Diagnosis Of Fatty Liver Disease Research Articles

The combination between praziquantel treatment and fatty liver disease in relation to diabetes mellitus in Northeast of Thailand

Diabetes mellitus (DM) is a growing global public health concern, including Thailand. Prior research has established an association between fatty liver disease (FLD) and DM. Moreover, the distribution of DM was also found in liver fluke endemic areas where praziquantel (PZQ) was used prevalently. However, limited information exists regarding factors associated with DM, specifically in FLD patients undergoing PZQ treatment. Our study aimed to evaluate the association between the combination of PZQ treatment and FLD diagnosis, and DM in Northeast Thailand. We conducted the study among participants in northeastern Thailand with self-reported DM diagnosis and PZQ treatment history using health questionnaires. Additionally, FLD diagnosis was confirmed through ultrasonography from the Cholangiocarcinoma Screening Program data collected from 2013-2022. We employed multilevel mixed-effect logistic regression to assess the association between the combination of PZQ treatments and FLD diagnosis, and DM, represented as adjusted odds ratios (AOR) and their 95% confidence intervals (CI). Of 756,431 participants, the overall DM prevalence was 7%. Notably, 10.45% of individuals with FLD+ and 8.23% with PZQ+ were found to have DM. Specifically, the prevalence of DM in individuals with PZQ+ and FLD-, PZQ- and FLD+, and PZQ+ and FLD+ combinations were 7.14%, 10%, and 11.81%, respectively. In comparison to PZQ- and FLD-, participants with PZQ+ and FLD-, PZQ- and FLD+, and PZQ+ and FLD+ were associated with DM (AOR = 1.27; 95% CI: 1.24-1.30, AOR = 1.8; 95% CI: 1.76-1.85, and AOR = 2.19; 95% CI: 2.12-2.27, respectively). In conclusion, the combination of PZQ and FLD plays a crucial role in the association with DM, particularly in individuals with PZQ+ and FLD+. Our findings emphasize the importance of DM screening, with special attention to individuals with a combination of PZQ treatment and FLD diagnosis, in order to promote early detection and management of DM in Northeast Thailand.

Development and validation of diagnostic risk score for fatty liver grading among rural population visiting tertiary care hospital

Background: Fatty liver disease caused by alcoholic or non-alcoholic etiologies is an emerging major public health issue in India as well as worldwide. Non-alcoholic fatty liver disease has a global prevalence of approximately 25%. Aims and Objectives: We aim to develop and validate a risk-scoring system for the diagnosis of fatty liver disease among high-risk individuals (diabetes mellitus and obesity) using basic clinical history, laboratory investigations, and radiological examinations. Materials and Methods: Study design: Cross-sectional study conducted in a tertiary care teaching hospital. A patient case form has been designed for this study which includes all the relevant information under three headings, personal history, laboratory investigation findings, and radiological examination findings. Patients who have a known medical history of diabetes mellitus and/or body mass index (BMI) more than or equal to 25.00 will be included in this study. Results: The total number of patient data included in the study was 164. The total sample under consideration comprised 88 males (53.7%) and 76 females (46.3%). The average height was reported to be 159 ± 10.27 cm. The average weight of participants was 68.4 ± 12.6 kg. The average BMI of the study populace was 27 ± 4.46 kg/m2. Fatty score grading showed a significant positive univariate correlation with the weight, BMI, and triglyceride levels of the patients. Rest all correlations were found to be insignificant. Patients additionally presented with fibrosis grading and LSM score which were found to be positively correlated significantly with fatty liver grading. Fibrosis score and low-density lipoprotein level showed a significant negative correlation. All significant univariate factors were found to produce an insignificant multivariate regression model. The receiver operating characteristic curve and cutoff scores could not be determined. Therefore, the study was not able to develop and validate a multivariable scoring system. Conclusion: Even though the study was not able to fulfill the objectives intended, problems were identified and solutions were recommended for conducting such a study. This study can be taken as a baseline for future studies taking the recommendations into consideration at the time of execution.

The Application of Artificial Intelligence (AI)-Based Ultrasound for the Diagnosis of Fatty Liver Disease: A Systematic Review.

