The Role of Ultrasound in the Diagnosis of Hepatic Steatosis in Morbidly Obese Patients

Mottin, Cláudio Corá; Moretto, Myriam; Padoin, Alexandre Vontobel; Swarowsky, Aline Maria; Toneto, Marcelo Garcia; Glock, Luiz; Repetto, Giuseppe

doi:10.1381/096089204323093408

Cited by 268 publications

(180 citation statements)

References 10 publications

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“…Although increased liver enzymes are insensitive at detecting hepatic steatosis, 41 the sensitivity of ultrasound also varies between 49% and 94%. 42 In population-based cohorts, ultrasonographic evidence of hepatic steatosis is found in almost 20% of normal weight persons and 80% of overweight persons. 43 Thus, we determined hepatic steatosis by using both laboratory markers as well as ultrasound.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic hepatic steatosis increases prediction of mortality risk from elevated serum gamma-glutamyl transpeptidase levels # †

et al. 2009

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The aim of the present study was to investigate the association of serum gamma-glutamyltransferase (GGT) levels with all-cause mortality and to assess the impact of ultrasonographic findings of hepatic hyperechogenicity in that association. We used data from 4,160 subjects (2,044 men and 2,116 women) recruited for the population-based Study of Health in Pomerania (SHIP) without baseline hepatitis B and C infections or liver cirrhosis. GGT was divided into age-and sex-dependent quintiles to calculate overall and sex-specific crude incidence mortality rates. Hepatic steatosis was defined by elevated GGT levels (>80%) and the presence of hyperechogenic liver ultrasound. We used multiple-adjusted Cox proportional hazards regression models, first, to assess the direct effect of GGT on all-cause mortality, second, to stratify according to the ultrasonographic finding, and third, to investigate potential mediating effects of cardiometabolic risk factors. During 29,810 person-years (7.3 years, median) of follow-up, 307 individuals (7.5%) died, resulting in a death rate of 0.86 deaths per 1000 person-years. Elevated GGT levels were associated with increased risk of mortality in men (hazard ratio [HR] 1.49; 95% confidence interval [CI], 1.08-2.05), but not in women (HR 1.30; 95% CI, 0.80-2.12). This association was even stronger in men with hepatic steatosis (HR 1.98; 95% CI, 1.21-3.27). Cause-specific mortality analysis by cardiovascular disease deaths confirmed the sex-specific association. Adjustment for cardiometabolic risk factors did not affect the estimates. Conclusion: In the case of increased GGT levels, liver ultrasound should be performed, not only for diagnosis, but also for further risk stratification.

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Section: Discussionmentioning

confidence: 99%

Ultrasonographic hepatic steatosis increases prediction of mortality risk from elevated serum gamma-glutamyl transpeptidase levels # †

et al. 2009

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“…However, US has acceptable accuracy to predict the absence of substantial hepatic steatosis. This is different from the severely obese adult population, in which the prevalence of hepatic steatosis is reported to be higher ( 24,25 ( 24,25 ). Again, we calculated predictive values from the reported data.…”

Section: Ultrasonography: Hepatic Steatosis In Obese Adolescentsmentioning

confidence: 92%

US Cannot Be Used to Predict the Presence or Severity of Hepatic Steatosis in Severely Obese Adolescents

Bohte

Koot²,

Baan-Slootweg³

et al. 2012

Radiology

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Purpose:To evaluate the diagnostic accuracy of ultrasonography (US) for the assessment of hepatic steatosis in severely obese adolescents, with proton magnetic resonance (MR) spectroscopy as the reference standard, and to provide insight on the infl uence of prevalence on predictive values by calculating positive and negative posttest probabilities. Materials and Methods:This prospective study was institutional review board approved. All participants, and/or their legal representatives, gave written informed consent. Sensitivity, specifi city, positive predictive value (PPV), and negative predictive value (NPV) were calculated for the overall presence of steatosis and for the presence of substantial (moderate to severe) steatosis. Positive and negative posttest probabilities were calculated and plotted against prevalence. Results:A total of 104 children (47 male, 57 female) were prospectively included. Conclusion:Positive US results in severely obese adolescents cannot be used to accurately predict the presence and severity of hepatic steatosis, and additional imaging is required. Negative US results exclude the presence of substantial steatosis with acceptable accuracy. Steatosis prevalence differs among specifi c populations, strongly infl uencing posttest probabilities.q RSNA, 2011 1

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“…Liver echopattern was graded according to Mottin et al [16]. Degree of NAFLD (steatosis) was determined throughout the ultrasonography scan imaging of liver echogenicity and liver biopsy when appropriate.…”

Section: Patientsmentioning

confidence: 99%

Efficacy of Tumor Necrosis Factor and Interleukin-10 Analysis in the Follow-up of Nonalcoholic Fatty Liver Disease Progression

et al. 2012

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The Role of Ultrasound in the Diagnosis of Hepatic Steatosis in Morbidly Obese Patients

Cited by 268 publications

References 10 publications

Ultrasonographic hepatic steatosis increases prediction of mortality risk from elevated serum gamma-glutamyl transpeptidase levels # †

Ultrasonographic hepatic steatosis increases prediction of mortality risk from elevated serum gamma-glutamyl transpeptidase levels # †

US Cannot Be Used to Predict the Presence or Severity of Hepatic Steatosis in Severely Obese Adolescents

Efficacy of Tumor Necrosis Factor and Interleukin-10 Analysis in the Follow-up of Nonalcoholic Fatty Liver Disease Progression

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