Degree Of Steatosis In Patients Research Articles

Ultrasound Attenuation Imaging vs MRI-PDFF, Echogenicity and Liver Function for Assessing Degree of Steatosis in NAFLD and Non-NAFLD Patients.

Nonalcoholic fatty liver disease (NAFLD) is a primary cause of parenchymal liver disease globally. There are currently several methods available to test the degree of steatosis in NAFLD patients, but all have drawbacks that limit their use.The objective of this study is to determine if a new technique, ultrasound (US) attenuation imaging (ATI), correlates with magnetic resonance proton density fat fraction imaging and hepatic echogenicity as seen on gray scale US imaging.Fifty-four patients were recruited at the University of Washington Medical Center from individuals who had already been scheduled for hepatic US or magnetic resonance imaging (MRI). All participants then underwent both hepatic MRI proton density fat fraction and US. Ultrasound images were then evaluated using ATI with 2 observers who individually determined relative grayscale echogenicity.Analysis showed positive correlation between ATI- and MRI-determined fat percentage in the case group (Spearman correlation: 0.50; P = 0.015). Furthermore, participants with NAFLD tended to have a higher ATI than controls (median: 0.70 vs 0.54 dB/cm/MHz; P < 0.001).This study demonstrates that US ATI combined with grayscale imaging is an effective way of assessing the degree of steatosis in patients with moderate to severe NAFLD.

Significantly higher atherosclerosis risks in patients with obstructive sleep apnea and non-alcoholic fatty liver disease.

There is limited data on the relationship between Obstructive Sleep Apnea (OSA) and Non-Alcoholic Fatty Liver Disease (NAFLD), each associated with increased cardiovascular risk. This study aimed to determine the relationships between severity of OSA, degree of steatosis in NAFLD and cardiovascular risk via CIMT and atherosclerosis markers ie intracellular adhesion molecule-1 (ICAM-1) an Lipoprotein-a (Lp(a)) in a group of patients with OSA. This was a cross-sectional, single center study. A total of 110 subjects between 18 to 65 years of age and diagnosed with OSA following sleep study examinations were recruited. Exclusion criteria included seropositive Hepatitis B or Hepatitis C, and significant alcohol intake. The prevalence of NAFLD was 81.8%. The mean CIMT (0.08±0.03 vs 0.06±0.01 cm, p = 0.001), ICAM-1 (334.53±72.86 vs 265.46±102.92 ng/mL, p = 0.001) and Lp(a) (85.41±52.56 vs 23.55±23.66 nmol/L, p<0.001) were significantly higher in the NAFLD group compared to the non-NAFLD group. Comparisons between the different groups showed significantly increasing levels of CIMT, ICAM-1 and Lp(a), lowest within the non-NAFLD, followed by the NAFLD 1 and NAFLD 2+3 groups. There was a significant positive correlation between degree of steatosis and the severity of OSA (r = 0.453, p<0.001). Logistic regression analysis revealed that patients with apnea/hypopnea index (AHI) of >30 were 52.77 (CI 6.34, 439.14) times more likely to have NAFLD compared to those with mild AHI (p<0.001). The prevalence of NAFLD is alarmingly high in this group of OSA patients. The degree of steatosis in patients with NAFLD was significantly correlated with severity of OSA, CIMT measurements, ICAM-1 and Lp(a). Our findings underscore screening for NAFLD in patients with OSA to ensure prompt risk stratification and management.

The relationship between intestinal microbiota and systemic inflammation in patients with non-alcoholic fatty liver disease