Fatty liver disease, also known as hepatic steatosis, poses a significant global health concern due to the excessive accumulation of fat within the liver. If left untreated, this condition can give rise to severe complications. Recent advances in artificial intelligence (AI, specifically AI-based ultrasound imaging) offer promising tools for diagnosing this condition. This review endeavors to explore the current state of research concerning AI's role in diagnosing fatty liver disease, with a particular emphasis on imaging methods. To this end, a comprehensive search was conducted across electronic databases, including Google Scholar and Embase, to identify relevant studies published between January 2010 and May 2023, with keywords such as "fatty liver disease" and "artificial intelligence (AI)." The article selection process adhered to the PRISMA framework, ultimately resulting in the inclusion of 13 studies. These studies leveraged AI-assisted ultrasound due to its accessibility and cost-effectiveness, and they hailed from diverse countries, including India, China, Singapore, the United States, Egypt, Iran, Poland, Malaysia, and Korea. These studies employed a variety of AI classifiers, such as support vector machines, convolutional neural networks, multilayer perceptron, fuzzy Sugeno, and probabilistic neural networks, all of which demonstrated a remarkable level of precision. Notably, one study even achieved a diagnostic accuracy rate of 100%, underscoring AI's potential in diagnosing fatty liver disease. Nevertheless, the review acknowledged certain limitations within the included studies, with the majority featuring relatively small sample sizes, often encompassing fewer than 100 patients. Additionally, the variability in AI algorithms and imaging techniques added complexity to the comparative analysis. In conclusion, this review emphasizes the potential of AI in enhancing the diagnosis and management of fatty liver disease through advanced imaging techniques. Future research endeavors should prioritize the execution of large-scale studies that employ standardized AI algorithms and imaging techniques to validate AI's utility in diagnosing this prevalent health condition.

Emerging Diagnostics and Therapeutics for Non-alcoholic Fatty Liver Disease.

The obesity epidemic has pushed fatty liver disease, which consists of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis, to the forefront of the 21st century. Disease identification can be done invasively with a liver biopsy or noninvasively through elastography and measurements of biomarkers, such as the alanine aminotransferase (ALT) and aspartate aminotransferase (AST) liver enzymes. Presently, there are no FDA-approved drugs on the market to treat the disease. Alternative medicinal treatments have been investigated, which include altering the intestinal microbiota and consuming anti-inflammatory, herbal-based, vitamin-based, and plant-based medications, in addition to following a healthy lifestyle. In this study, multiple databases were used to identify articles pertaining to fatty liver disease (FLD). Databases included Biomedical Reference Collection: Comprehensive, Cumulative Index of Nursing and Allied Health (CINAHL), Google Scholar, and PubMed. All articles gathered from the databases were peer-reviewed and less than 10 years old to ensure the credibility of the work and recent information regarding the disease. A total of 13 articles were used to gather information for this review. All articles were confirmed to be peer-reviewed by checking them with Ulrich's web. In all 13 peer-reviewed articles, the diagnosis of FLD was most commonly done by analyzing ALT and AST liver enzymes and lipid profiles. Liver ultrasound, liver FibroScan, and liver biopsy served as other tools used for detecting the presence of FLD. It was observed that anti-inflammatory, herbal-based, vitamin-based, and plant-based medications and healthy gut microbiota had beneficial and therapeutic effects in treating FLD when coupled with healthy lifestyle changes. All medicinal treatments were found to lower the ALT and AST liver enzymes, lipid profiles (total cholesterol, triglycerides, low-density lipoprotein), and liver steatosis scores in studies where ultrasound was used before and after treatment.Further investigation is needed to fully understand the mechanisms behind the therapeutic effects of treating FLD; however, the medicinal treatments discussed in this review show promising prospects for treating the disease. The therapeutic effects of anti-inflammatory, herbal-based, vitamin-based, and plant-based medications and living a healthy lifestyle were seen in lower levels of liver enzymes, improved lipid profiles, and lower steatosis scores, with no reported side effects on subjects. The treatment options studied may have beneficial impacts in treating FLD patients and may be used in the development of future medications to combat the disease.

