Correlation of the controlled attenuation parameter with indices of liver steatosis in overweight or obese individuals

Ferraioli, Giovanna; Tinelli, Carmine; Lissandrin, Raffaella; Zicchetti, Mabel; Faliva, Milena Anna; Perna, Simone; Perani, G; Alessandrino, Francesco; Calliada, Fabrizio; Rondanelli, Mariangela; Fı̀lice, Carlo

doi:10.1097/meg.0000000000000287

Cited by 7 publications

(4 citation statements)

References 37 publications

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“…Our results that CAP-HS correlated moderately well with MRS-HS are similar to other studies comparing CAP-HS and MRS-HS in HIV-uninfected populations, in which the correlation coefficients ranged from 0.50–0.69(27–29). There was no significant correlation between CAP and MRS in the HCV-monoinfected group, likely due to the very small sample size in this subgroup.…”

Section: Discussionsupporting

confidence: 91%

Controlled attenuation parameter and magnetic resonance spectroscopy-measured liver steatosis are discordant in obese HIV-infected adults

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Dodge

Ma³

et al. 2017

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Objective Hepatic steatosis (HS) is common in HIV-infected individuals. Magnetic resonance spectroscopy (MRS) is the preferred non-invasive method for HS measurement but is expensive. Controlled attenuation parameter (CAP) also assesses HS and is conveniently performed concomitantly with transient elastography. We aimed to assess the accuracy of CAP in the setting of HIV infection. Design Cross-sectional study Methods CAP and MRS were performed in 82 subjects (39 HIV-monoinfected;7 HCV-monoinfected;21 HIV/HCV-coinfected; 15 with neither infection). We used concordance correlation coefficients to compare log-transformed and standardized CAP and MRS values and linear regression to examine factors associated with CAP and MRS-measured HS. The accuracy of CAP to detect ≥mild HS, defined as MRS-liver fat fraction ≥0.05, and the factors associated with discordance between CAP and MRS were evaluated. Results Overall, CAP-HS and MRS-HS correlated moderately well (r=0.60, p<0.001), and correlation was strongest in the HIV-monoinfected group (r=0.67, p<0.001). Body composition factors (higher BMI, waist circumference, visceral and abdominal subcutaneous adipose tissue) and insulin resistance were significantly associated with both greater CAP-HS and MRS-HS. Using a validated CAP cut-off ≥238 decibels/meter, sensitivity and specificity for ≥mild HS were 84% and 75% in the entire cohort; 89% and 80% in the HIV-monoinfected group. Higher body composition parameters were more likely to be misclassified as having HS by CAP. Conclusions Our findings suggest CAP is an acceptable non-invasive surrogate for HS in HIV-infected individuals but may overestimate HS prevalence, especially in individuals with high BMI. Evaluation of factors that improve CAP accuracy and determination of optimal cut-offs are warranted.

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Section: Discussionsupporting

confidence: 91%

Controlled attenuation parameter and magnetic resonance spectroscopy-measured liver steatosis are discordant in obese HIV-infected adults

Price¹,

Dodge

Ma³

et al. 2017

Aids

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“…It was taken into account a mean CAP value of 268.6 ± 52 dB/m for individuals with liver steatosis (30). Thus, to detect a CAP score reduction of at least 12%, with an effect size (ES = mean CAP difference/ baseline SD) of 0.62, with 80% power on a two-sided level of significance of 0.05, a minimum of 44 subjects for each group were required.…”

Section: Discussionmentioning

confidence: 99%

Randomized Clinical Trial: Bergamot Citrus and Wild Cardoon Reduce Liver Steatosis and Body Weight in Non-diabetic Individuals Aged Over 50 Years

