Liver ultrasound is more sensitive in assessing the severity of nonalcoholic fatty liver disease with homeostasis model assessment-insulin resistance

Hegazy, Maha A.; Abdel-Rahman, Hatem M.; Elgayar, Dina F.; Amin, Yasser H.

doi:10.1097/01.elx.0000412375.06564.cd

Cited by 7 publications

(7 citation statements)

References 23 publications

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“…Central obesity contributes in causing IR, and increased visceral adiposity might be significant in NAFLD pathogenesis. 31 In our study, hip circumference showed gradual increase with increase of NAFLD grades. In addition, BMI and WC were significantly increased in parallel with NAFLD grades.…”

Section: Discussionsupporting

confidence: 59%

Evaluation of Biomarkers in Egyptian Patients with Different Grades of Nonalcoholic Fatty Liver Disease

Borai¹,

Shaker²,

Kamal³

et al. 2017

Journal of Clinical and Translational Hepatology

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Background and Aims: Nonalcoholic fatty liver disease (NAFLD) is a silent disease; its spectrum includes simple steatosis, nonalcoholic steatohepatitis and fibrosis. Pro- and anti-inflammatory cytokines play roles in the pathogenesis of NAFLD and insulin resistance (IR). Moreover, plasma cell antigen-1 (PC-1) is related to IR and associated with NAFLD progression. Therefore, we aimed to detect biomarkers, ultrasonographic and anthropometric findings capable of differentiating NAFLD grades, since most previous investigators were concerned more with NAFLD patients without classifying them into grades.Methods: A total of 87 NAFLD patients (31 with grade 1 (mild NAFLD), 26 with grade 2 (moderate NAFLD) and 30 with grade 3 (severe NAFLD) were included in the study, in addition to 47 controls (grade 0). All subjects underwent ultrasonographic examination for NAFLD diagnosis. Serum interleukin-10 (IL-10), plasma interleukin-18 (IL-18) and plasma PC-1 levels were determined using enzyme-linked immunosorbent assay.Results: Homoeostasis model assessment (HOMA)-IR was higher in different NAFLD grades than in controls. Ultrasonographic and anthropometric findings and lipid profile indices (except for high-density lipoprotein cholesterol, which was decreased) were increased with NAFLD progression. Grade 3 patients showed significant increase in levels of IL-18 and significant decrease in IL-10 and PC-1 levels when compared to grade 1 patients.Conclusion: Anthropometric and ultrasonographic findings were valuable in differentiating NAFLD grades. IR is very important in NAFLD pathogenesis. IL-18, HOMA-index and PC-1 levels could be used to differentiate between NAFLD grades, together with other measurements.

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Section: Discussionsupporting

confidence: 59%

Evaluation of Biomarkers in Egyptian Patients with Different Grades of Nonalcoholic Fatty Liver Disease

Borai¹,

Shaker²,

Kamal³

et al. 2017

Journal of Clinical and Translational Hepatology

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“…The combination of US of the liver and HOMA-IR is a sensitive and specific method not only to diagnose steatosis, but also in the prediction of severity [ 31 , 32 ]. Damiani et al (2011) have also shown a strong relationship between IR measured by HOMA-IR and hepatic fat.…”

Section: Discussionmentioning

confidence: 99%

Association of the Nonalcoholic Hepatic Steatosis and Its Degrees With the Values of Liver Enzymes and Homeostasis Model Assessment-Insulin Resistance Index

