Accuracy of a Semi-Quantitative Ultrasound Method to Determine Liver Fat Infiltration in Early Adulthood

Abstract

An inexpensive and simple method to determine non-alcoholic fatty liver disease (NAFLD) is the abdominal ultrasound, but there are still doubts about its accuracy. We assessed the precision of a semi-quantitative ultrasound method to determine liver fat infiltration, using magnetic resonance spectroscopy (MRS) as the reference. The study was conducted in youths from an ongoing cohort study. Clinical validation was performed, using receiver operating characteristic analysis, in n = 60 participants (22.6y; 50% males). Abdominal ultrasound was carried out with liver brightness (score 0–3), diaphragm attenuation (0–2) and liver vessel blurring (0–1) scored by two observers. Liver fat was estimated using MRS. Then, analytical validation was conducted in the remaining participants (n = 555; 22.7y; 51% males) using effects size estimates. An ultrasound score ≥4.0 had the highest sensitivity (78%) and specificity (85%) for NAFLD diagnosis. An area under the curve of 86% denotes a good diagnostic performance of the test, whereas a Kappa of 0.63 suggests substantial agreement of ultrasound vs. MRS. The analytical validation showed that participants having NAFLD according to ultrasound had an unhealthier cardiometabolic profile than participants without the condition. Abdominal ultrasound, combined with a semi-quantitative score system, is a reliable method to determine liver fat infiltration in young adults and should be encouraged whenever MRS is unavailable.

Obesity and impairment of pancreatic β‐cell function in early adulthood, independent of obesity age of onset: The Santiago Longitudinal Study

“…Thus, the SLS is particularly useful to study the impact of obesity in early childhood on the future risk of impaired β‐cell functioning or even T2D in individuals exposed to a thrifty phenotype. Another strength was the availability of BMI data from birth through adulthood, with multiple assessments that allowed estimation of BMI trajectories using models that provide a more realistic representation of BMI across the lifecourse 36,37 …”

“…When there was disagreement between observers, the images were analysed jointly, and an agreement about the final score was reached. Participants having a total ultrasound score of ≥ 4 were considered as having NAFL 36 …”

Multiple events case–control study in a prospective cohort to identify systemic, cellular, and molecular biomarkers of obesity-induced accelerated aging in 30-years-olds: the ObAGE study protocol

“…NAFLD occurs more often in males than in females and affects mainly the middle-aged and the elderly. At 23y, however, 28% of SLS participants had NAFLD, with no sex differences [ 42 ]. An abdominal ultrasound will be performed in SLS participants using a General Electric LogiQ ultra-sonographer with a 4C RS convex multifrequency probe (2–5.5 MHz) (GE Healthcare Systems, Wauwatosa, WI, USA).…”

“…An abdominal ultrasound will be performed in SLS participants using a General Electric LogiQ ultra-sonographer with a 4C RS convex multifrequency probe (2–5.5 MHz) (GE Healthcare Systems, Wauwatosa, WI, USA). As described in previous work from our group [ 42 ], all examinations will be done by the same operator, and images will be analyzed by two independent observers. Observers will be gastroenterologists with training in abdominal ultrasound interpretation, and will score liver brightness (0–3), diaphragm attenuation (0–2) and vessel blurring (0–1), according to Hamaguchi et al [ 43 ].…”

Associação entre níveis de ácido úrico sérico e o risco para doença gordurosa hepática não alcoólica (DHGNA) nos participantes do Estudo Longitudinal de Saúde do Adulto (EL

“…O diagnóstico de DHGNA que foi realizado por ultrassonografia, método relativamente pouco sensível comparado à da tomografia computadorizada, embora estudos recentes tenham mostrado que a ultrassonografia permite uma confiabilidade e precisão na detecção da gordura no fígado. (34,129)…”