Predictor Of Fatty Liver Research Articles

Atherogenic Index of Plasma (AIP) and Its Association with Fatty Liver in Obese Adolescents.

The atherogenic index of plasma (AIP) is the base-10 logarithmic conversion of the triglyceride to high-density lipoprotein cholesterol ratio [AIP = log10 (triglyceride/HDL cholesterol)]. Some studies have found a link between low serum vitamin D levels, AIP, and fatty liver. This study was conducted to evaluate the relationship between AIP levels, fatty liver, and vitamin D levels in obese adolescents aged 10-17 years. This study included 136 adolescents, including 83 obese and 53 healthy controls, in the age range of 10-17 years. Thirty-nine of the obese adolescents had fatty livers. Those with ultrasonography grades 2 or 3 of fat were in the fatty liver group. The AIP value was calculated as the logarithmic conversion of the ratio (triglyceride/HDL cholesterol) at the base of 10. Vitamin D and other laboratory tests were analyzed biochemically. Statistical evaluations were made with the SPSS program. The AIP, body mass index (BMI), homeostatic model assessment for insulin resistance (HOMA-IR), and insulin averages of obese adolescents with fatty liver were significantly higher than those of obese adolescents without fatty liver and the healthy control group (p < 0.05). Again, the mean AIP of obese patients without fatty liver was pointedly higher than that of the healthy control group (p < 0.05). There was a positive, moderate relationship between AIP and BMI, AIP and HOMA-IR, and AIP and insulin levels (p < 0.05), whereas there was a negative, moderate (37.3%) relationship between AIP and vitamin D (p = 0.019). AIP levels were higher in obese adolescents, and this increase was higher in obese adolescents with fatty liver in this study. Moreover, we detected a negative correlation between AIP and vitamin D levels and a positive correlation with BMI, insulin resistance, and insulin levels. Based on our data, we concluded that AIP can be a useful predictor of fatty liver in obese adolescents.

Validity of fatty liver prediction scores for diagnosis of fatty liver by Fibroscan

BackgroundThe Korea National Health and Nutrition Examination Survey nonalcoholic fatty liver disease (K-NAFLD) score was recently developed with the intent to operationally define nonalcoholic fatty liver disease (NAFLD). However, there remained an external validation that confirmed its diagnostic performance, especially in patients with alcohol consumption or hepatitis virus infection. MethodsDiagnostic accuracy of the K-NAFLD score was evaluated in a hospital-based cohort consisting of 1388 participants who received Fibroscan®. Multivariate-adjusted logistic regression models and the contrast estimation of receiver operating characteristic curves were used for validation of the K-NAFLD score, fatty liver index (FLI), and hepatic steatosis index (HSI). ResultsK-NAFLD-moderate [adjusted odds ratio (aOR) = 2.53, 95% confidence interval (CI): 1.13-5.65] and K-NAFLD-high (aOR = 4.14, 95% CI: 1.69-10.13) groups showed higher risks of fatty liver compared to the K-NAFLD-low group after adjustments for demographic and clinical characteristics, and FLI-moderate and FLI-high groups revealed aORs of 2.05 (95% CI: 1.22-3.43) and 1.51 (95% CI: 0.78-2.90), respectively. In addition, the HSI was less predictive for Fibroscan®-defined fatty liver. Both K-NAFLD and FLI also demonstrated high accuracy in the prediction of fatty liver in patients with alcohol consumption and chronic hepatitis virus infection, and the adjusted area under curve values were comparable between K-NAFLD and FLI. ConclusionsExternally validation of the K-NAFLD and FLI showed that these scores may be a useful, noninvasive, and non-imaging modality for the identification of fatty liver. In addition, these scores also predicted fatty liver in patients with alcohol consumption and chronic hepatitis virus infection.