Harnessing polarity-dependent fluorescent probe for lipid droplet metabolism dissection and in vivo nonalcoholic fatty liver disease diagnosis

Nonalcoholic fatty liver disease (NAFLD) has emerged as a prevalent chronic liver condition worldwide. The dysregulated metabolism of lipid droplets (LDs) in cells is physiologically and pathologically linked to NAFLD. The development of fluorescent probes for imaging LD metabolism holds promise for noninvasive diagnosis and understanding of NAFLD. However, the development of such probes is challenging, and their in vivo diagnostic potential remains largely unexplored. Here, we present the synthesis of ZP-1, a bright fluorophore serving as a specific probe for LDs. ZP-1 possesses a donor-acceptor electronic structure with intramolecular charge transfer characteristics and shows polarity-dependent emission. In highly polar solvents, such as water, ZP-1 exhibits minimal fluorescence, while in low-polarity solvents, it displays strong fluorescence. This property enables high-specificity LD detection with excellent imaging contrast. Attributed to its high photostability and pH stability, ZP-1 effectively visualizes LD metabolism in live cells via real-time imaging, encompassing processes such as growth, migration, fusion, and fission. Moreover, we demonstrate in vivo diagnosis of NAFLD in a mouse model, providing rich information regarding LD morphology, numbers, volumes, and tissue structures. This work introduces ZP-1 as a valuable tool for NAFLD diagnosis and research, facilitating noninvasive assessment and improved understanding of the disease.

Prevalence and incidence of MAFLD and associated anthropometric parameters among prepubertal children of the Shanghai Birth Cohort.

Metabolic dysfunction-associated fatty liver disease (MAFLD) is the most common chronic liver disease in adolescent and adult population. However, the epidemiologic data of MAFLD in prepubertal children remain limited. This study aimed to investigate the prevalence and incidence of MAFLD and assess the role of anthropometric parameters in identifying and predicting MAFLD in this population. Children from the Shanghai Birth Cohort Study who underwent an 8-year follow-up with anthropometric measurements and transient elastography FibroScan-502 examination (M probe, Echosens, Paris, France) were enrolled. Some of them also completed a 5-year follow-up. Diagnosis of fatty liver disease (FLD) was based on the controlled attenuation parameter (CAP) value exceeding 248dB/m, and MAFLD was defined as FLD combined with obesity or central obesity. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the diagnostic accuracy of anthropometric parameters for MAFLD. A total of 848 children (431 boys) from the Shanghai Birth Cohort Study were followed up for 8years, and among them, 385 children (189 boys) also participated in the 5-year follow-up. The prevalence of FLD and MAFLD at 5years old was 3.90% and 0.52%, respectively, while at 8years old, the prevalence rates increased to 5.07% for FLD and 3.42% for MAFLD. The 8-year-old children with MAFLD exhibited significantly higher weight, body mass index (BMI), chest circumference, waist circumference, hip circumference, waist-to-height ratio, waist-to-hip ratio, and liver stiffness measurement compared to those without MAFLD (all p < 0.05). The incidence rates of FLD and MAFLD at 8years old, considering the 5-year follow-up data, were 3.78% (14/370) and 3.13% (12/383), respectively. Obese or centrally obese children at 5years old had a higher incidence of FLD and MAFLD at the 8-year follow-up. Waist circumference and BMI showed significant associations with the presence and incidence of MAFLD, respectively, with the largest AUC values in ROC curve analysis. In addition, chest circumference was significantly associated with MAFLD in obese children. This study provides insights into the incidence and prevalence of MAFLD in prepubertal children. It underscores the importance of anthropometric parameters in identifying and predicting MAFLD in this population. Further research encompassing a broader age range and incorporating these indicators and additional metabolic markers is necessary to enhance the understanding and management of MAFLD in children.

