Repeating measurements by transient elastography in non-alcoholic fatty liver disease patients with high liver stiffness

ObjectiveThe latest model of vibration-controlled transient elastography (VCTE) automatically selects M or XL probe according to patients’ body built. We aim to test the application of a unified interpretation of VCTE results with probes appropriate for the body mass index (BMI) and hypothesise that this approach is not affected by hepatic steatosis.DesignWe prospectively recruited 496 patients with non-alcoholic fatty liver disease who underwent VCTE by both M and XL probes within 1 week before liver biopsy.Results391 (78.8%) and 433 (87.3%) patients had reliable liver stiffness measurement (LSM) (10 successful acquisitions and IQR:median ratio ≤0.30) by M and XL probes, respectively (p<0.001). The area under the receiver operating characteristic curves was similar between the two probes (0.75–0.88 for F2–4, 0.83–0.91 for F4). When used in the same patient, LSM by XL probe was lower than that by M probe (mean difference 2.3 kPa). In contrast, patients with BMI ≥30 kg/m2 had higher LSM regardless of the probe used. When M and XL probes were used in patients with BMI <30 and ≥30 kg/m2, respectively, they yielded nearly identical median LSM at each fibrosis stage and similar diagnostic performance. Severe steatosis did not increase LSM or the rate of false-positive diagnosis by XL probe.ConclusionHigh BMI but not severe steatosis increases LSM. The same LSM cut-offs can be used without further adjustment for steatosis when M and XL probes are used according to the appropriate BMI.

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Ipragliflozin ameliorates liver damage in non-alcoholic fatty liver disease

Open Medicine ◽

10.1515/med-2018-0059 ◽

2018 ◽

Vol 13 (1) ◽

pp. 402-409 ◽

Cited By ~ 16

Author(s):

Teruki Miyake ◽

Sakiko Yoshida ◽

Shinya Furukawa ◽

Takenori Sakai ◽

Fujimasa Tada ◽

...

Keyword(s):

Body Weight ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Transient Elastography ◽

Liver Steatosis ◽

Liver Stiffness ◽

Gamma Glutamyl Transpeptidase ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

AbstractBackgroundThere are few effective medications for non-alcoholic steatohepatitis (NASH). We investigated the efficacy of ipragliflozin (selective sodium-glucose cotransporter-2 inhibitor [SGLT2I]) for the treatment of patients with type 2 diabetes mellitus (T2DM) complicated by non-alcoholic fatty liver disease (NAFLD).MethodsWe prospectively enrolled patients with T2DM complicated by NAFLD treated at our institutions from January 2015 to December 2016. Patients received oral ipragliflozin (50 mg/day) once daily for 24 weeks. Body composition was evaluated using an InBody720 analyzer. We used transient elastography to measure liver stiffness and the controlled attenuation parameter for the quantification of liver steatosis in patients with NASH.ResultsForty-three patients with T2DM and NAFLD were enrolled (12 with biopsy-proven NASH and 31 with NAFLD diagnosed by ultrasonography). After 24 weeks, body weight, hemoglobin A1c (HbA1c), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase, body fat mass, and steatosis were significantly decreased compared to baseline measurements in patients with NASH. However, muscle mass was not reduced, and liver stiffness showed a statistically insignificant tendency to decrease. NAFLD patients also showed a significant reduction in body weight, HbA1c, AST, and ALT compared to baseline measurements. ConclusionIpragliflozin may be effective in patients with T2DM complicated by NAFLD.

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Prevalence of and risk factors for non-alcoholic fatty liver disease (NAFLD) and fibrosis among young adults in Egypt

BMJ Open Gastroenterology ◽

10.1136/bmjgast-2021-000780 ◽

2021 ◽

Vol 8 (1) ◽

pp. e000780

Author(s):

Shaheen Tomah ◽

Osama Hamdy ◽

Megahed M Abuelmagd ◽

Attia H Hassan ◽

Naim Alkhouri ◽

...

Keyword(s):

College Students ◽

Young Adults ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Parental Education ◽

Transient Elastography ◽

Liver Stiffness ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

ObjectiveLimited literature has examined the epidemiology of non-alcoholic fatty liver disease (NAFLD) and fibrosis among young adults in Egypt, a country with one of the highest obesity rates globally. We assessed the prevalence of steatosis and fibrosis among college students in Egypt.DesignIn this cross-sectional study, we recruited students unaware of having fatty liver via a call-for-participation at a private university in the Dakahlia governorate of Egypt. Primary outcomes were the prevalence of steatosis as determined by the controlled attenuation parameter component of transient elastography and fibrosis as determined by the liver stiffness measurement component of transient elastography. Secondary outcomes were clinical parameters and socioeconomic factors associated with the presence and severity of steatosis and fibrosis.ResultsOf 132 participants evaluated for the study, 120 (91%) were included (median (IQR) age, 20 (19–21) years; 65 (54.2%) female). A total of 38 participants (31.6%) had steatosis, among whom 22 (57.9%) had S3 (severe) steatosis. There was a higher risk for steatosis in persons with overweight (adjusted OR 9.67, 95% CI (2.94 to 31.7, p<0.0001) and obesity (adjusted OR 13.87, 95% CI 4.41 to 43.6, p<0.0001) compared with lean persons. Moreover, higher level of parental education was associated with progressing steatosis stages (S1–S3). Six (5%) participants had transient elastography values equivalent to F2–F3 fibrosis (four with F2 fibrosis (≥7.9 kPa), and two with F3 fibrosis (≥8.8 kPa)).ConclusionIn this cohort of college students in Egypt, around 1 in 3 had steatosis, and 1 in 20 had moderate-to-advanced fibrosis, an established risk factor for hepatic and extrahepatic morbidity and mortality. These data underscore the urgency to address the silent epidemic of NAFLD among young adults in the Middle East-North Africa region.

