Conventional ultrasound for diagnosis of hepatic steatosis is better than believed

2021 ◽  
Author(s):  
Christoph F. Dietrich ◽  
Long Shi ◽  
Axel Löwe ◽  
Yi Dong ◽  
Andrej Potthoff ◽  
...  
Keyword(s):  
Hepatic Steatosis ◽  
Imaging Techniques ◽  
Liver Steatosis ◽  
Scoring Systems ◽  
Nonalcoholic Fatty Liver ◽  
First Choice ◽  
High Prevalence ◽  
Hepatic Vessels ◽  
Conventional Ultrasound ◽  
Line Imaging

Abstract Background Hepatic steatosis is a condition frequently encountered in clinical practice, with potential progression towards fibrosis, cirrhosis, and hepatocellular carcinoma. Detection and staging of hepatic steatosis are of most importance in nonalcoholic fatty liver disease (NAFLD), a disease with a high prevalence of more than 1 billion individuals affected. Ultrasound (US) is one of the most used noninvasive imaging techniques used in the diagnosis of hepatic steatosis. Detection of hepatic steatosis with US relies on several conventional US parameters, which will be described. US is the first-choice imaging in adults at risk for hepatic steatosis. The use of some scoring systems may add additional accuracy especially in assessing the severity of hepatic steatosis. Summary In the presented paper, we discuss screening and risk stratification, ultrasound features for diagnosing hepatic steatosis, B-mode criteria, focal fatty patterns and Doppler features of the hepatic vessels, and the value of the different US signs for the diagnosis of liver steatosis including classifying the severity of steatosis using different US scores. Limitations of conventional B-mode and Doppler features in the evaluation of hepatic steatosis are also discussed, including those in grading and assessing the complications of steatosis, namely fibrosis and nonalcoholic steatohepatitis. Key Messages Ultrasound is the first-line imaging examination for the screening and follow-up of patients with liver steatosis. The use of some scoring systems may add additional accuracy in assessing the severity of steatosis. Conventional B-mode and Doppler ultrasound have limitations in grading and assessing the complications of steatosis.

scholarly journals Vibration-Controlled Transient Elastography and Controlled Attenuation Parameter for the Diagnosis of Liver Steatosis and Fibrosis in Patients with Nonalcoholic Fatty Liver Disease

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 787
Author(s):  
Sebastian Zenovia ◽  
Carol Stanciu ◽  
Catalin Sfarti ◽  
Ana-Maria Singeap ◽  
Camelia Cojocariu ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Hepatic Steatosis ◽  
Fatty Liver Disease ◽  
Transient Elastography ◽  
Liver Steatosis ◽  
Controlled Attenuation Parameter ◽  
Nonalcoholic Fatty Liver ◽  
Attenuation Parameter

Vibration-Controlled Transient Elastography (VCTE) with Controlled Attenuation Parameter (CAP) is a widely used non-invasive technique for concomitant assessment of liver steatosis and fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). We aimed to evaluate the level both of hepatic steatosis and fibrosis as well as the associated risk factors in patients referred to our unit with clinically suspected NAFLD or diagnosed by abdominal ultrasonography. Two hundred four patients were prospectively included in this study and assessed by VCTE with CAP. The final analysis included 181 patients with reliable liver stiffness measurements (LSMs) (53% female, mean age 57.62 ± 11.8 years and BMI 29.48 ± 4.85 kg/m2). According to the cut-off values for steatosis grading, there were 10 (5.5%) patients without steatosis (S0), 30 (16.6%) with mild (S1), 45 (24.9%) moderate (S2), and 96 (53%) severe (S3) steatosis. Based on LSM, there were 73 (40.3%) patients without fibrosis (F0), 42 (23.2%) with mild (F1), 32 (17.7%) significant (F2), 19 (10.5%) advanced (F3) fibrosis, and 15 (8.3%) with cirrhosis (F4). In addition, we found an association between several metabolic components and hepatic steatosis and fibrosis. Thus, in the multivariate analysis, higher BMI, fasting plasma glucose, triglycerides, low-density lipoprotein cholesterol, and serum uric were associated with increased CAP. Furthermore, higher serum uric acid and alpha-fetoprotein together with lower platelets count and albumin levels were associated with increased LSM. The assessment of steatosis and fibrosis using VCTE and CAP should be performed in all patients with suspected or previously diagnosed NAFLD in units with available facilities.