1102 A Rare Case of Parenchymal Liver Injury Presenting Initially as an Obstructive Jaundice

Abstract Parenchymal liver damage is secondary to a sudden insult on hepatocytes, most commonly due to hepatitis or secondary to drug injury. A 43-year-old gentleman with a pre-existing diagnosis of fatty liver disease, presented with obstructive jaundice. He had a bilirubin of 159 and ultrasound imaging showed gallstones in his gallbladder with a dilated common bile duct (CBD) of 6.7mm. An MRCP showed a dilated CBD with an intraluminal filling defect. He was discharged home when clinically well and referred for an outpatient ERCP. This did not happen for three weeks and at this point, no cause of obstruction was identified, but a plastic biliary stent was inserted. Despite this, his liver function worsened, and he was readmitted with a bilirubin of 421. Following discussion within a multidisciplinary team he underwent a further CT scan and ERCP with stent replacement, these showed no evidence of obstruction. All acute hepatic and virology screens were negative. His bilirubin continued to uptrend hitting 644 and he became coagulopathic with an elevated INR of 2.7. The patient admitted to taking weight loss supplements including a “fat burner” powder regularly for the last two months, in keeping with the duration of his worsening liver dysfunction. He underwent a liver biopsy; the results of which are pending and is currently being treated supportively. This case presented an interesting diagnostic challenge and there remains ongoing uncertainty. The current working diagnosis is that of an obstructive jaundice which has exacerbated an underlying parenchymal liver injury secondary to supplement use.

Bio-Inspired Network for Diagnosing Liver Steatosis in Ultrasound Images.

Using ultrasound imaging to diagnose liver steatosis is of great significance for preventing diseases such as cirrhosis and liver cancer. Accurate diagnosis under conditions of low quality, noise and poor resolutions is still a challenging task. Physiological studies have shown that the visual cortex of the biological visual system has selective attention neural mechanisms and feedback regulation of high features to low features. When processing visual information, these cortical regions selectively focus on more sensitive information and ignore unimportant details, which can effectively extract important features from visual information. Inspired by this, we propose a new diagnostic network for hepatic steatosis. In order to simulate the selection mechanism and feedback regulation of the visual cortex in the ventral pathway, it consists of a receptive field feature extraction module, parallel attention module and feedback connection. The receptive field feature extraction module corresponds to the inhibition of the non-classical receptive field of V1 neurons on the classical receptive field. It processes the input image to suppress the unimportant background texture. Two types of attention are adopted in the parallel attention module to process the same visual information and extract different important features for fusion, which improves the overall performance of the model. In addition, we construct a new dataset of fatty liver ultrasound images and validate the proposed model on this dataset. The experimental results show that the network has good performance in terms of sensitivity, specificity and accuracy for the diagnosis of fatty liver disease.

Relationship Between Plasma Aldosterone Concentrations and Non-Alcoholic Fatty Liver Disease Diagnosis in Patients with Hypertension: A Retrospective Cohort Study.

To investigate the association between plasma aldosterone concentration (PAC) and non-alcoholic fatty liver disease (NAFLD) diagnosis in Chinese hypertensive patients. We conducted a retrospective study of all patients diagnosed with hypertension between January 1, 2010, and December 31, 2021. We included 3713 hypertensive patients based on the criteria for inclusion and exclusion. PAC measurement was performed using a radioimmunoassay. NAFLD was diagnosed using abdominal ultrasonography. Cox regression analysis was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for univariable and multivariable models. A generalized additive model was used to identify nonlinear relationships between PAC and NAFLD diagnosis. A total of 3713 participants were included in the analysis. Over a median follow-up of 30 months, 1572 hypertensive individuals developed new-onset NAFLD. When PAC was used as a continuous variable, the risk of NAFLD increased by 1.04 and 1.24-fold for each 1 ng/dL and 5 ng/dL increase in PAC, respectively. When PAC was considered a categorical variable, the HR for tertile 3 was 1.71 (95% CI, 1.47-1.98, P < 0.001) compared to tertile 1. Overall, there was a J-shaped relationship between PAC and new-onset NAFLD. By fitting a two-piecewise linear regression model and using a recursive algorithm, we identified a PAC inflection point at 13 ng/dL (log-likelihood ratio test, P = 0.005). In adjusted model 3, for PAC ≥ 13 ng/dL, a 5 ng/dL increase in PAC was associated with a 30% increase in the risk of new-onset NAFLD (95% CI, 1.25-1.35, P < 0.001). The study revealed a non-linear relationship between elevated PAC levels and the incidence of NAFLD in hypertensive patients. Notably, the risk of new-onset NAFLD was significantly increased when PAC levels were ≥13 ng/dL. Larger, prospective studies are necessary to confirm these findings.

