Estimation of Liver Fat by FibroScan in Patients With Nonalcoholic Fatty Liver Disease

Abstract

BackgroundAssessment of nonalcoholic fatty liver disease (NAFLD) includes estimation of liver fat (steatosis).Controlled attenuation parameter (CAP) value obtained by FibroScan ® (Echosens, Paris, France) is an alternative to liver biopsy for diagnosing and estimating steatosis (S). This study aimed to estimate the liver fat by CAP in NAFLD patients. MethodsAn observational cross-sectional study was conducted at the Liver Unit of Bir Hospital, from January 2021 to May 2021 after ethical clearance from the Institutional Review Board of the National Academy of Medical Sciences. A convenient sampling method was used. Data were analyzed with descriptive and inferential statistics involving bivariate and multivariate analysis. ResultsA total of 127 NAFLD patients were enrolled. The mean (±SD) CAP value was 271.53 (±50.69) dB/m. Total cholesterol, triglyceride, and body mass index (BMI) correlated positively (p<0.05) while systolic blood pressure correlated negatively with CAP value (p=0.031). On multivariate analysis, patients with BMI ≥25 kg/m 2 were found 3.7 times more likely to have CAP ≥291 dB/m (S3, severe steatosis) than those with BMI <25 kg/m 2 (p=0.048, 95% CI 1.01, 13.50). The mean (±SD) CAP values were 276.19 (±49.93) and 246.60 (±48.50) dB/m among those with BMI ≥25 kg/m 2 and <25 kg/m 2 , respectively (p=0.016, using independent ttest). CAP steatosis grading correlated positively with both the ultrasound grading (p<0.001) and fibrosis grading by liver stiffness measurement (p=0.004). ConclusionIn this observational cross-sectional study of NAFLD patients, the mean (±SD) CAP value was 271.53 (±50.69) dB/m, which corresponds to moderate steatosis (S2). Obese NAFLD patients with ≥25 kg/m 2 were 3.7 times more likely to have severe steatosis (S3) than nonobese NAFLD patients with BMI <25 kg/m 2 .

Allopurinol versus Febuxostat: A New Approach for the Management of Hepatic Steatosis in Metabolic Dysfunction-Associated Steatotic Liver Disease

“…This study aimed to investigate the effects of febuxostat 40 mg and allopurinol 100 mg, along with lifestyle modifications, on hepatic steatosis improvement in MASLD patients. Previous studies demonstrated that the CAP score is a non-invasive, low-cost approach for diagnosing and quantifying steatosis [5].…”

“…The CAP value measured by FibroScan ® (Echosens, Paris, France) provides a non-invasive alternative to LB for detecting and measuring steatosis (S) with reasonable accuracy, lower cost, and without any implications. CAP reflects a decrease in the amplitude of the ultrasound signal in the liver and is measured in decibels per meter (dB/m) [5].…”

Novel Noninvasive Paraclinical Study Method for Investigation of Liver Diseases

“…The gold standard method to objectively detect the extent of the disease is liver biopsy [ 14 , 15 ]. In addition, laboratory tests and imaging techniques (abdominal ultrasound (US), computer tomography (CT), magnetic resonance imaging (MRI), echo transient elastography (TE)) are used in clinical practice [ 1 , 4 , 16 , 17 , 18 , 19 , 20 , 21 ]. Despite these techniques having shown many advantages, they still have limitations [ 1 , 19 ], such us high cost, ionizing radiation or reduced sensitivity and selectivity in obese patients.…”