Diagnostic Value of Ultrasonographic Examination for Nonalcoholic Steatohepatitis in Morbidly Obese Patients Undergoing Laparoscopic Bariatric Surgery

Liang, Ren-Jow; Wang, Hsih‐Hsi; Lee, Wei-Jei; Liew, Phui Ly; Lin, Jaw–Town; Wu, Ming–Shiang

doi:10.1007/s11695-007-9005-6

Cited by 53 publications

(43 citation statements)

References 29 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, levels of liver transaminases do not always reflect the degree of inflammation. However, there are clear evidences that a score of 2 or more corresponded to steatohepatitis [4,10]. Moreover, as demonstrated in the study, in grade 3 hepatosteatosis group, AFP level elevation is more striking than in the other groups, suggesting that AFP level is well correlated with the disease severity.…”

Section: Discussionsupporting

confidence: 54%

“…Several studies have demonstrated that the sensitivity, specificity, and positive predictive value of this technique to detect steatosis is as high as 80-100% [4,10,11]. However, there are several limitations as well, including operator dependency, less sensitivity in obese patients, and inability to diagnose steatohepatitis and hepatic fibrosis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Serum α-fetoprotein levels in liver steatosis

Babali¹,

Çakal

Pürnak

et al. 2009

Hepatol Int

View full text Add to dashboard Cite

Background Nonalcoholic fatty liver disease (NAFLD) is a common disorder and becoming a leading cause of cirrhosis in the western world. The monitoring of the disease is challenging and the prognostic importance of a-fetoprotein (AFP) level elevation in NAFLD remains uncertain. Methods Eighty-four patients were evaluated in the study. Patients with evidence of fatty liver in an abdominal ultrasonography performed for any reason were enrolled in the study. Degree of liver steatosis was graded into three groups. As a control group, patients without fatty liver or other liver diseases were included. All patients and controls were asked about prior hepatic diseases, consumption of alcohol, smoking, drug use, and a physical examination, biochemical analyses including liver function tests, different components of the metabolic syndrome, and the homeostasis model assessment-estimated insulin resistance (HOMA-IR) score were also performed. Results Body mass index, aspartate aminotransferase, alanine aminotransferase, glucose, insulin, and HOMA-IR in patients with NAFLD were higher than in control group. Triglyceride, total cholesterol, low-density lipoprotein, and high-density lipoprotein cholesterol levels were higher in NAFLD group than in control group. A statistically significant increase in AFP levels was noted in patients with NAFLD (4.09 ± 1.68) when compared with healthy controls (2.95 ± 0.41) (P \ 0.05). A statistically significant increase in AFP levels was noted in patients with grade 3 NAFLD (5.43 ± 1.51) when compared with grade 1 (2.92 ± 1.06) and grade 2 NAFLD groups (3.97 ± 1.45). Also, AFP was significantly higher in grade 2 NAFLD group than in grade 1 NAFLD group. AFP was correlated with NAFLD grade, but neither ALT nor AST showed correlation. According to multivariate analysis, correlation between NAFLD grade and serum AFP levels was independent from the other factors. Conclusion Patients with NAFLD have higher AFP levels than those without fatty liver changes. AFP levels rise as grade of liver steatosis increases. NAFLD should be among the differential diagnosis of elevated serum AFP levels.

show abstract

Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Serum α-fetoprotein levels in liver steatosis

Babali¹,

Çakal

Pürnak

et al. 2009

Hepatol Int

View full text Add to dashboard Cite

show abstract

“…FOXO1 mRNA did not differ significantly between groups (14.46 (8.70) and 14.70 (11.87) arbitrary units in the low and the high HOMA-IR groups, respectively). As increased expression and activity of FOXO1 has been associated with NASH 30 and NASH is strongly related to the steatosis score in obese subjects, 31 we determined the relation of hepatic FOXO1 mRNA with steatosis score. Although average values (s.d.)…”

Section: Resultsmentioning

confidence: 99%

“…29 These contrasting results may be reconciled by an association of ADIPOR1/2 mRNA levels with IR as observed in our study. As NASH is strongly related to the steatosis score in obese subjects as ascertained by ultrasound, 31 our analyses adjusting for steatosis grade and plasma ferritin would be expected to reduce potential confounding by NASH.…”

Section: Discussionmentioning

confidence: 99%

Hepatic adiponectin receptors (ADIPOR) 1 and 2 mRNA and their relation to insulin resistance in obese humans

et al. 2010

View full text Add to dashboard Cite

Objective: Adiponectin signalling attenuates insulin resistance (IR) and steatosis hepatis in animal models. As adiponectin receptor (ADIPOR)1 and ADIPOR2 are critical components in the adiponectin signalling cascade, we studied hepatic ADIPOR1/2 mRNA levels in humans and their relation to IR. Design: We determined metabolic risk factors and levels of hepatic mRNA transcribed from ADIPOR1, ADIPOR2 and FOXO1, a putative up-stream regulator, in 43 and 34 obese subjects with low and high homeostasis model assessment-IR, respectively. Results: Plasma adiponectin and metabolic risk factors showed associations with IR as expected. Both hepatic ADIPOR1 and ADIPOR2 mRNA expression levels were higher in insulin-resistant subjects (Po0.0035). ADIPOR1 mRNA correlated with FOXO1 mRNA in obese insulin resistant (P ¼ 0.0034), but not insulin-sensitive subjects, while no correlations of ADIPOR2 with FOXO1 mRNA were noted. FOXO1 enhanced transcription from the ADIPOR1, but not the ADIPOR2 promoter in HepG2 cells. Conclusion: Increased hepatic ADIPOR1 and ADIPOR2 mRNA in insulin-resistant obese subjects may, at least in part, reflect a compensatory mechanism for reduced plasma adiponectin. FOXO1 may contribute to enhanced ADIPOR1, but not ADIPOR2 transcription in IR.

