Transient hepatic elastography has the best performance to evaluate liver fibrosis in non-alcoholic fatty liver disease (NAFLD)

Tovo, Cristiane Valle; Villela-Nogueira, Cristiane Alves; Leite, Nathalie C.; Panke, Carine; Port, Gabriela Z.; Fernandes, Sabrina Alves; Buss, Caroline; Coral, Gabriela Perdomo; Cardoso, Ana Carolina; Cravo, Claudia; Calçado, Fernanda Luiza; Rezende, Guilherme; Ferreira, Frederico Castelo; Araujo-Neto, João Marcello de; Perez, Renata de Mello; Moraes-Coelho, Henrique Sergio; Mattos, Ângelo Alves de

doi:10.1016/j.aohep.2018.09.003

Cited by 30 publications

(25 citation statements)

References 39 publications

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“…Instead of a liver biopsy, the gold standard for assessing liver fibrosis, FibroScan ® , was the method of choice here and our findings were similar to the previous results described by Li et al, which demonstrated a significant reduction in liver fibrosis, assessed by histology, after six months of intervention with n-3 PUFA [16]. It is noteworthy that recent studies have shown that liver stiffness measured by FibroScan ® has good accuracy compared to liver biopsy, regardless of the type of probe used, the degree of liver steatosis, and inflammation [30,44,45].…”

Section: Discussionsupporting

confidence: 90%

Impact of Long-Term Supplementation with Fish Oil in Individuals with Non-Alcoholic Fatty Liver Disease: A Double Blind Randomized Placebo Controlled Clinical Trial

et al. 2020

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Non-alcoholic fatty liver disease (NAFLD) is a chronic disease affecting up to 25% of the population worldwide. n-3 long-chain polyunsaturated fatty acids (n-3 PUFA) have been associated with improved clinical parameters of NAFLD. Our purpose was to conduct a pilot study to evaluate the effects of n-3 PUFA supplementation in a randomized, double-blind, placebo-controlled clinical study performed on NAFLD individuals diagnosed by ultrasound. Patients received n-3 PUFA (n = 13) or placebo (n = 11) supplementation for six months. Circulating miR-122 expression (determined by quantitative real time-polymerase chain reaction (qRT-PCR), liver fibrosis (FibroScan®), red blood cells (RBC) fatty acids (gas chromatography), and biochemical tests were performed at baseline and after intervention. After the intervention, in the n-3 PUFA group, docosahexaenoic acid (DHA) and omega index increased significantly in RBC (p = 0.022 and p = 0.012, respectively), in addition to a significant reduction in alkaline phosphatase (ALP) (p = 0.002) and liver fibrosis (p = 0.039). However, there was no change in the expression of circulating miR-122 in both groups. Our results showed that omega-3 PUFA were incorporated in erythrocytes after six months of fish oil supplementary intake, and that n-3 PUFA were effective in reducing ALP and liver fibrosis without altering the expression of circulating miR-122 in individuals with NAFLD.

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Section: Discussionsupporting

confidence: 90%

Impact of Long-Term Supplementation with Fish Oil in Individuals with Non-Alcoholic Fatty Liver Disease: A Double Blind Randomized Placebo Controlled Clinical Trial

et al. 2020

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“…The current European Association for the Study of the Liver (EASL) guidelines for the management of NAFLD recommend TE as a non-invasive method for liver fibrosis assessment and monitoring (39). A recent study confirmed that transient elastography has the best non-invasive performance to evaluate liver fibrosis in NAFLD (19). In our series, no fibrosis changes were suggested by LSM, so a liver biopsy was not indicated in this cohort.…”

Section: Discussionmentioning

confidence: 56%

“…CAP analysis is effective in the diagnosis and quantification of hepatic steatosis, from absolute cut-off points, with 90% sensitivity (15)(16)(17)(18). Recent studies have shown that transient elastography has the best performance on the diagnosis and exclusion of advanced hepatic fibrosis in NAFLD (19). There is no previous literature report on the use of Transient Elastography to identify liver disease on MPHD hypopituitary patients.…”

