Abstract
An inexpensive and simple method to determine non-alcoholic fatty liver disease (NAFLD) is the abdominal ultrasound, but there are still doubts about its accuracy. We assessed the precision of a semi-quantitative ultrasound method to determine liver fat infiltration, using magnetic resonance spectroscopy (MRS) as the reference. The study was conducted in youths from an ongoing cohort study. Clinical validation was performed, using receiver operating characteristic analysis, in n = 60 participants (22.6y; 50% males). Abdominal ultrasound was carried out with liver brightness (score 0–3), diaphragm attenuation (0–2) and liver vessel blurring (0–1) scored by two observers. Liver fat was estimated using MRS. Then, analytical validation was conducted in the remaining participants (n = 555; 22.7y; 51% males) using effects size estimates. An ultrasound score ≥4.0 had the highest sensitivity (78%) and specificity (85%) for NAFLD diagnosis. An area under the curve of 86% denotes a good diagnostic performance of the test, whereas a Kappa of 0.63 suggests substantial agreement of ultrasound vs. MRS. The analytical validation showed that participants having NAFLD according to ultrasound had an unhealthier cardiometabolic profile than participants without the condition. Abdominal ultrasound, combined with a semi-quantitative score system, is a reliable method to determine liver fat infiltration in young adults and should be encouraged whenever MRS is unavailable.
Highlights
Excessive liver fat accumulation not associated with alcohol abuse, or non-alcoholic fatty liver disease (NAFLD), may progress to steatohepatitis, cirrhosis and hepatoma
We aimed to assess the accuracy of abdominal ultrasound to diagnose NAFLD in male and female young adults across all ranges of nutritional status
We studied n = 60 participants aged 22.6 (22.3–22.7) years (50% women); their median body-mass index (BMI) was
Summary
Excessive liver fat accumulation not associated with alcohol abuse, or non-alcoholic fatty liver disease (NAFLD), may progress to steatohepatitis, cirrhosis and hepatoma. It is closely associated with increasing obesity prevalence among adults; it is rapidly becoming the most common liver disease worldwide [1]. NAFLD is highly prevalent in all continents, but the highest rates are reported in the Middle East (32%), South America (31%), Asia (27%), the United States (24%) and Europe (23%) [2]. In Chile, a study conducted with ultrasound showed that 23% of participants had NAFLD [3], slightly below the global prevalence rate [3].
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