scholarly journals MAFLD/NAFLD Biopsy-Free Scoring Systems for Hepatic Steatosis, NASH, and Fibrosis Diagnosis

2022 ◽  
Vol 8 ◽  
Author(s):  
Nancy de los Ángeles Segura-Azuara ◽  
Carlos Daniel Varela-Chinchilla ◽  
Plinio A. Trinidad-Calderón
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Hepatic Steatosis ◽  
Fatty Liver Disease ◽  
Performance Metrics ◽  
Scoring Systems ◽  
Liver Disorder ◽  
Variable Degree ◽  
Nonalcoholic Fatty Liver ◽  
Non Invasive

Metabolic dysfunction-associated fatty liver disease (MAFLD), formerly known as nonalcoholic fatty liver disease, is the most prevalent liver disorder worldwide. Historically, its diagnosis required biopsy, even though the procedure has a variable degree of error. Therefore, new non-invasive strategies are needed. Consequently, this article presents a thorough review of biopsy-free scoring systems proposed for the diagnosis of MAFLD. Similarly, it compares the severity of the disease, ranging from hepatic steatosis (HS) and nonalcoholic steatohepatitis (NASH) to fibrosis, by contrasting the corresponding serum markers, clinical associations, and performance metrics of these biopsy-free scoring systems. In this regard, defining MAFLD in conjunction with non-invasive tests can accurately identify patients with fatty liver at risk of fibrosis and its complications. Nonetheless, several biopsy-free scoring systems have been assessed only in certain cohorts; thus, further validation studies in different populations are required, with adjustment for variables, such as body mass index (BMI), clinical settings, concomitant diseases, and ethnic backgrounds. Hence, comprehensive studies on the effects of age, morbid obesity, and prevalence of MAFLD and advanced fibrosis in the target population are required. Nevertheless, the current clinical practice is urged to incorporate biopsy-free scoring systems that demonstrate adequate performance metrics for the accurate detection of patients with MAFLD and underlying conditions or those with contraindications of biopsy.

scholarly journals Correlation of Hepatic Steatosis with Hepatic Fibrosis in NAFLD Patients by Fibroscan

2020 ◽  
Vol 9 (3) ◽  
pp. 1-7
Author(s):  
Rishabh Sehgal ◽  
Jyotisterna Mittal ◽  
Inderpal Singh
Keyword(s):  
Hepatic Steatosis ◽  
Hepatic Fibrosis ◽  
Transient Elastography ◽  
Liver Steatosis ◽  
Liver Stiffness ◽  
Controlled Attenuation Parameter ◽  
Nonalcoholic Fatty Liver ◽  
Attenuation Parameter ◽  
History Of ◽  
The Mean

Introduction: Nonalcoholic fatty liver disease (NAFLD) is a significant cause of liver injury in the world. Transient elastography with controlled attenuation parameter (CAP) is now days commonly used as a non-invasive modality to quantify liver steatosis and stage of Fibrosis in the Liver. This study was done to the correlation of hepatic Steatosis with hepatic Fibrosis in NAFLD Patients by fibroscan. Subjects and Methods: All NAFLD patients coming to DMCH from 1/1/18 to 30/11/18 were retrospectively analysed for the presence of any correlation between Steatosis and Fibrosis using a controlled attenuation parameter (CAP) and liver stiffness measurement (kPa), respectively by Fibroscan. Patients with a history of significant alcohol intake, viral infection, severe weight loss, on TPN, on drugs like amiodarone, diltiazem, steroids were excluded. Along with this history of hypertension, diabetes and smoking were noted from the available data. Results: The mean CAP of all 446 patients was 310.58  53.55 and the mean kPa was 7.14   4.75. Overall there was a significant correlation between CAP and kPa in all NAFLD patients (p <0.000). This was also true in patients who were more than 20 years of age, who have increased levels of triglycerides and were obese. Patients with S0 steatosis had a mean kPa value of 5.33 and as the steatosis stage worsened to S3 mean kPa value also increased to a maximum of 7.63. Conclusion: Quantification of Steatosis by CAP has a significant correlation with the stage of Fibrosis, especially in patients with increasing age, obese and who have high triglyceride levels.

