Frequency Of Hepatic Steatosis Research Articles

Insulin resistance and its role in the pathogenesis of pre-diabetes development in obese adolescents

Background. The prevalence of childhood obesity has increased significantly over the past three decades worldwide, and in this regard, the frequency of diseases associated with obesity, including disorders of carbohydrate metabolism, has increased. The involvement of insulin resistance and insulin deficiency in the development of prediabetes in obesity has been established. However, the significance of each pathological mechanism in the development of prediabetes in childhood and adolescence has not been established. In this regard, in children's practice, there is no reliable data on methods of prevention and treatment of prediabetes in obesity.
 Aim. To study the role of insulin resistance in the development of prediabetes in obese adolescents.
 Materials and methods. The study involved 95 adolescents with obesity. Inclusion criteria: SDS BMI≥2.0, Tanner stage ≥II, age 18.0 years, exclusion criteria: diabetes mellitus. The sample was divided into prediabetics (n=40, mean age 14.0±1.53 years; SDS BMI 3.09±0.54, boys n=23) and non-prediabetics (n=55, mean age 14.6±1.67 years; SDS BMI 3.11±0.54; boys n=32). Both groups were matched on age, SDS BMI, sex (p=0.082, p=0.975, p=0.947, respectively). The research consisted of estimates of BMI, insulin, C-peptide, fasting venous blood glucose, HbA1c, cholesterol, low-density lipoprotein, high Density Lipoprotein, triglycerides, alanine aminotransferase, aspartat aminotransferase, HOMA-IR and TyG indices, results of oral glucose tolerance test at 0 and 2 hours after glucose load, ultrasound of the hepatobiliary system. Prediabetes in adolescents was diagnosed using American Diabetes Association criteria. Data was analyzed by using SPSS Statistics for Windows, Version 26.0.
 Results. Prediabetes was diagnosed in 42.1% (40/95) of cases. There were statistically significant differences between the indices of groups with prediabetes and normal glucose metabolism: fasting plasma glucose – FPG (mean 5.63±0.49; 95% confidence interval – CI 5.48–5.79 vs 5.03±0.42; 4.92–5.15 mmol/L; p0.001); 2hPG (mean 7.04±0.93; 95% CI 6.74–7.34 vs 6.23±0.82; 6.01–6.46 mmol/l; p0.001); HbA1c (mean 5.5±0.31; 95% CI 5.39–5.59% vs 5.2±0.25; 5.15–5.29%; p0.001); cholesterol (4.47±0.73; 95% CI 4.23–4.72 vs 3.96±0.92; 3.73–4.24 mmol/l; p=0.004), low-density lipoprotein (2.89±0.96, 95% CI 2.55–3.20 vs 2.46±0.89, 2.21–2.71 mmol/l; p=0.036). There were no significant differences in fasting insulin, C-peptide, triglycerides, high density lipoprotein, aspartat aminotransferase, alanine aminotransferase, HOMA-IR index and TyG, were also no significant differences in the frequency of hepatic steatosis (47.5% vs 52.7%; p=0.532).
 Conclusion. Teenagers with obesity, with prediabetes, and without disorders of carbohydrate metabolism had a similar level of peripheral tissue sensitivity to the action of insulin. There are additional factors leading to the formation of prediabetes with obesity in the child population that have to be learned in future researches.

Contrast-Enhanced Imaging Features and Clinicopathological Investigation of Steatohepatitic Hepatocellular Carcinoma