WED-526 - Novel image analysis and immunohistochemistry advances to accompany pathologist driven non-alcoholic fatty liver disease diagnosis

WED-526 - Novel image analysis and immunohistochemistry advances to accompany pathologist driven non-alcoholic fatty liver disease diagnosis

Prediction of Fatty Liver Disease in a Chinese Population Using Machine-Learning Algorithms.

Fatty liver disease (FLD) is an important risk factor for liver cancer and cardiovascular disease and can lead to significant social and economic burden. However, there is currently no nationwide epidemiological survey for FLD in China, making early FLD screening crucial for the Chinese population. Unfortunately, liver biopsy and abdominal ultrasound, the preferred methods for FLD diagnosis, are not practical for primary medical institutions. Therefore, the aim of this study was to develop machine learning (ML) models for screening individuals at high risk of FLD, and to provide a new perspective on early FLD diagnosis. This study included a total of 30,574 individuals between the ages of 18 and 70 who completed abdominal ultrasound and the related clinical examinations. Among them, 3474 individuals were diagnosed with FLD by abdominal ultrasound. We used 11 indicators to build eight classification models to predict FLD. The model prediction ability was evaluated by the area under the curve, sensitivity, specificity, positive predictive value, negative predictive value, and kappa value. Feature importance analysis was assessed by Shapley value or root mean square error loss after permutations. Among the eight ML models, the prediction accuracy of the extreme gradient boosting (XGBoost) model was highest at 89.77%. By feature importance analysis, we found that the body mass index, triglyceride, and alanine aminotransferase play important roles in FLD prediction. XGBoost improves the efficiency and cost of large-scale FLD screening.

Computerized Tomography-Based Screening for Moderate to Severe Hepatic Steatosis in a Multiethnic Population.

Background and Aim Data on prevalence of nonalcoholic fatty liver disease in Hawaii is limited. This study determined the prevalence of moderate to severe hepatic steatosis within a multicultural, multiethnic, and multiracial cohort in Hawaii undergoing computerized tomography (CT) for reasons unrelated to fatty liver disease. Methods The authors performed a retrospective analysis of all patients who were members of an integrated health care system with CT scans including the liver between January 1, 2020, and December 31, 2020. Moderate to severe hepatic steatosis was determined by an average attenuation value < 40 Hounsfield units for non-contrast-enhanced CT and a mean attenuation value < 90 Hounsfield units for contrast-enhanced CT. Patients' electronic medical records were reviewed for existing diagnoses of hepatic steatosis, obesity, and diabetes mellitus type 2 and data to calculate a Fibrosis-4 (FIB-4) index. Results Approximately 26.6% had moderate to severe hepatic steatosis, while only 11.3% of those patients had an active diagnosis of fatty liver disease. Native Hawaiians and Pacific Islanders (33.1%) had the greatest prevalence of hepatic steatosis, followed by White people (28.4%), Asian people (27.7%), and other ethnicities (10.8%). About 61.4% patients with fatty liver had a diagnosis of obesity, while 33.4% had a body mass index < 30.0 kg/m2. Finally, 86.2% patients had enough information in their electronic medical records from which to calculate a FIB-4 score and the mean FIB-4 index was 1.66 ± 3.50. Conclusions Moderate to severe hepatic steatosis is common among patients undergoing CT studies for reasons not related to hepatic steatosis in this multiethnic population most of whom did not have a diagnosis of fatty liver disease.

