Diagnosis of hepatic steatosis in non-alcoholic fatty liver disease in the military


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Abstract

The diagnostic possibilities of non-invasive methods for assessing liver steatosis in patients suffering from non- alcoholic fatty liver disease have been studied. It was found that in patients suffering from non-alcoholic fatty liver disease, the values of the controlled parameter of ultrasound attenuation were significantly higher than normal values and were significantly higher (p<0,001) than in the group of subjects without liver pathology (277 [270; 283] and 215 [205; 225] dB/m). Patients suffering from non-alcoholic fatty liver disease were most often diagnosed with steatosis of the second and third degree (33,5 and30,9%), less often with steatosis of the first degree and absence of steatosis (26,4 and 9,2%). In the group of subjects without liver pathology, steatosis was not detected in 63,7% of people, in 29,8% the first degree was detected, in 6,5% of patients-the second degree of steatosis. Fatty liver index in the group of persons suffering from non-alcoholic fatty liver disease was higher than normal values and significantly (p<0,01) exceeded the value of the group of subjects without liver disease (75,4 [72,2;78,5] and 27,4 [23,1; 31,7] units). Results above the threshold were observed in 76,2% of patients, while values of less than30 units, indicating the absence of the disease, were determined only in 3,5% of people. Hepatic steatosis index in the groupof patients with non-alcoholic fatty liver disease was higher than the threshold values and significantly (p<0,001) differedfrom the control group (39,3 [37,9; 40,6 and 25,8 [24,9; 26,8] units). At the same time, in the group of patients sufferingfrom non-alcoholic fatty liver disease, it was detected in 71,3% of people, while in the healthy group only 7,3% of people.The quality of the diagnostic model, a value of the controlled attenuation parameter of the ultrasound was regarded as verygood (area under curve receiver is 0,854±0,026 units, Youden index 0,603 units), the indices of fatty liver disease and hepaticsteatosis as excellent (area under curve receiver 0,941±0,016 and 0,919±0,0168 units, Youden index 0,783 and 0,708 units).

About the authors

I I Zhirkov

Военно-медицинская академия им. С.М. Кирова

Email: vmeda-nio@mil.ru
Санкт-Петербург

References

  1. Жирков, И.И. Хронические диффузные заболевания печени невирусной этиологии у военнослужащих / И.И. Жирков [и др.] // Вестн. Росс. воен.-мед. акад. - 2019. - № 4 (68). - С. 72-76.
  2. Ивашкин, В.Т. Распространенность неалкогольной жировой болезни печени у пациентов амбулаторно-поликлинической практики в Российской Федерации: результаты исследования DIREG 2 / В.Т. Ивашкин [и др.] // Росс. журн. гастроэнтерол. гепатол. колопроктол. - 2015. - № 6. - С. 31-41.
  3. Павлов, Ч.С. Биопсия и морфологическое исследование в диагностике хронических заболеваний печени различной этиологии / Ч.С. Павлов, В.Б. Золотаревский, В.Т. Ивашкин // Росc. журн. гастроэнтерол., гепатол. и колопроктол. - 2007. - Т. 19, № 1. - С. 90-94.
  4. Bedogni, G. The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population / G. Bedogni [et al.] // BMC Gastroenterol. - 2006. - № 6. - P. 33.
  5. Bedossa, P. FLIP Pathology Consortium. Utility and appropriateness of the fatty liver inhibition of progression (FLIP) algorithm and steatosis, activity, and fibrosis (SAF) score in the evaluation of biopsies of nonalcoholic fatty liver disease / P. Bedossa // Hepatology. - 2014. - Vol. 60. - P. 565-575.
  6. Bohn, M.J. The Alcohol Use Disorders Identification Test (AUDIT): validation of a screening instrument for use in medical settings / M.J. Bohn, T.F. Babor, H.R. Kranzler // J. Stud. Alcohol. - 1995. - Vol. 56, № 4. - P. 423-432.
  7. Chon, Y.E. Controlled attenuation parameter (CAP) for detection of hepatic steatosis in patients with chronic liver diseases: a prospective study of a native Korean population / Y.E. Chon [et al.] // Liver Int. - 2014. - Vol. 34, № 1. - P. 102-109.
  8. de Lédinghen, V. Noninvasive diagnosis of liver steatosis using controlled attenuation parameter (CAP) and transient elastography / V. de Lédinghen [et al.] // Liver Int. 2012. - Vol. 32, № 6. - P. 911-918.
  9. EASL-EASD-EASO Clinical Practice Guideline for the management of non-alcoholic liver disease. European Association for the Study of the Liver (EASL) and European Association for the Study of Diabetes (EASD) and European Association for the Study of Obesity (EASO) // Diabetologia. - 2016. - Vol. 59. - P. 1121-1140.
  10. Kotronen, A. Prediction of non-alcoholic fatty liver disease and liver fat using metabolic and genetic factors / A. Kotronen [et al.] // Gastroenterology - 2009. - Vol. 137, № 3. - P. 865-872.
  11. Lee, J.H. Hepatic steatosis index: a simple screening tool reflecting nonalcoholic fatty liver disease / J.H. Lee [et al.] // Dig. Liver Dis. - 2010. - Vol. 42. - P. 503-508.
  12. Masaki, K. Utility of controlled attenuation parameter measurement for assessing liver steatosis in Japanese patients with chronic liver diseases / K. Masaki [et al.] // Hepatol. Res. - 2013. - Vol. 43, № 11. - P. 1182-1189.
  13. Poynard, T. The diagnostic value of biomarkers (SteatoTest) for the prediction of liver steatosis / T. Poynard [et al.] // Comp. Hepatol. - 2005. - Vol. 4. - Р. 1-10.
  14. Sasso, M. Controlled attenuation parameter (CAP): a novel VCTE guided ultrasonic attenuation measurement for the evaluation of hepatic steatosis: preliminary study and validation in a cohort of patients with chronic liver disease from various causes / M. Sasso [et al.] // Ultrasound Med. Biol. - 2010. - Vol. 36, № 11. - P. 1825-1835.
  15. Yoneda, M. Utility of controlled attenuation parameter measurement for assessing liver steatosis in Japanese patients with chronic liver disease / M. Yoneda // Hepatol. Res. - 2013. - Vol. 43, № 11. - P. 1125-1126.
  16. Younossi, Z.M. Global epidemiology of nonalcoholic fatty liver disease - meta-analytic assessment of prevalence, incidence, and outcomes / Z.M. Younossi [et al.] // Hepatology - 2016. - Vol. 63. - P. 73-84.

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