Ultrasonographic fatty liver indicator, a novel score which rules out <scp>NASH</scp> and is correlated with metabolic parameters in <scp>NAFLD</scp>

Ballestri, Stefano; Lonardo, Amedeo; Romagnoli, Dante; Carulli, Lucia; Losi, Luisa; Day, Christopher P.; Loria, Paola

doi:10.1111/j.1478-3231.2012.02804.x

Cited by 173 publications

(174 citation statements)

References 36 publications

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“…The optimal method of screening is presently unknown. However, given the limitations of serum liver enzymes for the screening of NAFLD [1,2,20], we believe that liver ultrasonography and transient elastography combined with the use of non-invasive fibrosis scoring systems (e.g., NAFLD fibrosis score) may be useful as firstline options in identifying both patients with NAFLD and those with suspected NASH to submit to liver biopsy among those with PCOS [1,47,[82][83][84]. Conversely, a high index of suspicion may help in identifying PCOS cases among female patients with documented NAFLD, who Endocrine exhibit compatible clinical features.…”

Section: Discussionmentioning

confidence: 99%

Evidence that non-alcoholic fatty liver disease and polycystic ovary syndrome are associated by necessity rather than chance: a novel hepato-ovarian axis?

2015

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Increasing evidence suggests that non-alcoholic fatty liver disease (NAFLD) and polycystic ovary syndrome (PCOS) are associated with obesity, insulin resistance, metabolic syndrome, cardiovascular disease, cirrhosis, and liver tumors. On these grounds, we have hypothesized that NAFLD and PCOS occur more frequently than expected by chance alone. We have tested this hypothesis by reviewing the clinical and biological evidence that supports a significant association between NAFLD and PCOS. PubMed was extensively searched for articles published through March 2015 using the keywords "nonalcoholic fatty liver disease" or "fatty liver" combined with "PCOS." Several cross-sectional and case-control studies have consistently demonstrated that the prevalence of NAFLD is remarkably increased in young women with PCOS, independent of overweight/obesity and other coexisting metabolic syndrome features, and that these women are more likely to have the more severe forms of NAFLD (non-alcoholic steatohepatitis, advanced fibrosis, and cirrhosis). Accumulating evidence suggests that NAFLD, especially its necro-inflammatory form, may exacerbate hepatic and systemic insulin resistance and releases multiple pro-inflammatory, pro-coagulant, and pro-fibrogenic mediators that may play important roles in the pathophysiology of PCOS. These findings call for more active and systematic search for NAFLD among women with PCOS. Conversely, gastroenterologists/hepatologists need to be aware of the presence of PCOS among female patients with NAFLD and compatible clinical features. Finally, all these patients should undergo regular follow-up not only for liver-related complications but also for cardio-metabolic diseases.

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Section: Discussionmentioning

confidence: 99%

Evidence that non-alcoholic fatty liver disease and polycystic ovary syndrome are associated by necessity rather than chance: a novel hepato-ovarian axis?

2015

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“…The result also indicates that even with a slightly echo-enhanced ultrasound image of the liver, fatty liver still could not be distinguished by the naked eye; but fatty liver could be identified early by using the indices of the quantitative ultrasound model. Hence, patients with early fatty liver can be diagnosed by using the quantitative ultrasound model [19,20] . Moreover, the quantitative ultrasound model is more convenient and easier to operate than the 1 H-MRS, especially for early fatty liver screening in a large population.…”

Section: Efficiency Of the Quantitative Ultrasound Model In Mild Fattmentioning

confidence: 99%

Ultrasound hepatic/renal ratio and hepatic attenuation rate for quantifying liver fat content

