Ultrasound Grade of Liver Steatosis Is Independently Associated with the Risk of Metabolic Syndrome

Mustapić, Sanda; Ziga, S.; Matić, Vladimir; Bokun, Tomislav; Radic, Bozo; Lucijanić, Marko; Marušić, Srečko; Babić, Žarko; Grgurević, Ivica

doi:10.1155/2018/8490242

Cited by 23 publications

(20 citation statements)

References 41 publications

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“…The present study revealed that in advanced liver fibrosis (≥F3) diagnosed by real time elastrography, Fib-4 index and NAFLD fibrosis score, there was a good relation between ultrasound grading of fatty liver and advanced fibrosis. This finding agrees with Mustapic 2018 and his colleagues who concluded that increase the grade of fatty liver by ultrasound associated with increase the degree of liver fibrosis [19]. FIB-4 INDEX and NAFLD-FIBROSIS SCORE are two time-honored non-invasive methods for estimating and monitoring of significant liver fibrosis in patients with NAFLD [10].…”

Section: Discussionsupporting

confidence: 88%

Real Time Elastography is an Easy Tool for Diagnosis of Liver Fibrosis in Non-Alcoholic Fatty Liver Disease

Abdulaziz¹,

Ibrahim²,

Khalil³

et al. 2020

OJMI

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Background: Non-alcoholic fatty liver disease (NAFLD) has emerged a major challenge and become the leading indication for liver transplantation. We aimed to assess the applicability and performance of real-time elastography (RTE) in diagnosis of liver fibrosis in patients with NAFLD compared with NAFLD fibrosis score (NFS) and FIB-4 index. Patients and Methods: A prospective case-control study was conducted on 260 subjects attended Hepatology, Gastroenterology and Infectious diseases and Internal Medicine departments in Benha University Hospital from Marsh 20, 2018, to September 1, 2019 and divided into group I included 200 cases with NAFLD and group II included 60 healthy control subjects. Results: There was statistically significant increase in FIB-4 scores between two groups (1.39 ± 1.02 and −0.75 ± 0.32 respectively with p < 0.001), also there was statistically significant increase in NAFLD fibrosis score mean ± SD between two groups (−1.74 ± 1.17 and −2.75 ± 0.91 respectively with p < 0.001). Fibrosis stages in NAFLD patients significantly higher than in control group diagnosed by RTE (P = 0.001). There was an agreement between RTE and FIB-4 index (93%) and NAFLD fibrosis score (86%). Diagnostic performance of RTE in advanced liver fibrosis ≥ F3 was assessed in comparing with FIB-4 index show sensitivity 90%, specificity 93.3%, PPV 60%, NPV 98.8% and accuracy 93% with AUC0.917 (p = 0.001) and in comparing with NAFLD fibrosis score sensitivity 52.6%, specificity 93.8%, PPV 66.7%, NPV 98.4% and accuracy 86% with AUC 0.732 (p = 0.002). Conclusion: Real time elastography could be valuable in diagnosis of fibrosis in NAFLD especially in cases more than F3 score.

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Section: Discussionsupporting

confidence: 88%

Real Time Elastography is an Easy Tool for Diagnosis of Liver Fibrosis in Non-Alcoholic Fatty Liver Disease

Abdulaziz¹,

Ibrahim²,

Khalil³

et al. 2020

OJMI

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“…Third, the ultrasonographic grade of hepatic steatosis was not considered in the present study. Mustapic et al reported that patients with higher ultrasonographic grade of hepatic steatosis significantly more frequently had metabolic syndrome, while the grade of hepatic steatosis did not correlate with the presence of hepatic fibrosis 37 . However, there have been no reports on the clinical importance of the reduction in the number of ultrasonographic findings of NAFLD.…”

Section: Discussionmentioning

confidence: 99%

Effect of weight change and lifestyle modifications on the development or remission of nonalcoholic fatty liver disease: sex-specific analysis