Long-term weight changes are associated with initial weight changes after nonalcoholic fatty liver disease diagnosis

Weight loss is the mainstay of treatment of NAFLD, but longitudinal data on weight changes and their impact on liver disease are limited. We aimed to characterize weight trajectory up to 5 years of follow-up, effects of weight loss on liver enzyme levels, and predictors of weight loss in NAFLD. This was a single-center retrospective study of consecutive patients with hepatic steatosis diagnosed on imaging, liver biopsy, or transient elastography between 2010 and 2020. The primary outcome was ≥5% weight change at 1-2 years. Secondary outcomes were weight change at 4-5 years and alanine aminotransferase level at 1-2 and 4-5 years. We conducted multivariable logistic regression to identify predictors of ≥5% weight loss at 1-2 years. We included 11,559 patients with NAFLD. At year 1-2, 27% had ≥5% weight loss, whereas 26% had ≥5% weight gain. Total 59% and 68% of patients with weight loss and gain, respectively, sustained their weight change by year 4-5. Patients with weight loss at year 1-2 had lower alanine aminotransferase levels at year 1-2 and 4-5. Predictors of ≥5% weight loss included female sex, severe obesity, diabetes, and consultation with a dietitian or pharmacist. Over half of patients with NAFLD had ≥5% weight loss or gain within 1-2 years, and these changes were usually sustained at 4-5 years. Intensive intervention early after NAFLD diagnosis may result in long-term weight loss and decreased NAFLD disease activity.

Diet was less significant than physical activity in the prognosis of people with sarcopenia and metabolic dysfunction-associated fatty liver diseases: Analysis of the National Health and Nutrition Examination Survey III.

Sarcopenia is prevalent in metabolic dysfunction-associated fatty liver diseases (MAFLD), and the primary treatment for both diseases is lifestyle modification. We studied how dietary components and physical activity affect individuals with sarcopenia and MAFLD. We conducted a study utilizing National Health and Nutrition Examination Survey (NHANES) III (1988-1994) data with Linked Mortality file (through 2019). The diagnosis of fatty liver disease (FLD) was based on ultrasound images revealing moderate and severe steatosis. Using bioelectrical measures, sarcopenia was assessed. Using self-report data, dietary intake and physical activity levels were evaluated. Among 12,259 participants, 2,473 presented with MAFLD, and 290 of whom had sarcopenia. Higher levels of physical activity (odds ratio [OR] = 0.51 [0.36-0.95]) and calorie (OR = 0.58 [0.41-0.83]) intake reduced the likelihood of sarcopenia in MAFLD patients. During a median follow-up period of 15.3 years, 1,164 MAFLD and 181 MAFLD patients with sarcopenia perished. Increased activity levels improved the prognosis of patients with sarcopenia (Insufficiently active, HR = 0.75 [0.58-0.97]; Active, HR = 0.64 [0.48-0.86]), which was particularly pronounced in older patients. In the general population, hyperglycemia was highly related to MAFLD prognosis. Physical inactivity and a protein-restricted diet corresponded to sarcopenia, with physical inactivity being connected to poor outcomes. Adding protein supplements would be beneficial for older people with sarcopenia who are unable to exercise due to frailty, while the survival benefits were negligible.

Rational design AIE fluorescent probes for wash-free and lipid droplet specific imaging of fatty liver based on coumarin

The aberrant accumulation of Lipid droplets (LDs) is connected to various diseases, in particular, fatty liver. Therefore, the development of fluorescent LDs-targeting probes with excellent permeability and high imaging contrast could provide powerful tools for the diagnosis of fatty liver disease. In this work, we constructed a family of fluorescent probes B1–B6 based on the coumarin moiety, which exhibited the aggregation-induced emission property (except for B5), an ultrahigh signal-to-noise (S/N) ratio and wash-free property (except for B6). With the advantage of ultrafast staining, compound B2 was successfully applied to real-time detection of dynamic LDs in living cells, such as motion, dissociation and fusion processes. By establishing the mouse model with LDs-related fatty liver, the imaging performance of compound B2 at the pathological tissue level was well investigated, implying exceptional selectivity and resolution. Taken together, this work would develop a promising method for LDs investigation, which contributed to a deeper insight into the physiological significance of LDs.

US Attenuation Imaging for the Evaluation and Diagnosis of Fatty Liver Disease.