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Disease Severity in Non-alcoholic Fatty Liver Disease (NAFLD) Patients with No Prior Diagnosis of Cirrhosis – A Unique Insight Using Vibration-Controlled Transient Elastography (VCTE)

Proceedings of IMPRS ◽

10.18060/22735 ◽

2018 ◽

Vol 1 (1) ◽

Author(s):

David Muschi ◽

Dr. Raj Vuppalanchi

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Disease Severity ◽

Fatty Liver Disease ◽

Transient Elastography ◽

Liver Stiffness ◽

Small Sample ◽

Study Cohort ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

Background and Hypothesis: The severity of fibrosis is a strong prognostic indicator in patients with non-alcoholic fatty liver disease (NAFLD). However, routine evaluation with a liver biopsy in patients with NAFLD is not feasible and as such, the assessment of disease severity is often limited in small sample sizes. Vibration-controlled transient elastography (VCTE) is a non-invasive tool that can simultaneously assess for both liver fibrosis and steatosis by estimating liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) respectively. The aim of the current study is to estimate the prevalence of (1) abnormal LSM indicative of any fibrosis based on LSM ≥ 6.5 kPa, (2) compensated Advanced Chronic Liver Disease (cACLD) – suggestive(10-15kPa) and highly suggestive (>15 kPa), and (3) severe steatosis Experimental Design or Project Methods: Patients seen at digestive and liver disorders clinic at Indiana University Hospital that underwent VCTE between 8/2013-4/2018 were identified from the Fibrocan502 Touch data table. The ICD10 codes used as the indication for performing the VCTE were extracted and confirmed with the review of electronic health records. Results: 1240 patients met the criteria. The prevalence of abnormal LSM in the study cohort was 66% with 38.5 % having LSM suggestive of cACLD and 22% having LSM highly suggestive of cACLD. The prevalence of severe steatosis was 77%. The proportion of NAFLD patients with cACLD (suggestive and highly suggestive) during the study period was not significantly different (Figure1). Conclusion and Potential Impact: There are many NAFLD patients with liver stiffness indicative of abnormal LSM and 22% have LSM that is highly suggestive of cACLD. The proportion of patients with cACLD is steady over the study duration.

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Assessment of 10‐year changes in liver stiffness using vibration‐controlled transient elastography in non‐alcoholic fatty liver disease

Hepatology Research ◽

10.1111/hepr.13349 ◽

2019 ◽

Vol 49 (8) ◽

pp. 872-880 ◽

Cited By ~ 6

Author(s):

Asako Nogami ◽

Masato Yoneda ◽

Takashi Kobayashi ◽

Takaomi Kessoku ◽

Yasushi Honda ◽

...

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Transient Elastography ◽

Liver Stiffness ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

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Correlation of the Lipid Ratios With Hepatic Steatosis and Liver Fibrosis in Non-alcoholic Fatty Liver Disease Patients

10.21203/rs.3.rs-109731/v1 ◽

2020 ◽

Author(s):

Wen Guo ◽

Pei Qin ◽

Xiaona Li ◽

Jing Lu ◽

Wenfang Zhu ◽

...

Keyword(s):

Liver Disease ◽

Liver Fibrosis ◽

Fatty Liver ◽

Hepatic Steatosis ◽

Fatty Liver Disease ◽

Transient Elastography ◽

Liver Stiffness ◽

Alcoholic Fatty Liver ◽

Lipid Ratios ◽

Alcoholic Fatty Liver Disease

Abstract Background: The work intends to investigate the correlation of the lipid ratios to the severity of hepatic steatosis and the presence of liver fibrosis among non-alcoholic fatty liver disease (NAFLD) patients.Methods: Randomly selected 3402 participants were differentiated into the NAFLD (n =2036) and the non-NAFLD group (n =1366) in accordance with the outcomes of the liver ultrasonography. The related anthropometric and biochemical parameters were measured, while the severity of hepatic steatosis and the presence of liver stiffness were appraised by transient elastography.Results: The triglycerides/ high-density lipoprotein cholesterol (TG/HDL-C) and total cholesterol/HDL-C (TC/HDL-C) ratios exhibited a close connection with the severity of hepatic steatosis. Furthermore, higher area under the receiver operator characteristic (AUROC) value for TG/HDL-C than those of TC, TG, LDL-C, HDL-C, TC/HDL-C and non-HDL-C, was observed. Accordingly, the AUROC and optimal cut-off point of TG/HDL-C for NAFLD were 0.771 (95%CI: 0.755-0.787), 1.08 (sensitivity: 72.2 %, specificity: 68.3%), respectively. TG/HDL-C and TC/HDL-C were independent risk factors for the presence of liver fibrosis in NAFLD. Notably, the fact of relatively high AUROC while low AUROC (0.610) values of TG/HDL-C for detecting the presence of liver fibrosis relative to other lipid indexes indicated that it could not function as a desirable indicator of the presence of liver fibrosis in NAFLD.Conclusions: TG/HDL-C can be an independent risk factor for the severity of hepatic steatosis and the presence of liver fibrosis in NAFLD, furthermore, it possesses predictive significance to NAFLD but not to liver fibrosis.

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