Transient Elastography Role in the Diagnosis of Nonalcoholic Fatty Liver Disease
Non-alcoholic fatty liver disease includes hepatic steatosis, steatohepatitis and fibrosis, which can progress to cirrhosis. In view of the prevalence of this disease, the deterioration of the quality of life of patients, mortality from complications, the development of methods for accurate and timely assessment of the severity of fatty liver and progression of fibrosis are becoming of greater interest. Purpose. The study of diagnostic potential of transient elastography in patients with idiopathic transaminase elevations. Methods. In 52 patients (20 men and 32 women) with idiopathic increased transaminases without signs of hepatic steatosis according to sonographic study, controlled attenuation parameter (CAP) and liver stiffness measurements (LSM) were performed using FibroScan with M probe. Exclusion criteria from the study were the presence of chronic viral, autoimmune hepatitis and alcohol abuse. Results. Forty one patients (78.8 %) had fatty liver disease according to CAP. The analysis of the data of transient elastography demonstrated that 63.4 % had fibrosis F0–F1, 29.3 % — F1–F2 and in 7.3 % — F3. In terms of the CAP there were significant differences between the group with severe fibrosis (F3) and groups with minimal fibrosis (F0–F1) ((203.0 ± 5.1) vs. (243.0 ± 10.1), p < 0.05). The analysis of biochemical parameters demonstrated significant differences in terms of gamma-glutamyltransferase in the groups with severe fibrosis (F3) and minimal fibrosis ((40.2 ± 5.7) vs. (26.4 ± 3.7), p < 0.05). Thus, the results obtained in the study indicate that a significant proportion of patients with idiopathic transaminase elevations inflammation factor is fatty liver disease, which is not detected at routine ultrasound examination. In the group with more expressed fibrosis reduction of fat in the liver and increased activity gamma glutamyltransferase were determined, that indicated the cholestasis deterioration in the liver in these patients. Consequently, patients with idiopathic transaminase increase, even with the absence of signs of steatosis according to sonography need CAP measurement using FibroScan, which is more sensitive in identifying fatty liver disease than ultrasound.
Full Text:PDF (Українська)
Dowman J.K. Pathogenesis of non-alcoholic fatty liver disease / J.K. Dowman, J.W. Tomlinson, P.N. Newsome // QJM. — 2010. — Vol. 103. — P. 71-83.
Skelly M.M. Findings on liver biopsy to investigate abnormal liver function tests in the absence of diagnostic serology / M.M. Skelly, P.D. James, S.D. Ryder // J. Hepatol. — 2001. — Vol. 35. — P. 195-199.
Gaidos J.K. A decision analysis study of the value of a liver biopsy in nonalcoholic steatohepatitis / J.K. Gaidos, B.E. Hillner, A.J. Sanyal // Liver Int. — 2008. — Vol. 28. — P. 650-658.
Complications following percutaneous liver biopsy. A multicentre retrospectivestudy on 68,276 biopsies / F. Piccinino, E. Sagnelli, G. Pasquale, G. Giusti // J. Hepatol. — 1986. — Vol. 2. — P. 165-173.
Interobserver variation in the histopathological assessment of nonalcoholic steatohepatitis / T. Fukusato, J. Fukushima, J. Shiga et al. // Hepatol. Res. — 2005. — Vol. 33. — P. 122-127.
Prospective biopsy-controlled evaluation of cell death biomarkers for prediction of liver fibrosis and nonalcoholic steatohepatitis / D. Joka, K. Wahl, S. Moeller [et al.] // Hepatology. — 2012. — Vol. 55. — P. 455-464.
High serum level of fibroblast growth factor 21 is an independent predictor of non-alcoholic fatty liver disease: a 3-year prospective study in China / H. Li, K. Dong, Q. Fang [et al.] // J. Hepatol. — 2013. — Vol. 58. — P. 557-563.
Fibroblast growth factor 21 levels are increased in nonalcoholic fatty liver disease patients and are correlated with hepatic triglyceride / H. Li, Q. Fang, F. Gao [et al.] // J. Hepatol. — 2010. — Vol. 53. — P. 934-940.
Noninvasive diagnosis of non-alcoholic steatohepatitis by combined serum biomarkers / J. Shen, H.L. Chan, G.L. Wong [et al.] // J. Hepatol. — 2012. — Vol. 56. — P. 1363-1370.
The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population / G. Bedogni, S. Bellentani, L. Miglioli [et al.] // BMC Gastroenterol. — 2006. — Vol. 6. — P. 33.
A simple index of lipid overaccumu.lation is a good marker of liver steatosis / G. Bedogni, H.S. Kahn, S. Bellentani, C. Tiribelli // BMC Gastroenterol. — 2010. — Vol. 10. — P. 98.
Hepatic steatosis index: a simple screening tool reflecting nonalcoholic fatty liver disease / J.H. Lee, D. Kim, H.J. Kim [et al.] // Dig. Liver Dis. — 2010. — Vol. 42. — P. 503-508.
The diagnostic value of biomarkers (SteatoTest) for the prediction of liver steatosis / T. Poynard, V. Ratziu, S. Naveau [et al.] // Comp. Hepatol. — 2005. — Vol. 4. — P. 10.
Hepatorenal index as an accurate, simple, and effective tool in screening for steatosis / R.H. Marshall, M. Eissa, E.I. Bluth [et al.] // J. Roentgenol. — 2012. — Vol. 199. — P. 997-1002.
Relationship between controlled attenuation parameter and hepatic steatosis as assessed by ultrasound in alcoholic or nonalcoholic fatty liver disease / Jem Ma Ahn, Yong-Han Paik, Sin Yeong Min [et al.] // Gut and Live. — 2016. — Р. 295-302.
- There are currently no refbacks.
Copyright (c) 2016 GASTROENTEROLOGY
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2017