This study aimed to determine whether the attenuation coefficient (AC) from attenuation imaging (ATI) was correlated with visual US assessment in patients with hepatic steatosis. Moreover, it aimed to assess whether the patient's blood chemistry results and CT attenuation were correlated with AC. Patients who underwent abdominal US with ATI between April 2018 and December 2018 were included in this study. Patients with chronic liver disease or cirrhosis were excluded. The correlation between AC and other parameters, such as visual US assessment, blood chemistry results, liver attenuation, and liver-to-spleen (L/S) ratio, were analyzed. AC values according to visual US assessment grades were compared using analysis of variance. A total of 161 patients were included in this study. The correlation coefficient between US assessment and AC was 0.814 (p < 0.001). The mean AC values for the normal, mild, moderate, and severe grades were 0.56, 0.66, 0.74, and 0.85, respectively (p < 0.001). Alanine aminotransferase levels were significantly correlated with AC (r = 0.317, p < 0.001). The correlation coefficients between liver attenuation and AC and between L/S ratio and AC were -0.702 and -0.626, respectively (p < 0.001). Visual US assessment and AC showed a strong positive correlation with the discriminative value between the groups. Computed tomography attenuation and AC showed a strong negative correlation.

A Novel Portable Unilateral Magnetic Resonance Magnet for Noninvasive Quantification of Human Liver Fat

Fatty liver disease has become one of the common liver diseases seriously affecting people’s health and quality of life. Existing means to quantify liver fat content are usually invasive and high-cost. Our research aims to design a single-sided magnet to develop a low-cost, non-invasive, and lightweight unilateral magnetic resonance (UMR) system that can satisfy the needs for fatty liver screening and diagnosis. A novel single-sided permanent magnet with a pear-shaped magnetic field iso-surface was designed to avoid the excitation of subcutaneous tissue in the human body. The weight of the magnet was optimized to 12.9 kg, and the mean magnetic field strength of the region of interest (ROI) was 0.07 T. The radio frequency (RF) coil set, the pulse sequence, and the modeling method for measuring proton density fat fraction (PDFF) were also introduced. Experiments for phantoms and volunteers were carried out by the UMR system to verify the performance of detection. The phantom detection results show that the UMR system can effectively avoid the influence of the subcutaneous tissue part on PDFF detection, with reasonable accuracy (around 5% fat fraction error) and robustness (within 10% relative error). Compared with a conventional MRI scanner, measurement results of volunteers (around 3% fat fraction error) show the effectiveness of the UMR system for screening fatty liver diseases. The UMR system developed based on the proposed portable single-sided magnet could be a low-cost and reliable diagnostic tool for noninvasive fatty liver disease diagnosis.

Clinical Importance Of Elevated Levels Of Alpha-fetoprotein In Early Diagnosis Of Non-alcoholic Fatty Liver Disease In Native Population Of Southern Punjab, Pakistan

Objective: To evaluate the relationship between elevated levels of AFP (alpha-fetoprotein) and NAFLD (Non-Alcoholic Fatty Liver Disease) in the native population of Southern Punjab, Pakistan.Place of Study: Ibn-e-Siena Hospital &amp; research institute, MultanStudy Design: Descriptive Cross-Sectional StudyDuration of Study: December 2021 to July 2022Methodology: 800 patient samples were included in this study. All subjects showed elevated serum Alpha-fetoprotein (AFP) levels. To measure AFP sandwich immune detection FIA (fluorescence immunoassay) technique was used. The tests were performed on chroma for the quantitative analysis. A value above the cut-off value was 10.9 ng/mL was further investigated for the clinical history and full clinical record of anthropometric and biochemical tests.Results: Fatty Liver Disease (FLD) was diagnosed in 19.5% of subjects. Most of the cases were of Non-Alcoholic Fatty Liver Disease (NAFLD) with 98.71%. More males were affected with NAFLD with 11.5%. NAFLD was more observed in &gt;50years aged patients at 12.62% than in patients &lt; 50 years at 6.625%. There was a non-significant correlation between the residence type of the patient with the disease incidence. There was a significant relationship between NAFLD and Blood Pressure, Fasting Blood Sugar, Triglycerides, Total Cholesterol, HBA1C, and High-Density Lipids (HDL) with a p-value &lt;0.01.Conclusion: It is concluded that elevated levels of alpha-fetoproteins are clinically important and can be useful tools for the early diagnosis of fatty liver disease, especially NAFLD.