scholarly journals β2-Adrenergic Receptor Agonist Induced Hepatic Steatosis in Mice: Modeling Nonalcoholic Fatty Liver Disease in Hyperadrenergic States

2021 ◽  
Author(s):  
Yun Shi ◽  
Jason Pizzini ◽  
Hanzhou Wang ◽  
Falguni Das ◽  
Parveez Ahamed Abdul Azees ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Hepatic Steatosis ◽  
Intracellular Signaling ◽  
Fatty Liver Disease ◽  
Cellular Localization ◽  
Liver Steatosis ◽  
Nonalcoholic Fatty Liver ◽  
Hepatic Expression

Nonalcoholic fatty liver disease (NAFLD) is a spectrum of disorders ranging from hepatic steatosis (excessive accumulation of triglycerides [TG]) to nonalcoholic steatohepatitis, which can progress to cirrhosis and hepatocellular carcinoma. The molecular pathogenesis of steatosis and progression to more severe NAFLD remains unclear. Obesity and aging, two principal risk factors for NAFLD, are associated with a hyperadrenergic state. β-Adrenergic responsiveness in liver increases in animal models of obesity and aging, and in both is linked to increased hepatic expression of β2-adrenergic receptors (β2-ARs). We previously showed that in aging rodents intracellular signaling from elevated hepatic levels of β2-ARs may contribute to liver steatosis. In this study we demonstrate that injection of formoterol, a highly selective β2-AR agonist, to mice acutely results in hepatic TG accumulation. Further, we have sought to define the intrahepatic mechanisms underlying β2-AR mediated steatosis by investigating changes in hepatic expression and cellular localization of enzymes, transcription factors and coactivators involved in processes of lipid accrual and disposition-and also functional aspects thereof-in livers of formoterol treated animals. Our results suggest that β2-AR activation by formoterol leads to increased hepatic TG synthesis and de novo lipogenesis, increased but incomplete β-oxidation of fatty acids with accumulation of potentially toxic long-chain acylcarnitine intermediates, and reduced TG secretion-all previously invoked as contributors to fatty liver disease. Experiments are ongoing to determine whether sustained activation of hepatic β2-AR signaling by formoterol might be utilized to model fatty liver changes occurring in hyperadrenergic states of obesity and aging, and thereby identify novel molecular targets for the prevention or treatment of NAFLD.

scholarly journals Assessing Interactions between PNPLA3 and Dietary Intake on Liver Steatosis in Mexican-Origin Adults

2021 ◽  
Vol 18 (13) ◽  
pp. 7055
Author(s):  
Kristin E. Morrill ◽  
Victoria L. Bland ◽  
Yann C. Klimentidis ◽  
Melanie D. Hingle ◽  
Cynthia A. Thomson ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Hepatic Steatosis ◽  
Genetic Model ◽  
Liver Steatosis ◽  
Dietary Factors ◽  
Mexican Origin ◽  
Cross Sectional ◽  
Nonalcoholic Fatty Liver ◽  
Increased Risk ◽  
Dietary Variable

Mexican-origin (MO) adults have among the highest rates of nonalcoholic fatty liver disease (NAFLD) placing them at increased risk of liver cancer. Evidence suggests that a single nucleotide polymorphism (SNP) in the PNPLA3 gene, rs738409, increases the risk and progression of NAFLD and may modify the relationship between certain dietary factors and liver steatosis. The purpose of this study was to identify whether interactions exist between specific dietary factors and rs738409 genotype status among MO adults in relation to levels of liver steatosis. We analyzed cross-sectional data from a sample of 288 MO adults. Participants completed at least two 24-h dietary recalls. Multiple linear regression was performed assuming an additive genetic model to test the main effects of several dietary variables on levels of hepatic steatosis, adjusting for covariates. To test for effect modification, the product of the genotype and the dietary variable was included as a covariate in the model. No significant association between dietary intake and level of hepatic steatosis was observed, nor any significant gene-diet interactions. Our findings suggest that dietary intake may have the same magnitude of protective or deleterious effect even among MO adults with high genetic risk for NAFLD and NAFLD progression.

