A Noninvasive Clinical Scoring Model Predicts Risk of Nonalcoholic Steatohepatitis in Morbidly Obese Patients

Ulitsky, Alex; Ananthakrishnan, Ashwin N.; Komorowski, Richard; Wallace, James R.; Surapaneni, Sri Naveen; Franco, José; Saeian, Kia; Gawrieh, Samer

doi:10.1007/s11695-010-0118-y

Cited by 55 publications

(42 citation statements)

References 29 publications

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“…Gholam et al [53] AST level NASH clinical scoring system for morbid obesity Hypertension Weighted sum (0-7) Not reported Campos et al [54] DM Ⅱ Elevated AST (> 27 IU/L) Elevated ALT (> 27 IU/L) OSA non-black race Ulitsky's score DM Ⅱ Weighted sum (0-5) Not reported Ulitsky et al [55] Elevated ALT (> 40 IU/L) Elevated triglycerides (> 150 mg/dL) OSA NASH predictive index Female sex Algorithm 0. 78 Zein et al [56] Body evidenced association between these entities [60] .…”

Section: Composite Diagnostic Models For Nashmentioning

confidence: 99%

Composite prognostic models across the non-alcoholic fatty liver disease spectrum: Clinical application in developing countries

Luckhoff

Kruger

Kotze

2015

WJH

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Heterogeneity in clinical presentation, histological severity, prognosis and therapeutic outcomes charac teristic of nonalcoholic fatty liver disease (NAFLD) necessitates the development of scientifically sound classification schemes to assist clinicians in stratifying patients into meaningful prognostic subgroups. The need for replacement of invasive liver biopsies as the standard method whereby NAFLD is diagnosed, graded and staged with biomarkers of histological severity injury led to the development of composite prognostic models as potentially viable surrogate alternatives. In the present article, we review existing scoring systems used to (1) confirm the presence of undiagnosed hepatosteatosis; (2) distinguish between simple steatosis and NASH; and (3) predict advanced hepatic fibrosis, with particular emphasis on the role of NAFLD as an independent cardiometabolic risk factor. In addition, the incorporation of functional genomic markers and application of emerging imaging technologies are discussed as a means to improve the diagnostic accuracy and predictive performance of promising composite models found to be most appropriate for widespread clinical adoption. Composite prognostic models across the non-alcoholic fatty liver disease spectrum: Clinical application in developing countries have entered the clinical domain as potentially viable alternatives. Lifestylebased intervention remains the cornerstone of treatment in patients with NAFLD. The widespread clinical adoption of composite diagnostic and predictive models could however prove useful in informing clinical and therapeutic decision making with the goal of adding value to patient care across the NAFLD spectrum.Lückhoff HK, Kruger FC, Kotze MJ. Composite prognostic models across the non-alcoholic fatty liver disease spectrum:

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Section: Composite Diagnostic Models For Nashmentioning

confidence: 99%

Composite prognostic models across the non-alcoholic fatty liver disease spectrum: Clinical application in developing countries

Luckhoff

Kruger

Kotze

2015

WJH

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“…Obstructive sleep apnea has been shown to improve diagnostic accuracy of the panels for NASH [52,53]. The NASH Clinical Scoring System for Morbid Obesity is consisted of six components including hypertension, type 2 diabetes, AST ≥ 27 U/L, ALT ≥ 27 U/L, sleep apnea, and non-black race.…”

Section: Introductionmentioning

confidence: 99%

Noninvasive biomarkers for the diagnosis of steatohepatitis and advanced fibrosis in NAFLD

2013

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Nonalcoholic fatty liver disease (NAFLD) is the most common cause of abnormal liver enzymes in both adults and children. NAFLD has a histologic spectrum ranging from simple steatosis to nonalcoholic steatohepatitis (NASH), advanced fibrosis, and cirrhosis. It is imperative to distinguish simple steatosis from NASH since the latter has a progressive disease course and can lead to end-stage liver disease. Liver biopsy has been considered as the gold standard for the diagnosis of NASH. However, liver biopsy is invasive, costly, and can rarely cause significant morbidity (risk of morbidity, 0.06-0.35%; risk of mortality, 0.1-0.01%). Imaging studies such as ultrasonography, computed tomography, and magnetic resonance imaging have limited sensitivity in detecting steatosis and cannot distinguish steatosis from NASH. Alanine aminotransferase (ALT) has been used as a surrogate marker for liver injuries. However, ALT is not an ideal marker for either diagnosis of NAFLD or distinguishing steatosis from NASH. Better noninvasive biomarkers or panels of biomarkers that are cheaper, reliable, and reproducible are urgently needed for patients with NASH to assist in establishing diagnosis, providing risk information, and monitoring disease progression and treatment response. In this article, we plan to concisely review the current advances in the use of biomarkers for the diagnosis of NASH.

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“…11,12 Liver biopsies done in patients undergoing bariatric surgery in the United States led to the diagnostic of NASH in 20.6% of them. 13 Active research is aimed at understanding the natural history of NAFLD. It is still not clear whether simple steatosis, NASH, and cirrhosis are a continuum or separate disease entities.…”

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confidence: 99%

The Role of Nutrients in the Development, Progression, and Treatment of Nonalcoholic Fatty Liver Disease

Mouzaki

Allard

2012

Journal of Clinical Gastroenterology

104

101

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Nonalcoholic fatty liver disease (NAFLD) is the most common cause of liver disease in adults and children and is currently the third most common indication for liver transplantation in North America. Its pathogenesis is thought to be secondary to multiple "hits" derived from the dietary components, adipose tissue, immune system, and intestinal microbiota. Lack of physical activity may contribute as well. Nutrients may exert their effect directly or through alteration of the intestinal microbiota. Research focusing on specific dietary components predisposing to NAFLD has shown conflicting results. Total energy intake, and macronutrients, has been linked to the development of NAFLD. Fructose not only contributes to hepatic steatosis but may trigger inflammatory signals as well. Polyunsaturated fatty acids are thought to exert anti-inflammatory effects. The role of vitamins as well as minerals in this field is actively being investigated. In this review, we discuss the evidence-linking macronutrients (such as carbohydrates and fat in general and fructose, fiber, short chain fatty acids, polyunsaturated fatty, and choline specifically) and micronutrients (such as vitamin E and C and minerals) with the development and treatment of NAFLD. We also discuss the literature on physical activity and NAFLD.

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A Noninvasive Clinical Scoring Model Predicts Risk of Nonalcoholic Steatohepatitis in Morbidly Obese Patients

Abstract: A simple scoring system performs well in predicting NASH and can be used in the clinic to optimize the selection of morbidly obese patients for liver biopsy.

Cited by 55 publications

References 29 publications

Composite prognostic models across the non-alcoholic fatty liver disease spectrum: Clinical application in developing countries

Composite prognostic models across the non-alcoholic fatty liver disease spectrum: Clinical application in developing countries

Noninvasive biomarkers for the diagnosis of steatohepatitis and advanced fibrosis in NAFLD

The Role of Nutrients in the Development, Progression, and Treatment of Nonalcoholic Fatty Liver Disease

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