Zhang

Ding

Chen

et al. 2014

WJG

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AIM:To establish and validate a simple quantitative assessment method for nonalcoholic fatty liver disease (NAFLD) based on a combination of the ultrasound hepatic/renal ratio and hepatic attenuation rate. METHODS:A total of 170 subjects were enrolled in this study. All subjects were examined by ultrasound and 1 H-magnetic resonance spectroscopy ( 1 H-MRS) on the same day. The ultrasound hepatic/renal echointensity ratio and ultrasound hepatic echo-intensity attenuation rate were obtained from ordinary ultrasound images using the MATLAB program. RESULTS:Correlation analysis revealed that the ultrasound hepatic/renal ratio and hepatic echo-intensity attenuation rate were significantly correlated with 1 H-MRS liver fat content (ultrasound hepatic/renal ratio: r = 0.952, P = 0.000; hepatic echo-intensity attenuation r = 0.850, P = 0.000). The equation for predicting liver fat content by ultrasound (quantitative ultrasound model) is: liver fat content (%) = 61.519 × ultrasound hepatic/renal ratio + 167.701 × hepatic echo-intensity attenuation rate -26.736. Spearman correlation analysis revealed that the liver fat content ratio of the quantitative ultrasound model was positively correlated with serum alanine aminotransferase, aspartate aminotransferase, and triglyceride, but negatively correlated with high density lipoprotein cholesterol. Receiver operating characteristic curve analysis revealed that the optimal point for diagnosing fatty liver was 9.15% in the quantitative ultrasound model. Furthermore, in the quantitative ultrasound model, fatty liver diagnostic sensitivity and specificity were 94.7% and 100.0%, respectively, showing that the quantitative ultrasound model was better than conventional ultrasound methods or the combined ultrasound hepatic/renal ratio and hepatic echo-intensity attenuation rate. If the 1 H-MRS liver fat content had a value < 15%, the sensitivity and specificity of the ultrasound quantitative model would be 81.4% and 100%, which still shows that using the model is better than the other methods. CONCLUSION:The quantitative ultrasound model is a simple, low-cost, and sensitive tool that can accurately assess hepatic fat content in clinical practice. It provides an easy and effective parameter for the early diagnosis of mild hepatic steatosis and evaluation of the efficacy of NAFLD treatment. Key words: Non-alcoholic fatty liver disease; Ultrasound hepatic/renal ratio; Ultrasound hepatic echo-intensity attenuation rateCore tip: The quantitative ultrasound model is a simple, low-cost, and sensitive tool that can accurately assess hepatic fat content in clinical practice. It provides an easy and effective parameter for early diagnosis of mild hepatic steatosis and evaluation of the efficacy of Zhang B, Ding F, Chen T, Xia LH, Qian J, Lv GY. Ultrasound hepatic/renal ratio and hepatic attenuation rate for quantifying liver fat content.

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“…US-FLI 점수는 94%의 NPV로 NASH를 배제할 수 있었다 [13]. 비장의 장경 116 mm를 기준으로 하였을 때 NASH 진 단에 대한 AUROC는 0.920, 예민도 88%, 특이도 95% 로 보고되었다 [30].…”

Section: 비알코올성 지방간염(Non-alcoholic Steatohepatitis Nash)의 진단unclassified

“…이 가운데 h e p a t o-r e n a l i n d e x contrast는 7.0 dB 이상일 때 간 지방증의 진단에 대해 각각 91%와 84%의 예민도와 특이도를 보였다 [12]. 또 다른 방법인 ultrasonographic fatty liver indicator (US-FLI)는 다음과 같은 기준으로 산출된다 [13]. a) brighter liver than kidney, whose intensity in contrast can be graded as mild/moderate (2 points) or severe (3 points).…”

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Diagnosis of Non-alcoholic Fatty Liver Disease

Gwak

2014

J Korean Diabetes

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Ultrasonographic fatty liver indicator, a novel score which rules out NASH and is correlated with metabolic parameters in NAFLD

Abstract: Data confirm the hypothesis that US-FLI significantly correlates with metabolic derangements and individual pathologic criteria for NASH and may better select patients for liver biopsy.

Cited by 173 publications

References 36 publications

Evidence that non-alcoholic fatty liver disease and polycystic ovary syndrome are associated by necessity rather than chance: a novel hepato-ovarian axis?

Evidence that non-alcoholic fatty liver disease and polycystic ovary syndrome are associated by necessity rather than chance: a novel hepato-ovarian axis?

Ultrasound hepatic/renal ratio and hepatic attenuation rate for quantifying liver fat content

Diagnosis of Non-alcoholic Fatty Liver Disease

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