Objective — to determine the relation of the main phylotypes of the intestinal microbiota (IM) with markers of systemic inflammation and the degree of hepatic steatosis in patients with non‑alcoholic fatty liver disease (NAFLD) with metabolic disorders.&#x0D; Materials and methods. The study included 114 patients with NAFLD with excessive body mass and obesity and 30 people as a control group, who were investigated on the basis of the Department of Gastroenterology and Therapy of the Polyclinics of the L. T. Mala National Therapy Institute of NAMS of Ukraine. The mean age of the investigated subjects was (52.56 ± 11.70) years. Anthropometric measurements were carried out with the calculation of the body mass index (BMI), determination of the percentage of visceral adipose tissue (VAT) using the OMRON BF‑511 body composition monitor. To determine the VAT dysfunction, the visceral obesity index (VOI) was calculated by the M. C. Amato method. Determination of CRP and TNF‑alpha levels was carried out by enzyme immunoassay. The assessment of the degree of steatosis was carried out by determining the wave attenuation coefficient (WAC) and shear wave elastometry. Determination of the composition of the intestinal microbiota at the level of the main phylotypes was carried out by identifying the total bacterial DNA and DNA of Bacteroidetes, Firmicutes, and Actinobacteria by the method of quantitative polymerase chain reaction (PCR) in real time.&#x0D; Results. The NAFLD patients displayed significantly increased levels of CRP and TNF‑alpha in comparison with the control group. A weak direct correlation has been established between CRP, TNF‑alpha and Firmicutes (r = 0.24 (p = 0.0029) and r = 0.17 (p = 0.0350), respectively), and an inverse correlation dependence of CRP on Bacteroidetes (r` = – 0.29 (p = 0.0003)). Analysis of the dependence of the ratio of the main intestinal phyla (Firmicutes/Bacteroidetes) on markers of systemic inflammation in NAFLD patients with different activity of visceral adipose tissue (VAT) revealed an increase in the ratio of the main phyla of IM with an increase in VAT activity. In the group of NAFLD patients with high VAT activity maximum values of the Firmicutes/Bacteroidetes ratio have been defined. Patients with increased levels of CRP an TNF‑alpha displayed an increase in the Firmicutes/Bacteroidetes ratio. Patients with advanced steatosis showed more significant changes in the main phyla of IM towards an increase in Firmicutes.&#x0D; Conclusions. The dependence of the Firmicutes/Bacteroidetes ratio from the markers of systemic inflammation and VAT activity has been established. The maximum values of the index (Firmicutes/Bacteroidetes) were observed in NAFLD patients with a high degree of visceral obesity index and hepatic steatosis as well as elevated CRP and TNF‑alpha levels.&#x0D;

Diagnostic possibilities of the method of elastography and shear wave steatorei patients with non-alcoholic fatty liver disease

The steady increase in the number of patients with chronic diff use liver diseases, including non-alcoholic fatty liver disease, leads to the need to introduce non-invasive methods of diagnosis and monitoring changes in the structure of the organ into clinical practice.Objective. To evaluate the possibility of using shear wave steatometry and elastography in the diagnosis of fi brosis stage and degree of steatosis in patients with non-alcoholic fatty liver disease.Materials and methods of research. The study involved 52 patients of the I. I. Mechnikov NWSMU clinic with NAFLD, 28 of them men and 24 women, the average age was 51-+11.2 g, the average BMI-30,7-+5,4 kg / m2. The control group consisted of 20 healthy volunteers. All patients underwent complex ultrasound on the Angiodin-Sono/P-Ultra device (Bioss, Russia) with a 1–6 MHz convexic sensor (B-mode, Doppler modes—vascular mapping and spectral pulse, shear wave elastometry, elastography (active and natural compression—Active / Natural Strain)).

Pathogenetic role of visceral adipose tissue in the development of non-alcoholic fatty liver disease in patients with metabolic syndrome

Objective — to study the nature of changes in carbohydrate and lipid metabolism, depending on the distribution and activity of visceral adipose tissue (VAT), and the degree of liver steatosis in patients with nonalcoholic fatty liver disease (NAFLD) against the background of a metabolic syndrome (MS). Materials and methods. Were examined 62 patients with NAFLD: 26 men (40 %) and 36 women (60 %). The mean age of patients was 57.3 ± 9.2 years. The control group consisted of 30 healthy donors of the same age group of males and females. All patients were assessed the parameters of an objective examination and laboratory and instrumental examination in accordance with the current order MOH № 826 from 06.11.2014. In addition to the standard survey, the body composition of patients was monitored, and the visceral adiposity index (VAI) was calculated by the method of Amato MC (2010) to determine visceral adipose tissue dysfunction (VAT). Statistical processing of data was carried out using the SPSS 17.0 software package. Results. In patients with NAFLD, elevated insulin levels 29.23 ± 5.26 μS/ml were established in comparison with control group 6.83 ± 2.08 μS/ml and a significant increase in the HOMA index to 8.93 ± 3.01 μmol fructose/1 g Nv (p < 0.05). The maximum levels of insulin and the HOMA-IR index were found in patients with high IVO that exceeded 5μm. unit. Concentrations of total cholesterol (CH), triglycerides (TG), low density lipoprotein (LDL) in patients with NAFLD were also significantly higher than those in the control group (p < 0.05). The maximal TG level 2.87 ± 0.14 mmol was observed in patients with high IVO (p < 0.05). In addition to the changes in carbohydrate and lipid metabolism rates, with the degree of fusion of IVO, the steatosis rates (p < 0.05) also increased. Conclusions. The obtained data evidence about the dependence of the depth of the carbohydrate and lipid metabolism violations on the activity. In patients with NAFLD against the background of MS, index HOMA-IR and CH, TG, LDL and degree of steatosis significantly increased with the growth of IVO (p < 0.05), which makes it possible to consider IVO as a significant additional prognostic criterion for the risk of development of not only metabolic disorders, but also as a risk factor for the progression of fibroblastic processes.

