Hamaguchi et al [4] was used in this study. Ultrasonographic findings scored in this study included hepatorenal echo contrast, liver brightness, deep attenuation, and vascular blurring.…”

Section: Methodsmentioning

confidence: 99%

Serum α-fetoprotein levels in liver steatosis

Babali¹,

Çakal

Pürnak

et al. 2009

Hepatol Int

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Background Nonalcoholic fatty liver disease (NAFLD) is a common disorder and becoming a leading cause of cirrhosis in the western world. The monitoring of the disease is challenging and the prognostic importance of a-fetoprotein (AFP) level elevation in NAFLD remains uncertain. Methods Eighty-four patients were evaluated in the study. Patients with evidence of fatty liver in an abdominal ultrasonography performed for any reason were enrolled in the study. Degree of liver steatosis was graded into three groups. As a control group, patients without fatty liver or other liver diseases were included. All patients and controls were asked about prior hepatic diseases, consumption of alcohol, smoking, drug use, and a physical examination, biochemical analyses including liver function tests, different components of the metabolic syndrome, and the homeostasis model assessment-estimated insulin resistance (HOMA-IR) score were also performed. Results Body mass index, aspartate aminotransferase, alanine aminotransferase, glucose, insulin, and HOMA-IR in patients with NAFLD were higher than in control group. Triglyceride, total cholesterol, low-density lipoprotein, and high-density lipoprotein cholesterol levels were higher in NAFLD group than in control group. A statistically significant increase in AFP levels was noted in patients with NAFLD (4.09 ± 1.68) when compared with healthy controls (2.95 ± 0.41) (P \ 0.05). A statistically significant increase in AFP levels was noted in patients with grade 3 NAFLD (5.43 ± 1.51) when compared with grade 1 (2.92 ± 1.06) and grade 2 NAFLD groups (3.97 ± 1.45). Also, AFP was significantly higher in grade 2 NAFLD group than in grade 1 NAFLD group. AFP was correlated with NAFLD grade, but neither ALT nor AST showed correlation. According to multivariate analysis, correlation between NAFLD grade and serum AFP levels was independent from the other factors. Conclusion Patients with NAFLD have higher AFP levels than those without fatty liver changes. AFP levels rise as grade of liver steatosis increases. NAFLD should be among the differential diagnosis of elevated serum AFP levels.

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The Severity of Ultrasonographic Findings in Nonalcoholic Fatty Liver Disease Reflects the Metabolic Syndrome and Visceral Fat Accumulation

Abstract: The scoring system with abdominal ultrasonography could provide accurate information about hepatic steatosis, visceral obesity, and the metabolic syndrome in apparently healthy people who do not consume alcohol.

Cited by 733 publications

References 17 publications

Soft Drink Consumption Linked with Fatty Liver in the Absence of Traditional Risk Factors

Soft Drink Consumption Linked with Fatty Liver in the Absence of Traditional Risk Factors

Nonalcoholic fatty liver disease: a challenge for pediatricians

Serum α-fetoprotein levels in liver steatosis

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