Steatohepatitic hepatocellular carcinoma (SH-HCC) is a distinctive histologic variant of HCC for the presence of steatohepatitis. This study intended to evaluate the contrast-enhanced imaging features and clinicopathological characteristics of 26 SH-HCCs in comparison with 26 age-and-sex-matched non-SH-HCCs. The frequency of obesity (34.6%, p = 0.048) and type 2 diabetes mellitus (23.1%, p = 0.042) were significantly higher in SH-HCC patients. As seen via B-mode ultrasound (BMUS), SH-HCCs were predominantly hyperechoic (65.4%, p = 0.002) lesions, while non-SH-HCCs were mainly hypo-echoic. As seen via contrast-enhanced ultrasound (CEUS), 96.2% of SH-HCCs exhibited hyperenhancement in the arterial phase. During the portal venous and late phase, 88.5% of SH-HCCs showed late and mild washout. Consequently, most SH-HCCs and all non-SH-HCCs were categorized as LR-4 or LR-5. As seen via magnetic resonance imaging (MRI), a signal drop in the T1WI opposed-phase was observed in 84.6% of SH-HCCs (p = 0.000). Notably, diffuse fat in mass was detected in 57.7% (15/26) SH-HCCs (p < 0.001). As seen via contrast-enhanced MRI (CEMRI), most of the SH-HCCs and non-SH-HCCs exhibited heterogeneous hyperenhancement in the arterial phase (80.8% versus 69.2%, p = 0.337). During the delayed phase, 76.9% SH-HCCs and 88.5% non-SH-HCCs exhibited hypo-enhancement. Histopathologically, the rate of microvascular invasion (MVI) was significantly lower in SH-HCCs than non-SH-HCCs (42.3% versus 73.1%, p = 0.025). The frequency of hepatic steatosis >5% in non-tumoral liver parenchyma of SH-HCCs was significantly higher than in non-SH-HCCs (88.5% versus 26.9%, p = 0.000). Additionally, the fibrotic stages of S0, S1 and S2 in SH-HCCs were significantly higher than in non-SH-HCCs (p = 0.044). During follow-up, although the PFS of SH-HCC patients was significantly longer than non-SH-HCC patients (p = 0.046), for the overall survival rate of SH-HCC and non-SH-HCC patients there was no significant difference (p = 0.162). In conclusion, the frequency of metabolism-related diseases in SH-HCC patients was significantly higher than in non-SH-HCC patients. The imaging features of SH-HCCs combined the fatty change and typical enhancement performance of standard HCC as seen via CEUS/CEMRI.

Frequency of hepatic steatosis and its association with the pneumonia severity score on chest computed tomography in adult COVID-19 patients.

BACKGROUNDRecent studies of the coronavirus disease 2019 (COVID-19) demonstrated that obesity is significantly associated with increased disease severity, clinical outcome, and mortality. The association between hepatic steatosis, which frequently accompanies obesity, and the pneumonia severity score (PSS) evaluated on computed tomography (CT), and the prevalence of steatosis in patients with COVID-19 remains to be elucidated.AIMTo assess the frequency of hepatic steatosis in the chest CT of COVID-19 patients and its association with the PSS.METHODSThe chest CT images of 485 patients who were admitted to the emergency department with suspected COVID-19 were retrospectively evaluated. The patients were divided into two groups as COVID-19-positive [CT- and reverse transcriptase-polymerase chain reaction (RT-PCR)-positive] and controls (CT- and RT-PCR-negative). The CT images of both groups were evaluated for PSS as the ratio of the volume of involved lung parenchyma to the total lung volume. Hepatic steatosis was defined as a liver attenuation value of ≤ 40 Hounsfield units (HU).RESULTSOf the 485 patients, 56.5% (n = 274) were defined as the COVID-19-positive group and 43.5% (n = 211) as the control group. The average age of the COVID-19-positive group was significantly higher than that of the control group (50.9 ± 10.9 years vs 40.4 ± 12.3 years, P < 0.001). The frequency of hepatic steatosis in the positive group was significantly higher compared with the control group (40.9% vs 19.4%, P < 0.001). The average hepatic attenuation values were significantly lower in the positive group compared with the control group (45.7 ± 11.4 HU vs 53.9 ± 15.9 HU, P < 0.001). Logistic regression analysis showed that after adjusting for age, hypertension, diabetes mellitus, overweight, and obesity there was almost a 2.2 times greater odds of hepatic steatosis in the COVID-19-positive group than in the controls (odds ratio 2.187; 95% confidence interval: 1.336-3.580, P < 0.001).CONCLUSIONThe prevalence of hepatic steatosis was significantly higher in COVID-19 patients compared with controls after adjustment for age and comorbidities. This finding can be easily assessed on chest CT images.

Racial and Ethnic Differences in Metabolic Disease in Adolescents With Obesity and Polycystic Ovary Syndrome.