228-OR: Differential Expression of miRNA in Human Subcutaneous and Visceral Adipose Tissue Is Related to Insulin Resistance

Introduction: Obesity is related to insulin resistance (IR) but not all obese individuals are IR. Differences in regional fat distribution and function contribute to the metabolic heterogeneity of obesity. miRNA is known to regulate mRNA and may play a role in mediating IR by modifying adipose tissue function. We tested the hypothesis that miRNA in human visceral (VAT) and subcutaneous (SAT) fat would be differentially expressed in individuals who were classified as insulin sensitive (IS) or IR. Methods: 12 participants, classified as IR or IS (top 40 percentile) via steady-state plasma glucose (SSPG) test, were recruited from the Stanford Bariatric Surgery Clinic. Tissue samples (SAT and VAT) were harvested from the greater momentum during bariatric surgery. Total RNA was extracted with QIAGEN RNeasy® Lipid Tissue Mini Kit. The miRNA experiment used QuantStudio™ 12K Flex OpenArray® microRNA Starter Kit with modifications by adding Ath-miR-159a spike-in, and use of SuperScript VILO cDNA Synthesis Kit. Data analysis done via Applied Biosystems™ Relative Quantitation Analysis. miRNA comparisons with fold-change &amp;lt;0.5 or &amp;gt;2 and p&amp;lt;0.were considered statistically significant. Known target genes of significant miRNA were quantified via RT-PCR from tissue samples. Results: Differential expression in VAT vs. SAT showed one upregulated (miR-885-5p) and 12 downregulated miRNAs. In SAT, for IR vs. IS individuals showed 12 upregulated miRNA, while in VAT, IR vs. IS included one upregulated (miR-30c) and downregulated miRNA. Conclusion: In VAT relative to SAT, miR-885-5p was a significant predictor of fatty liver and majority of downregulated miRNA (miR-335, 196b, 497, 22, 106b, 340) reduced lipogenesis and increased insulin signaling. In IR vs. IS of SAT, majority of miRNA reduced insulin sensitivity (miR-146b, 29c, 502-3p) . For IR vs. IS of VAT, miR-30c promoted adipocyte differentiation and majority of downregulated miRNA increased insulin sensitivity (miR-106b, 24, 143, 340) . Disclosure N.Saini: None. A.Deng: None. H.Chen: None. Y.Xu: None. P.S.Tsao: None. T.Mclaughlin: Board Member; January, Inc., Research Support; Merck &amp; Co., Inc., Novo Nordisk, Stock/Shareholder; Eiger BioPharmaceuticals.

Metabolic Syndrome (MetS) as a Predictor of Fatty Liver in HIV Infected Adults from the Miami Adult Studies on HIV (MASH) Cohort (FS12-06-19)

ObjectivesOne of the major comorbidities among people living with HIV (PLWH) is liver disease. MetS is common in this population and may also play a role in the development of liver disease. In order to better understand the mechanisms of liver disease in PLWH, it is important to investigate the relationship between components of MetS and the risk of fatty liver, an early precursor to liver disease. The objective of this study was to determine if the 5 criteria used to diagnose MetS contribute to liver steatosis. MethodsCrossectional analyses of data from the MASH cohort were analyzed. Waist circumference (WC) and blood pressure (BP) were measured by a research nurse. Serum triglycerides (TRG), glucose (GLU), and HDL were determined in fasting by LabCorp. Liver fat % was estimated with proton density fat fraction using Magnetic Resonance Elastography conducted on a 3T Siemens MAGNETOM Prisma MRI. Liver fat >5% was defined as stage 1 steatosis. Components of MetS were taken from the NCEP ATP III definition of MetS. Spearman correlations and logistic regression were used for analyses. ResultsA total of 324 PLWH aged 53.5 ± 7.5 years were included. Liver fat% was correlated with WC (r = 0.394, P < 0.001), TRG (r = 0.332, P < 0.001), GLU (r = 0.358, P < 0.001), and systolic BP (r = 0.183, P = 0.011), inversely correlated with HDL (r = −0.236, P = 0.001), and trended toward significance with diastolic BP (r = 0.133, P = 0.065). Participants with stage 1 steatosis had a larger WC (41.02in ± 5.3 vs 36.95 ± 5.5, P = 0.001), higher TRG (210.3 mg/dL ± 173.9 vs 121.3 ± 67.9, P = 0.002), and higher GLU (126.1 mg/dL ± 77.7 vs 93.92 ± 50.8, P = 0.001) than those without steatosis. No significant difference was found for HDL cholesterol, SBP, or DBP. A logistic regression model that included all 5 MetS criteria and was controlled for age, gender, and alcohol AUDIT score >8 found that WC (OR 1.11, 95% CI 1.01–1.23, P = 0.030), TRG (OR 1.01, 95% CI 1.00–1.01, P = 0.040), and GLU (OR 1.01, 95% CI 1.00–1.03, P = 0.033) are significant predictors of stage 1 steatosis. ConclusionsWC, TRG, and GLU, three of the 5 criteria for diagnosing MetS were significant predictors of stage 1 steatosis in PLWH. Future studies investigating the risk of liver disease progression in PLWH need to account for these confounding factors as they explore HIV specific mechanisms for liver disease. Funding SourcesNational Institutes on Drug Abuse #5UO1DA040381.