Section: Introductionmentioning

confidence: 99%

Transient Elastography and Controlled Attenuation Parameter (CAP) in the Assessment of Liver Steatosis in Severe Adult Growth Hormone Deficiency

et al. 2019

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Non-alcoholic fatty liver disease (NAFLD) is common in patients with growth hormone deficiency (GHD). Some noninvasive techniques have been used to quantify liver fat, such as the controlled attenuation parameter (CAP). Objective: To evaluate CAP as a tool to identify liver steatosis and its relationship with different clinical and biochemical metabolic parameters in a group of patients with severe adult growth hormone deficiency (AGHD), and to compare the evolution of metabolic profiles after 6 months of human growth hormone (rhGH) replacement therapy in a subgroup of patients. Methods: Cross-sectional observational study at baseline of naive rhGH multiple pituitary hormonal deficiency (MPHD) hypopituitarism patients. A 6-month intervention clinical trial in a selected group of a non-randomized, non-controlled cohort was also applied. Results: Liver stiffness measurement (LSM) was normal in severe AGHD patients. CAP evaluation showed steatosis in 36.3% of baseline patients (8/22), associated with higher BMI, waist circumference, insulin, and alanine aminotransferase (ALT) levels. According to steatosis degree by CAP, child-onset growth hormone deficiency (CO-GHD) was graded as 68.75% (11/16) S0, 12.5% (2/16) S1, and 18.75% (3/16) S3, whereas AO-GHD was graded as 50% (3/6) S0, 16.66% (1/6) S2, and 33.33% S3. After 6 months of hrGH replacement, CAP measurements did not change significantly, neither on group without hepatic steatosis at baseline (194.4 ± 24.3 vs. 215.4 ± 51.3; p = 0.267) nor on the group with hepatic steatosis (297.2 ± 32.3 vs. 276.4 ± 27.8; p = 0.082). A significant improvement of body composition was observed only in the first group. Conclusions: We have demonstrated the importance of CAP as a non-invasive tool in the liver steatosis identification on hypopituitary patients. This method may be an important indicator of the severity of metabolic disorders in MPHD patients. In our study, no liver health modification in LSM at baseline or after 6 months of rhGH replacement was found. Longer studies can help to establish the potential repercussions of growth hormone replacement therapy on liver steatosis.

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“…89 Similar to noninvasive models and blood-based biomarkers, VCTE performance has been validated in accurately distinguishing advanced from early fibrosis in several multicenter cohort's studies. [90][91][92][93][94] In a recent prospective cohort study of 393 patients with biopsy-proven NAFLD, VCTE performed with a sensitivity of 90% and 90% and NPV of 91% and 99% at excluding advance fibrosis and cirrhosis, respectively. Furthermore, VCTE diagnostic accuracy was high with an AUROC of 0.83.…”

Section: Vibration-controlled Transient Elastographymentioning

confidence: 99%

“…90 In a head-to-head comparison to the most validated noninvasive models, VCTE outperformed APRI, FIB4, BARD and NFS at excluding advanced fibrosis with similar performance as mentioned above. 92,95 Nevertheless, noninvasive models are a simple and more accessible tools to primary health provider that can easily be extracted from readily available clinical and laboratory information and accurately exclude advanced fibrosis and cirrhosis.…”

Section: Vibration-controlled Transient Elastographymentioning

confidence: 99%

The role of noninvasive biomarkers in diagnosis and risk stratification in nonalcoholic fatty liver disease

Román

Siddiqui

2020

Endocrino Diabet & Metabol

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Nonalcoholic fatty liver disease (NAFLD) is characterized by the presence of ectopic fat deposition within the liver not attributable to alcohol or secondary causes of hepatic steatosis. 1 NAFLD, as the aetiology of chronic liver disease, has increased rapidly over the past three decades in the United States and is now the most common cause of chronic liver disease accounting for nearly 75% of all chronic liver diseases and affecting nearly one in three individuals. 2,3 NAFLD is commonly associated with obesity, type 2 diabetes mellitus, hyperlipidemia, and hypertension 4-6 and is considered the hepatic manifestation of metabolic syndrome. 7 NAFLD comprises a histological spectrum of nonalcoholic fatty liver (NAFL) characterized by the presence of hepatic steatosis with none or minimal inflammation to nonalcoholic steatohepatitis (NASH), which is characterized by lobular inflammation, ballooning and varying degrees of hepatic fibrosis. 8 Serum liver enzymes, which are often the first clinical clue to presence of liver disease, can be normal or mildly elevated

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Transient hepatic elastography has the best performance to evaluate liver fibrosis in non-alcoholic fatty liver disease (NAFLD)

Cited by 30 publications

References 39 publications

Impact of Long-Term Supplementation with Fish Oil in Individuals with Non-Alcoholic Fatty Liver Disease: A Double Blind Randomized Placebo Controlled Clinical Trial

Impact of Long-Term Supplementation with Fish Oil in Individuals with Non-Alcoholic Fatty Liver Disease: A Double Blind Randomized Placebo Controlled Clinical Trial

Transient Elastography and Controlled Attenuation Parameter (CAP) in the Assessment of Liver Steatosis in Severe Adult Growth Hormone Deficiency

The role of noninvasive biomarkers in diagnosis and risk stratification in nonalcoholic fatty liver disease

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