Cruz

Macena

et al. 2015

Gastroenterol Res

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BackgroundNonalcoholic fatty liver disease (NAFLD) is among the most common chronic diseases of the modern world with a wide variety of factors including genetic, environmental and metabolic. The aim of this study was to verify the association between the degrees of hepatic steatosis at the abdominal ultrasound and the values of aminotransferases (aspartate aminotransferase (AST) and alanine transferase (ALT)), gamma glutamyl transpeptidase (GGT) and homeostasis model assessment-insulin resistance (HOMA-IR) index.MethodsA prospective, descriptive survey study, using a quantitative analytical examination, was conducted from July 2013 to July 2014. In the statistical analysis, values were expressed as median, first and third quartiles. We used the nonparametric Kruskal-Wallis test to compare the medians between the degrees of steatosis, adopted a statistical significance of 5% (P ≤ 0.05) and used the statistical program SPSS 22.0.ResultsWe diagnosed 233/800 (29.1%) patients with hepatic steatosis on routine ultrasound, and 65.7% were female. Regarding degrees, 119 had grade 1 (51.0%), 94 grade 2 (40.4%) and 20 grade 3 (8.6%). The median age of the patients with grade 1, 2 or 3 did not vary significantly (P > 0.05). The median body mass index (BMI), although clinically important because of its elevation, did not differ significantly (P > 0.05). ALT levels increased as the degree of hepatic steatosis has advanced as well as the levels of AST, GGT and HOMA-IR. AST values showed a greater association with the severity of fatty liver (P = 0.0001) than the ALT (P = 0.001).ConclusionsALT, AST, GGT and HOMA-IR are associated to the degrees of hepatic steatosis on ultrasound and can help in the selection of patients for the liver histological evaluation.

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“…But there is the cost-effective need to routinely monitor the liver in patients with chronic health conditions that eventually impact liver health, as in the cases of diabetes mellitus type 2 14 and nonalcoholic fatty liver disease. 7 The clinical challenge then is to be able to detect changes in RLL length, accurately. The aim of this study is to establish objective anatomical criteria to obtain accurate and reliable measurements of RLL length by ultrasound.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, it is of pivotal clinical importance that sonographers and physicians feel confident about their assessment of liver health through 2D ultrasound. Whereas there is agreement in the imaging field about how to evaluate liver texture, there is lack of consensus on whether measurements of RLL through 2D ultrasound are accurate and reproducible between sonographers . Moreover, there is also a wide range of RLL length values reported in medical textbooks and research publications to indicate normal liver length .…”

Section: Introductionmentioning

confidence: 99%

“…It is not surprising that some physicians, biomedical researchers and imaging technologists are left with the impression that assessment of liver health through 2D ultrasound is qualitative at best. But there is the cost-effective need to routinely monitor the liver in patients with chronic health conditions that eventually impact liver health; as in the cases of diabetes mellitus type 2 14 and nonalcoholic fatty liver disease (NAFLD) 7 . The clinical challenge then, is to be able to detect changes in RLL length, accurately.…”

Section: Introductionmentioning

confidence: 99%

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Anatomical criteria to measure the adult right liver lobe by ultrasound

2018

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Introduction. This study aims to establish objective anatomical criteria to obtain accurate and reliable measurements of the right liver lobe (RLL) length by ultrasound while considering sex and anthropometry of the patient. Methods. Thirty-three (n = 33) adult participants underwent two-dimensional (2D) and panoramic (PAN) ultrasound imaging of the RLL in the anterior axillary region (AAR). Each measurement was performed in the standard oblique plane and in a tested craniocaudal (CC) plane by two independent observers. Pearson analysis was conducted to evaluate correlation between measurements and Intraclass Correlation Coefficient (ICC) for inter-rater reliability. Two-tail paired T test was used to compare groups. Statistical significance was attained at p < 0.05. Results. The proposed craniocaudal 2D RLL length was 13.0 ± 1.5 cm for females and 14.1 ± 1.3 cm for males whereas PAN RLL size was 13.7 ± 1.8 cm for females and 15.0 ± 1.1 cm for males. A strong correlation between the proposed 2D CC measurement of the RLL length with PAN CC measurements was found (r = 0.87). Inter-rater reliability for 2D CC measurements showed high reliability (ICC 0.96). Discussion. CC measurement of RLL by ultrasound in AAR is a precise and reliable measurement that may allow for the routine monitoring of RLL length across time.

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Liver ultrasound is more sensitive in assessing the severity of nonalcoholic fatty liver disease with homeostasis model assessment-insulin resistance

Cited by 7 publications

References 23 publications

Evaluation of Biomarkers in Egyptian Patients with Different Grades of Nonalcoholic Fatty Liver Disease

Evaluation of Biomarkers in Egyptian Patients with Different Grades of Nonalcoholic Fatty Liver Disease

Association of the Nonalcoholic Hepatic Steatosis and Its Degrees With the Values of Liver Enzymes and Homeostasis Model Assessment-Insulin Resistance Index

Anatomical criteria to measure the adult right liver lobe by ultrasound

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