Semi-Quantitative Ultrasonographic Evaluation of NAFLD

2020 ◽  
Vol 26 (32) ◽  
pp. 3915-3927 ◽  
Author(s):  
Stefano Ballestri ◽  
Claudio Tana ◽  
Maria Di Girolamo ◽  
Maria Cristina Fontana ◽  
Mariano Capitelli ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Imaging Techniques ◽  
Metabolic Complications ◽  
Nonalcoholic Fatty Liver ◽  
Non Invasive ◽  
Increased Risk ◽  
Risk Of Progression ◽  
Progressive Liver Disease

: Nonalcoholic fatty liver disease (NAFLD) embraces histopathological entities ranging from the relatively benign simple steatosis to the progressive form nonalcoholic steatohepatitis (NASH), which is associated with fibrosis and an increased risk of progression to cirrhosis and hepatocellular carcinoma. NAFLD is the most common liver disease and is associated with extrahepatic comorbidities including a major cardiovascular disease burden. : The non-invasive diagnosis of NAFLD and the identification of subjects at risk of progressive liver disease and cardio-metabolic complications are key in implementing personalized treatment schedules and follow-up strategies. : In this review, we highlight the potential role of ultrasound semiquantitative scores for detecting and assessing steatosis severity, progression of NAFLD, and cardio-metabolic risk. : Ultrasonographic scores of fatty liver severity act as sensors of cardio-metabolic health and may assist in selecting patients to submit to second-line non-invasive imaging techniques and/or liver biopsy.

scholarly journals E3 ubiquitin ligase Grail promotes hepatic steatosis through Sirt1 inhibition

2021 ◽  
Vol 12 (4) ◽  
Author(s):  
Pei-Yao Liu ◽  
Cheng-Cheung Chen ◽  
Chia-Ying Chin ◽  
Te-Jung Liu ◽  
Wen-Chiuan Tsai ◽  
...  
Keyword(s):  
Hepatic Steatosis ◽  
Lipid Accumulation ◽  
Acid Synthesis ◽  
Sirtuin 1 ◽  
Nonalcoholic Fatty Liver ◽  
Expression Of Genes ◽  
Hepatic Fat ◽  
Underlying Mechanisms

AbstractIn obese adults, nonalcoholic fatty liver disease (NAFLD) is accompanied by multiple metabolic dysfunctions. Although upregulated hepatic fatty acid synthesis has been identified as a crucial mediator of NAFLD development, the underlying mechanisms are yet to be elucidated. In this study, we reported upregulated expression of gene related to anergy in lymphocytes (GRAIL) in the livers of humans and mice with hepatic steatosis. Grail ablation markedly alleviated the high-fat diet-induced hepatic fat accumulation and expression of genes related to the lipid metabolism, in vitro and in vivo. Conversely, overexpression of GRAIL exacerbated lipid accumulation and enhanced the expression of lipid metabolic genes in mice and liver cells. Our results demonstrated that Grail regulated the lipid accumulation in hepatic steatosis via interaction with sirtuin 1. Thus, Grail poses as a significant molecular regulator in the development of NAFLD.

scholarly journals Dynamics of hepatic steatosis resolution and changes in gut microbiome with weight loss in nonalcoholic fatty liver disease

2021 ◽  
Author(s):  
Jaideep Behari ◽  
Lisa Graham ◽  
Renwei Wang ◽  
Claudiu Schirda ◽  
Amir A. Borhani ◽  
...  
Keyword(s):  
Weight Loss ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Hepatic Steatosis ◽  
Gut Microbiome ◽  
Fatty Liver Disease ◽  
Nonalcoholic Fatty Liver
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