Fibroscan as a noninvasive tool in the assessment of the degree of hepatic steatosis in patients with nonalcoholic fatty liver disease

BackgroundTransient elastography (TE) is a noninvasive method for predicting liver fibrosis, mainly validated in patients with viral hepatitis.AimTo study the diagnostic value of fibroscan (TE) as a noninvasive tool in the assessment of the degree of hepatic steatosis in patients with nonalcoholic f

Association Between Serum Vitamin B12 Levels and the Degree of Steatosis in Patients With Nonalcoholic Fatty Liver Disease

PurposeA relationship between liver diseases and serum vitamin B12 levels was observed in previous reports. The purpose of this study was to determine if a similar relationship existed between vitamin...

Super paramagnetic iron oxide MRI shows defective Kupffer cell uptake function in non-alcoholic fatty liver disease

BackgroundThe pathogenesis of non-alcoholic fatty liver disease (NAFLD) is incompletely understood. Kupffer cells (KCs), phagocytic liver-resident macrophages, provide a protective barrier against egress of endotoxin from the portal to the...

Leptin has no role in determining severity of steatosis and fibrosis in patients with chronic hepatitis C.

The presence of steatosis is a common histological finding in patients with chronic hepatitis C (CHC). The causes of the severity of this condition are not yet clear, although both metabolic and viral factors supposedly are involved. In this study our aim was to examine the possible influence that leptin levels, hepatitis C virus (HCV) RNA levels, and hepatitis G virus (HGV) infection have on the severity of steatosis and on the presence and degree of fibrosis in patients with CHC. One hundred eighty-two CHC patients with histological findings of steatosis were chosen from among a cohort of patients referred to our center for staging of liver disease. Among them 48 CHC patients were accurately selected so as to rule out possible confounding factors for the presence of steatosis (diabetes mellitus, hyperlipemia, obesity, alcohol). Leptin levels, HCV RNA levels, and HCV genotype, and the presence of HGV RNA were assessed in these patients and related to histological findings. We found that leptin levels in CHC patients were similar to those in healthy subjects. No relationship was found between leptin levels and severity of steatosis. HCV RNA levels, HCV genotype, and the presence of HGV infection were no different among CHC patients with various degrees of steatosis. Leptin was not related to different degrees of fibrosis, whereas higher viral load was the only parameter associated to higher fibrosis scores. These findings suggest that the degree of steatosis in patients with CHC does not seem to depend on serum leptin levels or on viral factors, at least as far as HCV viremia and genotype and HGV infection are concerned. The severity of fibrosis does not seem to be influenced by leptin levels, whereas HCV viral load does seem to play some role.

Leptin has no role in determining severity of steatosis and fibrosis in patients with chronic hepatitis C

OBJECTIVE: The presence of steatosis is a common histological finding in patients with chronic hepatitis C (CHC). The causes of the severity of this condition are not yet clear, although both metabolic and viral factors supposedly are involved. In this study our aim was to examine the possible influence that leptin levels, hepatitis C virus (HCV) RNA levels, and hepatitis G virus (HGV) infection have on the severity of steatosis and on the presence and degree of fibrosis in patients with CHC. METHODS: One hundred eighty-two CHC patients with histological findings of steatosis were chosen from among a cohort of patients referred to our center for staging of liver disease. Among them 48 CHC patients were accurately selected so as to rule out possible confounding factors for the presence of steatosis (diabetes mellitus, hyperlipemia, obesity, alcohol). Leptin levels, HCV RNA levels, and HCV genotype, and the presence of HGV RNA were assessed in these patients and related to histological findings. RESULTS: We found that leptin levels in CHC patients were similar to those in healthy subjects. No relationship was found between leptin levels and severity of steatosis. HCV RNA levels, HCV genotype, and the presence of HGV infection were no different among CHC patients with various degrees of steatosis. Leptin was not related to different degrees of fibrosis, whereas higher viral load was the only parameter associated to higher fibrosis scores. CONCLUSIONS: These findings suggest that the degree of steatosis in patients with CHC does not seem to depend on serum leptin levels or on viral factors, at least as far as HCV viremia and genotype and HGV infection are concerned. The severity of fibrosis does not seem to be influenced by leptin levels, whereas HCV viral load does seem to play some role.

Factors associated with steatosis in patients with chronic hepatitis C

Purpose: Steatosis is a common feature of chronic Hepatitis C (HCV). The pathophysiology of steatosis is not clear. Multiple factors may play a role in the degree of steatosis in patients with HCV infection. We investigated the correlation between pre-treatment body mass index (BMI), serum liver injury tests, and HCV viral load (HCV-RNA), and steatosis in patients with HCV.