show abstract

“…): healthy liver, <2%; mild HS, ≥2% to 5%; moderate HS, ≥5% to 10%; and severe HS, ≥10% [12] . According to the fat classes, the following four widely accepted items were used for image analysis to establish standards for fatty liver grade of sheep [13,14] : echogenicity of liver parenchyma (bright liver) compared with the echogenicity of the renal cortex (L-K contrast), visualization of intrahepatic vessels (vessels blurring), and visualization of the posterior hepatic lobe, including the diaphragm, postcaval vein, rumen, and intestines. Visualization of these image characteristics were classified as absent, slight, intermediate, and marked.…”

Section: Imaging Analysismentioning

confidence: 99%

Negatif Enerji Dengesiyle Oluşturulmuş Koyun Yağlı Karaciğerinin Ultrasonografik Değerlendirmesi

Yang¹,

Xu²,

Cheng³

et al. 2017

Kafkas Univ Vet Fak Derg

View full text Add to dashboard Cite

Fatty liver disease is a common liver disease in humans and animals alike, and macrofauna are considered an ideal model of fatty liver disease for ultrasonography (US)-based diagnostic research. Here, a model of fatty liver disease in lactating thin-tail sheep induced by negative energy balance was developed by restricted feeding. Ultrasonographic images were divided into the following fat classes according to liver triglyceride concentrations (ratio of triglyceride weight to wet liver weight): healthy liver, <2%; mild hepatic steatosis (HS), ≥2% to 5%; moderate HS, ≥5% to 10%; and severe HS, ≥10%. Characteristics of Ultrasonographic images according to HS severity were evaluated. As the results, mild to severe HS was detected by restricted feeding. The sensitivity of 5 MHz for diagnostic differentiation of healthy liver, and mild, moderate, and severe HS were 66.7%, 60.0%, 66.7%, and 82.5%, respectively, with a moderate κ statistic ranging from 0.667 to 0.735 among observers. The sensitivity of 3.5 MHz for diagnosis of healthy liver, and mild, moderate, and severe HS were 69.7%, 60.5%, 81.5%, and 75.4%, respectively, with moderate κ statistics ranging from 0.575 to 0.684 among observers. The sensitivities of 3.5 and 5 MHz for moderate to severe HS reached 97.4% and 98.2%, respectively. In summary, visualization at 3.5 and 5 MHz was ideal for diagnosis of HS except mild cases with established US diagnostic standards. Furthermore, with the established model, newer methods, such as image digitizing analysis, can be used for US-based diagnosis of fatty liver in further investigations. Keywords: Ultrasound, Fatty liver, Sheep, Negative energy balance Negatif Enerji Dengesiyle Oluşturulmuş Koyun Yağlı Karaciğerinin Ultrasonografik Değerlendirmesi ÖzetYağlı karaciğer hastalığı insanlarda ve benzer olarak hayvanlarda yaygın bir karaciğer hastalığı olup, makrofauna yağlı karaciğer hastalığının ultrasonografi (US)-temelli diagnostik araştırmaları için ideal bir modeldir. Bu çalışmada, laktasyondaki ince kuyruklu koyun ırkında negatif enerji dengesi ile yağlı karaciğer hastalığı modeli beslemenin kısıtlaması yoluyla oluşturulmuştur. Ultrasonografik görüntüler karaciğer trigliserid konsantrasyonu (yaş karaciğer ağırlığının trigliserid ağırlığına oranı) baz alınarak yağ sınıflarına ayrılmıştır; sağlıklı karaciğer, <2%; hafif hepatik steatozis (HS), ≥2% ile 5% arası; orta derecede HS, ≥5% ile 10% arası ve şiddetli HS, ≥10%. HS şiddetine göre ultrasonografik görüntülerin özellikleri değerlendirildi. Sonuç olarak kısıtlı besleme ile hafif ve orta derecelerde HS tespit edildi. Sağlıklı, hafif, orta ve şiddetli HS'nin diagnostik ayırımı için 5 MHz'nin hassasiyeti sırasıyla %66.7, %60.0, %66.7 ve %82.5 olarak belirlendi. Gözlemciler arasında ortalama κ istatistik 0.667 ile 0.735 arasında değişim gösterdi. Sağlıklı, hafif, orta ve şiddetli HS'nin diagnostik ayırımı için 3.5 MHz'nin hassasiyeti sırasıyla %69.7, %60.5, %81.5 ve %75.4 olarak belirlendi. Gözlemciler arasında ortalama κ istatistik 0.575 ile 0.684 arasında değiş...

show abstract

Diagnostic Value of Ultrasonographic Examination for Nonalcoholic Steatohepatitis in Morbidly Obese Patients Undergoing Laparoscopic Bariatric Surgery

Abstract: FS and MFS on US examination exhibit acceptable sensitivity and high specificity for the detection of the presence of NASH in morbidly obese patients and may aid in the selection of patients for closer follow-up or liver biopsy.

Cited by 53 publications

References 29 publications

Serum α-fetoprotein levels in liver steatosis

Serum α-fetoprotein levels in liver steatosis

Hepatic adiponectin receptors (ADIPOR) 1 and 2 mRNA and their relation to insulin resistance in obese humans

Negatif Enerji Dengesiyle Oluşturulmuş Koyun Yağlı Karaciğerinin Ultrasonografik Değerlendirmesi

Contact Info

Product

Resources

About