Which Method is Superior in the Diagnosis of Nonalcoholic Fatty Liver and Steatohepatatis in Children?

Context: Nonalcoholic fatty liver disease (NAFLD) is increasing with the increased rate of obesity and reduced physical activity in children worldwide. Despite high prevalence of the disease, a standard and acceptable diagnostic method is not available. The current study aimed at collecting all related articles and evaluating the challenges. Methods: The current study searched Scopus, Web of Science, and PubMed. Articles and guidelines in English in the field of invasive and noninvasive diagnostic methods for NAFLD and nonalcoholic steatohepatitis (NASH) in children and adolescents up to Oct 2016 were used. It was tried to evaluate all laboratory and radiologic methods, biomarkers, and scores in addition to mention the challenges. Results: Ultrasonography and laboratory evaluation, which were routine methods in early diagnosis, did not have enough accuracy in this field. Diagnosis of steatosis and fibrosis and determining the severity of disease were achieved by fibro scan and controlled attenuation parameter (CAP) without the challenges of computed tomography (CT) scan and magnetic resonance imaging (MRI). Fatty liver can be predicted with high accuracy by body analyzer, anthropometric, and DEXA methods. Conclusions: Diagnosis and prediction of fatty liver should be done in all children with obesity aged > 3 years, and physician should seek the genetic and metabolic causes in children aged < 3 years and/or without overweight.

Influence of light alcohol consumption on lifestyle-related diseases: a predictor of fatty liver with liver enzyme elevation in Japanese females with metabolic syndrome.

BackgroundAlthough heavy drinking is known to lead to liver injury, some recent studies have reported that light alcohol consumption (LAC) may play a protective role against fatty liver in the general population, and may even play a protective role against non-alcoholic fatty liver disease (NAFLD) in males with metabolic syndrome (MS). However, the association between LAC and fatty liver with liver enzyme elevation in females with MS is unclear.MethodsParticipants of this study were 20,853 females who underwent a regular health check-up between April 2008 and March 2012 at our hospital. Enrolled subjects were 1141 females with MS, who underwent all necessary tests and drank less than 20 g/day of alcohol. We investigated the presence of fatty liver with liver enzyme elevation, defined in this study as alanine aminotransferase (ALT) levels ≧31 IU/I, and the association between LAC and fatty liver with ALT elevation.ResultsThere was no significant difference in the prevalence of fatty liver and ALT between light drinkers and non-drinkers. The prevalence of individuals receiving a treatment for dyslipidemia and impaired glucose tolerance (IGT) was significantly lower in light drinkers than in non-drinkers. Body mass index (BMI), waist circumference (WC), diastolic blood pressure (DBP), triglyceride (TG), uric acid (UA), IGT, and visceral fat type MS (V-type MS) were significant predictors of the prevalence of fatty liver with ALT elevation in logistic regression analysis. The odds ratio [OR] (95 % confidence interval [CI], p value) for fatty liver with ALT elevation were as follows: BMI, 2.181 (1.445–3.293, p <0.001); WC, 1.853 (1.280–2.684, p <0.01); DBP, 1.604 (1.120–2.298, p <0.05); TG, 2.202 (1.562–3.105, p <0.001); UA, 2.959 (1.537–5.698, p <0.01); IGT, 1.692 (1.143–2.506, p <0.01); and V-type MS, 3.708 (2.529–5.437, p <0.001).ConclusionsThere was no significant difference in the prevalence of fatty liver with ALT elevation in females with MS between light drinkers and non-drinkers, suggesting that other factors such as BMI, WC, V-type MS, and lifestyle-related disease may be more important than LAC for the prevalence of fatty liver with ALT elevation.