Yoshioka

Ishigami

Watanabe

et al. 2020

Sci Rep

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The effects of changes in various lifestyle habits on nonalcoholic fatty liver disease (NAFLD) have not been well elucidated. We aimed to clarify how weight change and lifestyle modifications were associated with the development or remission of NAFLD. In this longitudinal cohort study, we reviewed the periodic health checkup data of 1,421 subjects with no causes of liver disease besides NAFLD who had received at least two health checkups between 2009 and 2018. The prevalence of NAFLD at baseline was 34.1% (484/1,421). During follow-up period (4.6 ± 2.8 years), 104 subjects developed NAFLD and 127 subjects demonstrated NAFLD remission. The frequency of NAFLD development or that of NAFLD remission significantly increased as the larger weight gain or weight loss was, respectively (both, p < 0.001). Approximately 40% of the subjects who maintained ≥ 1%/year weight loss achieved NAFLD remission. By multivariate analysis, quitting smoking were independently associated with NAFLD development (adjusted odds ratio [AOR], 2.86; 95% CI, 1.24-6.62). Subjects who quit smoking demonstrated large weight gain (≥1%/year) significantly more frequently than the other subjects (p < 0.001). In sex-specific analysis, starting to exercise was independently associated with NAFLD remission in men (AOR, 2.38; 95% CI, 1.25-4.53). Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases and will become the leading cause of end-stage liver disease in the near future. NAFLD is a global public health concern with a heavy healthcare burden 1. NAFLD encompasses a spectrum of progressive pathological conditions, ranging from nonalcoholic fatty liver (NAFL) to steatohepatitis (NASH) 2. Many clinical trials have shown that weight loss and lifestyle intervention improve markers of liver function and histological features in patients with NAFLD 3-13. Thus, NAFLD is closely related to lifestyle habits, and is often described as the hepatic manifestation of metabolic syndrome. NAFLD is reversible to some extent. There have been several studies on lifestyle habits associated with the development or remission of NAFLD 14-18. However, most of the studies focused only on the lifestyle habits at baseline, but not the changes in lifestyle habits during the study period. Beginning in April 2008, Japan initiated a change in the national health policy in order to prevent metabolic syndrome. This comprehensive preventive policy involves unprecedented nationwide screening and lifestyle intervention for abdominal obesity, and the effectiveness of the nationwide preventive program has been demonstrated 19. In addition, various lifestyle habits can be modified as a result of recently growing health consciousness across Japanese society.

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“…Finally, since NAFLD is closely related to insulin resistance, MetS, and its individual components (T2DM dyslipidaemia, obesity, and arterial hypertension), all NAFLD patients should be evaluated for these conditions by performing simple anthropometric measurements and simple laboratory tests [8,66]. In addition, it has become clear that NAFLD is not only a "liver disease" but also a risk factor for many other extrahepatic diseases, including cardiovascular diseases (CVD), chronic kidney disease (CKD), T2DM, and colorectal cancer [7].…”

Section: What To Search For In a Patient Diagnosed With Nafld?mentioning

confidence: 99%

Natural History of Nonalcoholic Fatty Liver Disease: Implications for Clinical Practice and an Individualized Approach

Grgurević

Podrug

Mikolašević

et al. 2020

Canadian Journal of Gastroenterology and Hepatology

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Nonalcoholic fatty liver disease (NAFLD) is becoming the most prevalent liver disease worldwide, associated with epidemics of overweight and resulting metabolic syndrome (MetS). Around 20–30% of patients with NAFLD develop progressive liver fibrosis, which is the most important predictor of liver-related and overall morbidity and mortality. In contrast to classical understanding, no significant association has been demonstrated between the inflammatory component of NAFLD, i.e., nonalcoholic steatohepatitis (NASH), and the adverse clinical outcomes. Older age (>50 years) and presence of type 2 diabetes mellitus, in addition to some genetic variants, are most consistently reported indicators of increased risk of having liver fibrosis. However, critical driving force for the progression of fibrosis and risk factors for this have still not been fully elucidated. Apart from the genetic profile, gut dysbiosis, weight gain, worsening of insulin resistance, and worsening of liver steatosis represent candidate factors associated with unfavourable development of liver disease. Cardiovascular events, extrahepatic malignancies, and liver-related deaths are the leading causes of mortality in NAFLD. As patients with advanced fibrosis are under highest risk of adverse clinical outcomes, efforts should be made to recognize individuals under risk and rule out the presence of this stage of fibrosis, preferably by using simple noninvasive tools. This process should start at the primary care level by using validated biochemical tests, followed by direct serum tests for fibrosis or elastography in the remaining patients. Patients with advanced fibrosis should be referred to hepatologists for aggressive lifestyle modification and correction of the components of MetS, and cirrhotic patients should be screened for hepatocellular carcinoma and oesophageal varices.

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Ultrasound Grade of Liver Steatosis Is Independently Associated with the Risk of Metabolic Syndrome

Cited by 23 publications

References 41 publications

Real Time Elastography is an Easy Tool for Diagnosis of Liver Fibrosis in Non-Alcoholic Fatty Liver Disease

Real Time Elastography is an Easy Tool for Diagnosis of Liver Fibrosis in Non-Alcoholic Fatty Liver Disease

Effect of weight change and lifestyle modifications on the development or remission of nonalcoholic fatty liver disease: sex-specific analysis

Natural History of Nonalcoholic Fatty Liver Disease: Implications for Clinical Practice and an Individualized Approach

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