Artificial intelligence model with deep learning in nonalcoholic fatty liver disease diagnosis: genetic based artificial neural networks

Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease in the world. The NAFLD spectrum includes simple steatosis, steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). Genetic, nutritional factors, obesity, insulin resistance, gut microbiota are among the risk factors for NAFLD. The genetic variant Patatin-like phospholipase domain-containing protein 3 (PNPLA3) plays an important role in the development of a number of liver diseases ranging from steatosis, chronic hepatitis, cirrhosis and HCC. Due to the increase in the prevalence of NAFLD, new models are being developed with machine learning, deep learning, artificial neural network (ANN) algorithms in the field of artificial intelligence (AI) to determine low-cost, noninvasive diagnostic methods. Models developed with ANN from AI modules are important in order to examine biochemical and genomic information in detail in the diagnosis of NAFLD. The aim of this study is to develop a simple ANN model using biochemical and genotypic parameters in the diagnosis of NAFLD. A total of 300 patients followed up with the diagnosis of NAFLD and 100 controls were included in the study. The data set was divided into two as training and test set. Genotyping of PNPLA3 (CC, CG, GG) as genomic analysis was performed with real time PCR device. The algorithm used for the diagnosis of NAFLD was designed using age, body mass index (BMI), mean platelet volume (MPV), insulin resistance (IR), alanine aminotransferase (ALT), genotype PNPLA3 (CC, CG, GG) parameters. MLP Classifier algorithm from ANN was used in the development of the model. ANN algorithms are used in python programming language. Statistical analyzes were made in SPSS program. Percent accuracy, area under the ROC curve, confusion matrix, Positive (PPV) and Negative Predicted Value (NPV) values, precision, recall, and f1-score results were determined. The accuracy percentage was determined as 0.979 in the train set and 0.970 in the test set. The Log Loss value was set to 0.09. The developed neural network achieved an accuracy percentage of 97.0% during testing, with an area under the ROC curve value of 0.95. We think that the ANN model developed with genomic and biochemical parameters can be used as a cost-effective, noninvasive new predictive diagnostic model in clinical practice in the diagnosis of NAFLD.

Glucose metabolism status modifies the relationship between lipoprotein(a) and carotid plaques in individuals with fatty liver disease.

Glucose and lipoprotein(a) [Lp(a)] have been recognized risk factors for atherosclerosis. The impact of both factors on fatty liver patients has not been studied. The aim of this study is to explore the role of high-level Lp(a) and different glucose metabolism statuses on carotid plaques in fatty liver patients. We selected 4,335 fatty liver patients in this cross-sectional study. The diagnosis of fatty liver disease and carotid plaques was made by ultrasound. Participants were divided into four groups based on glucose metabolism status (normal glucose regulation [NGR], lower bound of impaired fasting glucose [IFG-L], higher bound of impaired fasting glucose [IFG-H], diabetes mellitus [DM]) and then categorized into 12 subgroups according to Lp(a) concentrations. The association between variables was estimated by odds ratio (OR). Carotid plaques were present in 1,613 (37.2%) fatty liver patients. Lp(a)≥30 mg/dL was associated with high risk of carotid plaques in those patients with IFG-L, IFG-H and DM (OR 1.934 [95% CI 1.033-3.618], 2.667 [1.378-5.162], 4.000 [2.219-7.210], respectively; p<0.05). Fatty liver patients with DM plus Lp(a)<10 mg/dL and 10≤Lp(a)<30 mg/dL were more vulnerable to carotid plaques (OR 1.563 [95% CI 1.090-2.241], 1.930 [1.279-2.914]), respectively, p<0.05). Our study first suggested that high-level Lp(a) may raise the risk of carotid plaques in fatty liver patients with not only diabetes but also IFG, manifesting that Lp(a) may be helpful for the early discovery of subclinical atherosclerosis in fatty liver patients with impaired glucose metabolism.