ContextPolycystic ovary syndrome (PCOS) is common and associated with metabolic syndrome. In the general population, metabolic disease varies by race and ethnicity.ObjectiveThis work aimed to examine in depth the interaction of race and ethnicity with PCOS-related metabolic disease in adolescent youth.MethodsA secondary analysis was conducted of data from girls (age 12-21 years) with overweight or obesity (> 90 body mass index [BMI] percentile) and PCOS. Measurements included fasting hormone and metabolic measures, a 2-hour oral glucose tolerance test (OGTT), and magnetic resonance imaging for hepatic fat. Groups were categorized by race or ethnicity.ResultsParticipants included 39 non-Hispanic White (NHW, age 15.7 ± 0.2 years; BMI 97.7 ± 0.2 percentile), 50 Hispanic (HW, 15.2 ± 0.3 years; 97.9 ± 0.3 percentile), and 12 non-Hispanic Black (NHB, 16.0 ± 0.6 years; 98.6 ± 0.4 percentile) adolescents. Hepatic markers of insulin resistance were worse in NHW, including lower sex hormone–binding globulin and higher triglycerides over high-density lipoprotein cholesterol (TGs/HDL-C) ratio (P = .002 overall, HW vs NHB [P = .009] vs NHW [P = 0.020]), although homeostasis model assessment of estimated insulin resistance was worst in NHB (P = .010 overall, NHW vs NHB P = .014). Fasting and 2-hour OGTT glucose were not different between groups, although glycated hemoglobin A1c (HbA1c) was lowest in NHW (overall P < .001, NHW 5.2 ± 0.3 vs HW 5.5 ± 0.3 P < .001 vs 5.7 ± 0.4%, P < .001). The frequency of hepatic steatosis (HW 62%, NHW 42%, NHB 25%, P = .032); low HDL-C < 40 mg/dL (HW 82%, NHW 61%, NHB 50%, P < .001) and prediabetes HbA1c 5.7% to 6.4% (NHB 50%, HW 36%, NHW 5%, P < .001) were different between the groups.ConclusionAdolescents with PCOS appear to show similar racial and ethnic variation to the general population in terms of metabolic disease components.

SAT-627 Racial and Ethnic Differences in Metabolic Disease in Obese Adolescents with Polycystic Ovary Syndrome

Background: Polycystic ovary syndrome (PCOS) affects up to 15% of women and is associated with a multitude of metabolic complications including insulin resistance, type 2 diabetes, cardiovascular disease, and hepatic steatosis. In the general population, metabolic disease rates vary by race and ethnicity. The interaction of race and ethnicity with PCOS-related metabolic disease in adolescent youth has not been extensively examined. Methods: Secondary analysis of data from overweight and obese (>90 BMI%ile) adolescent (12-21 years) female participants with PCOS enrolled across 4 protocols. Measurements included fasting hormone and metabolic measures, a 2-hour oral glucose tolerance test and MRI for hepatic fat. Groups were compared by ANOVA, with and without correction for BMI or chi-square tests for proportions. Results: Participants included 39 white (NHW 15.7±0.2 years; 97.7±0.2 BMI%ile), 50 Hispanic (15.2±0.3 years; 97.9±0.3 BMI%ile) and 12 black (NHB 16.0±0.6 years; 98.6±0.4 BMI%ile) adolescents. BMI%ile was different between groups (p=0.04), but age of menarche, free testosterone and hirsutism severity were not. Hepatic markers of insulin resistance were worse in Hispanic youth, including lower sex hormone binding globulin and TG/HDL ratio (p<0.001), although HOMA-IR was worst in NHB (p=0.009) and Hispanic (p=0.036) compared to NHW youth. There were no significant differences in insulin concentrations—either fasting or during the OGTT—although fasting C-peptide was higher in Hispanic (p=0.008) compared to NHW youth. Fasting and 2-hour glucose concentrations were not different between groups. HbA1c was highest in NHB (5.7±0.4%, p<0.001 vs. NHW, p=0.026 vs. Hispanic), then Hispanic (5.5±0.3, p<0.001 vs. NHW), then NHW (5.2±0.3) youth. Fasting triglycerides differed between groups (p=0.029), being highest in Hispanic youth (129 [105,167] mg/dL). The frequency of hepatic steatosis (NHW 42%, Hispanic 62% NHB 25%, p=0.032) and the metabolic syndrome components HDL <40 mg/dL (NHW 61%, Hispanic 82% NHB 50%, p<0.001) and HbA1c 5.7-6.4% (NHW 5%, Hispanic 36% NHB 50%, p<0.001) were different between the groups. Conclusions: Adolescents with PCOS appear to show similar racial and ethnic variation to the general population in terms of metabolic disease components.

