Abstract
Liver fat can be non-invasively measured by proton magnetic resonance spectroscopy (1H-MRS) and fibrosis estimated as stiffness using transient elastography (FibroScan). There are no longitudinal data on changes in liver fat in Europids or on predictors of liver stiffness using these methods. We determined liver fat (1H-MRS) and clinical characteristics including features of insulin resistance at baseline and after a median follow-up period of 11.3 (range 7.3–13.4) years in 97 Finnish subjects. Liver stiffness was measured at 11.3 years. Liver fat content decreased by 5% (p < 0.05) over time. Values at baseline and 11.3 years were closely interrelated (r = 0.81, p < 0.001). Baseline liver fat (OR 1.32; 95%CI: 1.15–1.50) and change in BMI (OR 1.67; 95%CI: 1.24–2.25) were independent predictors of liver fat at 11.3 years (AUROC 0.90; 95%CI: 0.83–0.96). Baseline liver fat (AUROC 0.84; 95%CI: 0.76–0.92) predicted liver fat at 11.3 years more accurately than routinely available parameters (AUROC 0.76; 95%CI: 0.65–0.86, p = 0.02). At 11.3 years, 29% of the subjects had increased liver stiffness. Baseline liver fat (OR 2.17; 95%CI: 1.05–4.46) was an independent predictor of increased liver stiffness. These data show that liver fat is more important than the associated metabolic abnormalities as the predictor of future liver fat and fibrosis.
Highlights
The natural course of steatosis was recently characterized using proton magnetic resonance spectroscopy (1H-MRS), the state-of-the-art technique to quantify steatosis, in 565 Chinese subjects followed for 3.9 years[15]
The recent EASL-EASD-EASO Clinical Practice Guidelines for management of NAFLD and EASL-ALEH Clinical Practice Guidelines for evaluation of liver disease severity concluded that this technique is an acceptable non-invasive procedure for identification of cases at high risk of advanced fibrosis and cirrhosis[1,17]
We examined the natural course of liver triglyceride content using1H-MRS in 97 Finnish subjects during an 11-year follow-up period, and determined which baseline factors predict NAFLD and liver stiffness measured by transient elastography (TE)
Summary
The natural course of steatosis was recently characterized using proton magnetic resonance spectroscopy (1H-MRS), the state-of-the-art technique to quantify steatosis, in 565 Chinese subjects followed for 3.9 years[15]. Kim et al studied 76 obese youth of mixed ethnic origin for an average of 1.9 years and found liver fat measured by magnetic resonance imaging to remain unchanged during the follow-up[16]. We examined the natural course of liver triglyceride content using1H-MRS in 97 Finnish subjects during an 11-year follow-up period, and determined which baseline factors predict NAFLD (liver triglyceride content exceeding 5.6%) and liver stiffness measured by TE. The ethics committee of the Helsinki University Hospital approved the study protocol
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