Serum alanine aminotransferase concentration as a predictive factor for the development or regression of fatty liver

Serum alanine aminotransferase (ALT) concentration is the most commonly used marker for hepatocellular injury. We investigated the suitable cutoff value of serum ALT for the diagnosis or prediction of fatty liver. In 1578 Japanese adults (1208 men, 370 women; 35–69 years of age) who visited our center both in 2000 and between April 2007 and March 2008 (2007–2008), serum ALT concentration was an independent predictor of fatty liver in men in 2000 and in both sexes in 2007–2008. A significant increase in the frequency of fatty liver was detected in participants with elevated serum ALT concentrations, and serum levels of ALT in 2000 were associated with fatty liver in 2007–2008 when the cutoff value was set at 30 IU/L in men and 19 IU/L in women. The frequency of fatty liver in 2007–2008 was significantly lower in participants without fatty liver in 2000 whose serum ALT decreased between 2000 and 2007–2008. Our results suggest that serum ALT might be not only an indicator of fatty liver but also a predictor of the regression of fatty liver, and cutoff values of serum ALT of 30 IU/L in men and 19 IU/L in women are suitable for the screening of fatty liver.

Alcohol drinking patterns and the risk of fatty liver in Japanese men

Alcohol is considered to be a major cause of fatty liver (FL). In contrast, however, recent investigations have suggested that moderate alcohol consumption is protective against FL. To clarify the role of alcohol consumption in FL development, we examined the association between drinking patterns and FL prevalence. We enrolled 9,886 male participants at regular medical health checks. Each subject's history of alcohol consumption was determined by questionnaire. The subjects were classified according to alcohol consumption as non-, light, moderate, and heavy drinkers (0, <20, 20-59, and ≥60 g/day, respectively). FL was defined by ultrasonography. Independent predictors of FL were determined by logistic regression analysis. The prevalence of FL displayed a "U-shaped curve" across the categories of daily alcohol consumption (non-, 44.7%; light, 39.3%; moderate, 35.9%; heavy drinkers, 40.1%; P < 0.001). The prevalence of FL was associated positively with body mass index and other obesity-related diseases and inversely with alcohol consumption (light, odds ratio [OR] 0.71, 95% confidence interval [CI] 0.59-0.86; moderate, OR 0.55, CI 0.45-0.67; heavy, OR 0.44, CI 0.32-0.62) as determined by multivariate analysis after adjusting for potential confounding variables. In addition, examination of drinking patterns (frequency and volume) revealed that the prevalence of FL was inversely associated with the frequency of alcohol consumption (≥21 days/month) (OR 0.62, CI 0.53-0.71) but not with the volume of alcohol consumed. Our observations suggest that alcohol consumption plays a protective role against FL in men, and consistent alcohol consumption may contribute to this favorable effect.

Metabolic predictors for early identification of fatty liver using doppler and B-mode ultrasonography in overweight and obese adolescents

(1) to evaluate the frequency of asymptomatic fatty liver disease (FLD) using both Doppler and B-mode ultrasound (US) in overweight and obese adolescents; (2) to compare metabolic findings of fatty liver (FL) assessed by two methods; and (3) to evaluate metabolic predictors of FL shown by these methods. Fifty-nine overweight and obese adolescents aged between 9.0 and 17.0 years and 41 non-obese healthy adolescents were included in this study. B-mode and right hepatic vein Doppler ultrasonography (US) were performed and anthropometric indices, lipid profiles, and adiponectin levels were evaluated in all adolescents. HDL-C levels were significantly lower in patients with FL detected by Doppler US compared to patients without FL (p < 0.05). HDL-C levels were inversely correlated with presence of FL assessed by two methods (r = -0.285, p = 0.004; r = -0.328, p = 0.001, respectively) and adiponectin levels were correlated with presence of FL only detected by B-mode US (r = -0.263, p = 0.008). Adiponectin levels were significantly lower in patients with FL than those without FL assessed by B-Mode US (p = 0.049). Multiple regression analysis revealed that HDL-C levels was the most important predictor of FL assessed by Doppler US (p = 0.027), while body mass index was the determinant of FL assessed by two methods (p < 0.001) in asymptomatic overweight and obese adolescents. It was found that FLD, identified by both B-mode and Doppler US, is seen frequently in asymptomatic overweight and obese adolescents. Elevated BMI is associated with increased risk of FL assessed by two ultrasonographic methods. When using Doppler US, low HDL-C levels can be used as a good predictor for presence of FLD in overweight and obese adolescents.