FREQUENCY OF HEPATIC STEATOSIS IN A RADIOLOGY CLINIC IN PALMAS

ABSTRACT&#x0D; Introduction: Recent studies suggest that hepatic steatosis is a worldwide distribution pathology that can progress to chronic liver disease with a highly unfavorable outcome resulting in the need for liver transplantation. That’s why early diagnosis is important. The liver biopsy’s considered a "gold standard" in its diagnosis, but the use of ultrasonography helps to detect steatosis in a non-invasive manner and is a very accessible method for the population. Objectives: To evaluate the frequency of steatosis in patients treated at a radiological clinic in Palmas using abdominal ultrasonography; observing its distribution in genders and age groups and its difference between 2010 and 2016. Methods: It was used ultrasound reports of abdomen of 3.222 patients made in 2010 and of 2.346 patients made in 2016. A longitudinal analysis was performed, between these two years, regarding the frequency of hepatic steatosis at the people and also between the genders and the age groups. Results: In 2010, 25,67% of people had hepatic steatosis in the ultrasound report, while in 2016 were 31,67%. In 2010, of the total number of people with steatosis, 52,48% were women and 47,52% were men; however in 2016, 51,94% were women and 48,06% were men. Regarding the age groups, in both periods, as in men and in women, steatosis was lower at the extremes of age and more frequent around the 5th to 7th decades of life. Discussion: The frequency of hepatic steatosis has increased in the period from 2010 to 2016. It was, as seen in the literature, quite high in the 5th and 6th decades of life, besides being more frequent in females. Unlike 2010, in 2016 begins to have children under 20 with signs of steatosis. Conclusion: In the year 2010 the frequency of hepatic steatosis was 25,67%, whereas in 2016 it was 31,84%. &#x0D; Keywords: Steatosis; ultrasonography; liver.

Prevalence of Nonalcoholic Fatty Liver Disease and Its Association With Cardiovascular Disease Among Type 2 Diabetic Patients

We appreciate the comments by Schindhelm et al. (1) regarding our recent article reporting the prevalence of nonalcoholic fatty liver disease (NAFLD) and its association with cardiovascular disease (CVD) in a type 2 diabetic population (2). In that study, we found that NAFLD is extremely common in type 2 diabetes and is associated with a higher frequency of manifest CVD. The prevalence of NAFLD was 69.5% among participants, and NAFLD was the most common cause (81.5%) of hepatic steatosis on ultrasound. In contrast, the frequency of hepatic steatosis likely due to other nonalcoholic …

Prevalence of hepatic steatosis in an urban population in the United States: Impact of ethnicity

Despite the increasing prevalence of nonalcoholic fatty liver disease (NAFLD), its pathogenesis and clinical significance remain poorly defined. In this study, we examined and compared the distribution of hepatic triglyceride content (HTGC) in 2,287 subjects from a multiethnic, population-based sample (32.1% white, 48.3% black, and 17.5% Hispanic) using proton magnetic resonance spectroscopy. HTGC varied over a wide range (0.0%-41.7%; median, 3.6%) in the population. Almost one third of the population had hepatic steatosis, and most subjects with hepatic steatosis had normal levels of serum alanine aminotransferase (79%). The frequency of hepatic steatosis varied significantly with ethnicity (45% in Hispanics; 33% in whites; 24% in blacks) and sex (42% in white men; 24% in white women). The higher prevalence of hepatic steatosis in Hispanics was due to the higher prevalence of obesity and insulin resistance in this ethnic group. However, the lower frequency of hepatic steatosis in blacks was not explained by ethnic differences in body mass index, insulin resistance, ethanol ingestion, or medication use. The prevalence of hepatic steatosis was greater in men than women among whites, but not in blacks or Hispanics. The ethnic differences in the frequency of hepatic steatosis in this study mirror those observed previously for NAFLD-related cirrhosis (Hispanics > whites > blacks). In conclusion, the significant ethnic and sex differences in the prevalence of hepatic steatosis documented in this study may have a profound impact on susceptibility to steatosis-related liver disease.

Overweight and obesity, hepatic steatosis, and progression of chronic hepatitis C: a retrospective study on a large cohort of patients in the United States

Background: Hepatic steatosis has been associated with chronic hepatitis C (CHC), but its prevalence, risk factors, and clinical significance remain to be determined. Aims: The present study determined the frequency of, and risk factors for hepatic steatosis and its association with activity and progression of CHC in a large cohort of U.S. patients. Methods: This is a retrospective study that utilized systematic chart review and statistical analyzes to investigate 324 U.S. patients with CHC from a university medical center and a regional VA medical center. Results: The frequency of hepatic steatosis was 66.0%. We demonstrated that not only being obese, but also overweight (i.e. body mass index ≥25 kg/m 2) was independently associated with hepatic steatosis. In our cohort of patients with CHC, hepatic steatosis, especially grade II/III steatosis, was significantly associated with elevated aspartate aminotransferase at entry, persistently elevated alanine aminotransferase, and stage III/IV fibrosis. Grade II/III steatosis, was significantly associated with a higher histology activity index as well. Multivariate analysis indicated that steatosis, especially grade II/III steatosis, was independently associated with stage III/IV fibrosis. Conclusions: Being overweight/obese serves as an independent risk factor for hepatic steatosis in U.S. patients with CHC. Steatosis accelerates activity and progression of CHC, and is independently associated with stage III/IV hepatic fibrosis in these patients.