Screening of patients with non-alcoholic fatty liver disease using non-invasive methods in clinical practice

Mária Belovičová

doi:10.24144/2077-6594.4.2019.193531

Abstract

The aim of study: to find out the incidence of non-alcoholic fatty liver disease in the internal outpatient clinic during 2017–2018 and compare the degree of liver damage found through transient elastography and fibrosis indices.Materials and methods. A total of 742 new patients were examined in the outpatient clinic. In each new patient we performed blood sample examination and a USG examination. When an enlarged liver or fatty liver was detected, a transient elastography was done. We included 300 patients in our sample. Besides that we used selected liver fibrosis indices for detection of liver fibrosis and compared the results with fibroscan. We realized statistical analysis of results. The aim of the statistical analysis was to find out the mutual correlations of the monitored parameters, indices of liver damage and degree of liver damage (using fibroscan), the influence of the presence of diabetes mellitus on the degree of liver damage.Results. The results of the multivariant analysis confirm the conclusions of the univariate analysis and can be summarized as follows: a) Independent predictors of liver damage are obesity, DM and patient’s age; b) Independent predictors of DM is obesity and age of patients (p = 0.001); c) Gender, as expected, does not appear to be a predictive factor.Conclusions. The results of statistical analysis of liver fibrosis indices in a group of patients confirmed the validity of laboratory tests in assessing liver damage as well as their easy applicability for clinical practice. However, a comprehensive assessment of a patient using the fibrosis index, abdominal cavity ultrasound examination and transient elastography examination is ideal.

Highlights

NAFLD – Non-alcoholic fatty liver disease – is characterized by the presence of hepatic steatosis – by excess accumulation of fat in liver tissue, which is associated with insulin resistance (IR)
We intended to focus on non-alcoholic fatty liver disease in overweight/obese patients and in patients with type 2 diabetes mellitus who appeared to be more at risk for liver damage.The average age of the patients in the group was 59 years, women accounted for 53.3% of the group (160), number of men was 140
Type 2 diabetes mellitus was present in 191/300 (63.7%)

Summary

Introduction

NAFLD – Non-alcoholic fatty liver disease – is characterized by the presence of hepatic steatosis – by excess accumulation of fat in liver tissue (steatosis must be present in more than 5% of hepatocytes), which is associated with insulin resistance (IR). NAFLD is considered benign, non-progressive form of the disease, while NASH – Non-alcoholic steatohepatitis – is a progressive form with the development of fibrogenesis, with high risk for liver cirrhosis and hepatocellular carcinoma of the liver [1,2]. NAFLD is the most common liver disease in economically developed countries. Over the past 20 years, the incidence of NAFLD has doubled worldwide, while the number of other chronic liver diseases has remained without significant changes. Fibrosis is the most important predictor of overall and hepatic mortality

Methods

Results

Discussion

Conclusion