Measurement of food and alcohol intake in relation to chronic liver disease

It is well established that the consumption of alcohol is implicated in both the cause and progression of chronic liver disease. The quantity of drink that is consumed, the pattern of drinking and type of alcoholic beverages consumed are all possible factors in disease aetiology. The impact of specific dietary components on the cause and progression of chronic liver disease is unclear although it is known that obesity, and hence the over-consumption of energy, is a predictor of fatty liver. Work to elucidate the role of both diet and alcohol in the aetiology of liver disease is hindered by the methods currently available to measure dietary (including alcohol) intake. The validity and reliability of retrospective methods of assessing diet are limited by their reliance on memory and, for the 24 h recall, the short-time period of intake assessed and its inability to assess variability across the week. Prospective methods which measure food and drink intake at the time of consumption, and include weighed or estimated food diaries, are useful for prospective cohort studies but are expensive and have a high respondent burden. For estimation of alcohol intake retrospectively, the Cognitive Lifetime Drinking questionnaire, which prompts responses using a lifetime calendar, is a useful tool but still depends on memory. More work is required to develop valid, reliable and easily administered tools for measurement of both diet and alcohol.

The medical examination data of fatty liver cases and the prediction of fatty liver

The medical examination data of fatty liver cases and the prediction of fatty liver

Prevalence of fatty liver in Japanese children and relationship to obesity. An epidemiological ultrasonographic survey.

The prevalence of fatty liver in children is unknown and its relationship to obesity is poorly defined. The present study of 810 northern Japanese children (4-12 years old) determined the prevalence of fatty liver in the pediatric population and its relationship to obesity. Diagnosis of fatty liver was based on established real-time ultrasonographic criteria. The overall prevalence of fatty liver was 2.6% and was higher for boys (3.4%) than for girls (1.8%), although not statistically significant (P = 0.15). Fatty liver was found in children as young as 6 years of age. There was no significant association between the prevalence of fatty liver and height (physical growth). There was a strong positive correlation between fatty liver prevalence and established obesity indices: Rohrer's Index--chi 2 linear trend = 59.2, P < 0.0001; body mass index--chi 2 linear trend = 91.6, P < 0.0001; and age-gender-adjusted Japanese standard index of weight for height--chi 2 linear trend = 93.2, P < 0.0001. However, direct measurement of abdominal subcutaneous fat thickness by ultrasonography was the best predictor of fatty liver: chi 2 linear trend = 159, P < 0.0001. These results indicate that fatty liver may develop very early in life, and there is a direct relationship between degree of obesity and fatty liver in children.

Prediction of fatty liver from serum triglyceride levels and body weight indexes.

Fatty liver is a common disease in Taiwan. In this study, we tried to evaluate the validity of predicting the presence of fatty liver from clinical data instead of liver biopsy or sonography. From a community survey in Putai, a total of 873 adults older than 30 years and quantified as to triglyceride level, body height, body weight, and the results of the oral glucose tolerance test and upper abdominal sonography were recruited for analysis. Using a receiver operating characteristic (ROC) curve, the best 'cutoff values' for determination of fatty liver were predicted from body weight index and serum triglyceride level in 8 clusters grouped by sex, age and presence or absence of diabetes mellitus. The best cutoff values of triglyceride in the 8 clusters varied from 100 to 170 mg/dl with worse validity. Most of the values were 130 and 140 mg/dl. The cutoff values of body weight index were constant in all clusters and showed greater validity than those for triglyceride. They were 115% or 120%. Their accuracy for the prediction of fatty liver was positively correlated with its prevalence. However, their accuracy was lower than 70% in non-diabetic females. We conclude that body weight index is a good parameter for prediction of fatty liver especially in the high risk groups and we recommend that health-determining cutoff values of serum triglyceride and body weight index should be set at 130 mg/dl and 115%, respectively.