et al. 2020

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Background: Non-alcoholic fatty liver disease is the most common cause of liver-related morbidity and mortality in the world. However, no effective pharmacological treatment for this condition has been found. Purpose: This study evaluated the effect of a nutraceutical containing bioactive components from Bergamot citrus and wild cardoon as a treatment for individuals with fatty liver disease. The primary outcome measure was the change in liver fat content. Methods: A total of 102 patients with liver steatosis were enrolled in a double-blind placebo controlled clinical trial. The intervention group received a nutraceutical containing a Bergamot polyphenol fraction and Cynara Cardunculus extract, 300 mg/day for 12 weeks. The control group received a placebo daily. Liver fat content, by transient elastography, serum transaminases, lipids and glucose were measured at the baseline and the end of the study. Results: We found a greater liver fat content reduction in the participants taking the nutraceutical rather than placebo (−48.2 ± 39 vs. −26.9 ± 43 dB/m, p = 0.02); The percentage CAP score reduction was statistically significant in those with android obesity, overweight/obesity as well as in women. However, after adjustment for weight change, the percentage CAP score reduction was statistically significant only in those over 50 years (44 vs. 78% in placebo and nutraceutical, respectively, p = 0.007). Conclusions: This specific nutraceutical containing bioactive components from Bergamot and wild cardoon reduced the liver fat content during 12 weeks in individuals with liver steatosis over 50 years. If confirmed, this nutraceutical could become the cornerstone treatment of patients affected by liver steatosis. Clinical Trial Registration: www.isrctn.com, identifier ISRCTN12833814.

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“…First, the reduction in the CAP score is apparently lower than expected. In sample size calculation we referred to a less severe population [ 53 ]. However, the main finding is that individuals with severe hepatic steatosis at baseline have the greatest benefit from the present nutraceutical compared to those with mild/moderate hepatic steatosis.…”

Section: Discussionmentioning

confidence: 99%

“…It was considered a mean CAP value of 268.6 ± 52 dB/m for adults with NAFLD [ 53 ]. Thus, to detect a CAP score reduction of at least 12%, with an effect size (ES = mean CAP difference/baseline SD) of 0.62, with 80% power on a two-sided level of significance of 0.05, a minimum of 44 subjects for each group were required.…”

Section: Methodsmentioning

confidence: 99%

A new nutraceutical (Livogen Plus®) improves liver steatosis in adults with non-alcoholic fatty liver disease

et al. 2022

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Background Currently, there is no approved medication for non-alcoholic fatty liver disease management. Pre-clinical and clinical studies showed that several bioactive molecules in plants or foods (i.e., curcumin complex, bergamot polyphenol fraction, artichoke leaf extract, black seed oil, concentrate fish oil, picroliv root, glutathione, S-adenosyl-l-methionine and other natural ingredients) have been associated with improved fatty liver disease. Starting from these evidences, our purpose was to evaluate the effects of a novel combination of abovementioned nutraceuticals as a treatment for adults with fatty liver disease. Methods A total of 140 participants with liver steatosis were enrolled in a randomized, double-blind, placebo controlled clinical trial. The intervention group received six softgel capsules daily of a nutraceutical (namely Livogen Plus®) containing a combination of natural bioactive components for 12 weeks. The control group received six softgel capsules daily of a placebo containing maltodextrin for 12 weeks. The primary outcome measure was the change in liver fat content (CAP score). CAP score, by transient elastography, serum glucose, lipids, transaminases, and cytokines were measured at baseline and after intervention. Results After adjustment for confounding variables (i.e., CAP score and triglyceride at baseline, and changes of serum γGT, and vegetable and animal proteins, cholesterol intake at the follow-up), we found a greater CAP score reduction in the nutraceutical group rather than placebo (− 34 ± 5 dB/m vs. − 20 ± 5 dB/m, respectively; p = 0.045). The CAP score reduction (%) was even greater in those with aged 60 or less, low baseline HDL-C, AST reduction as well as in men. Conclusion Our results showed that a new combination of bioactive molecules as nutraceutical was safe and effective in reducing liver fat content over 12 weeks in individuals with hepatic steatosis. Trial registration ISRCTN, ISRCTN70887063. Registered 03 August 2021—retrospectively registered, https://doi.org/10.1186/ISRCTN70887063

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Correlation of the controlled attenuation parameter with indices of liver steatosis in overweight or obese individuals

Abstract: Measurement of CAP is a reliable method for noninvasive assessment of liver steatosis, showing a correlation with other indirect markers of central obesity and a good correlation with MRI results.

Cited by 7 publications

References 37 publications

Controlled attenuation parameter and magnetic resonance spectroscopy-measured liver steatosis are discordant in obese HIV-infected adults

Controlled attenuation parameter and magnetic resonance spectroscopy-measured liver steatosis are discordant in obese HIV-infected adults

Randomized Clinical Trial: Bergamot Citrus and Wild Cardoon Reduce Liver Steatosis and Body Weight in Non-diabetic Individuals Aged Over 50 Years

A new nutraceutical (Livogen Plus®) improves liver steatosis in adults with non-alcoholic fatty liver disease

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