Non-drug treatment of non-alcoholic fatty liver disease: evaluation of effectiveness with ultrasound steatometry

Abstract

Objective. Evaluation of the effectiveness of non-drug treatment in patients with non-alcoholic fatty liver disease using the method of quantitative ultrasound steatometry.Material and methods. We examined 118 patients aged 18–75 years, including 52 (44 %) men and 66 (56 %) women using a single diagnostic algorithm of four stages: questioning and collecting complaints, assessing the quality of life, clinical examination, non-invasive bioimpedansometry, followed by assessment of fat mass index, ultrasound examination of the liver in the B-mode, quantitative ultrasound steatometry by evaluating the attenuation coefficient of the ultrasonic wave. Individual non-drug therapy is prescribed to patients in the form of an individual program of therapeutic nutrition and physical activity. A dynamic assessment of the decrease in the proportion of adipose tissue and the severity of fatty liver infiltration was carried out at points of 6, 12, 18, 24 months. A liver biopsy followed by histological analysis on an SAF scale was performed in 32 patients.Results. To assess the effectiveness of non-drug treatment in patients, a tendency of reducing the proportion of fat content and the severity of fatty infiltration in the liver was observed. All patients were divided into two groups according to their level of compliance with the prescribed treatment. Decrease in the proportion of adipose tissue in patients with a high level of compliance – up to 76.2 %, in patients with a low level of compliance – up to 89.1 % of the initial values. Decrease in fatty liver infiltration in patients with a high level of compliance – up to 80.2 %, in patients with a low level of compliance – up to 92.1 % of the initial one.Conclusion. Ultrasound steatometry is an informative method for non-alcoholic fatty liver disease screening. The correlation of quantitative ultrasound diagnostics data for steatosis with a biopsy at stage S0 corresponds to r = 0.85; at stage S1 r = 0.72, at S2 r = 0.73, at stage S3 corresponds to r = 0.84, which indicates the high informativity of this method.