Prevalence of nonalcoholic fatty liver disease (NAFLD) diagnosed by controlled attenuation parameter with transient elastography in subjects with and without metabolic syndrome.

Authors

  • K. Vanduangden Thai Red Cross Society
  • R. Chaiteerakij Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
  • K. Thanapirom Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
  • K. Sonsiri Thai Red Cross Society
  • S. Treeprasertsuk Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Keywords:

NAFLD, fatty liver, metabolic syndrome, CAP-Transient elastography, prevalence

Abstract

Background : Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disease worldwide. The prevalence of NAFLD in the adult ranges from 20% to 40%. Currently, controlled attenuation parameter with transient elastography (CAP-TE) is an accepted standard of diagnostic tool for grading the severity of liver steatosis and liver fibrosis with high accuracy.

Objectives : To compare the prevalence of NAFLD and to identify risk factors of significant steatosis in participants with and without metabolic syndrome (mets) by CAP-TE.

Methods : We conducted a study of 161 subjects who worked at King Chulalongkorn Memorial Hospital, from March to October 2016. We collected age, sex, weight, height, waist and hip circumference, comorbidities and the medical history of the risks of liver diseases including history of alcohol consumption, chronic viral hepatitis B and hepatitis C infection by using questionnaire. The laboratory tests including fasting plasma glucose, HDL-C, triglyceride, ALT, HBsAg, AntiHCV were conducted. CAP-TE was used to measure the degree of liver steatosis and fibrosis by experienced operator (KS). The result of liver stiffness result was reported in kPa, using the median value of 10 measurements whereas the degrees of fatty liver were reported in dB/m. The definition of NAFLD was the presence of liver fat >10%, whereas liver fat of >33% is classified as significant steatosis and >66% is classified as severe fatty liver.

Results : From 161 subjects, 99 of them (61.5%) had NAFLD. The prevalence of NAFLD in subjects with mets was significantly higher than those without mets (97% vs. 52%, P <0.001). The risk factors of significant steatosis were BMI gif.latex?\geq25 kg/m2 (OR 12.4, 95% CI 5.8 - 26.4), elevated waist circumference (OR 11.0, 95% CI 4.9 - 24.4), hypertension (OR 5.5, 95% CI 1.9 - 15.9), impaired fasting glucose (OR 3.3, 95% CI 1.4 - 7.7), high triglyceride level (OR 8.7, 95% CI 3.1 - 24.6), low level of HDL-C (OR 3.5, 95% CI 1.7 - 7.1) and presence of mets (OR 26.6, 95% CI 7.6 - 92.6). The significant risk factors from multivariate analysis were BMI gif.latex?\geq 25 kg/m2 (OR 3.6, 95% CI 1.3 - 9.9, P = 0.014) and high ALT (OR 1.05, 95% CI 1.00 - 1.09, P = 0.03). Additionally, the grading severity of significant fibrosis of at least 7 kPa (>F2) of the total cohort was 3.8% and the severe fatty liver of at least 66% (>296 dB/m) was 19.3%.

Conclusion : The prevalence of NAFLD in the subjects with metabolic syndrome was significantly higher than those without metabolic syndrome. Additionally, this cohort showed a high prevalence of NAFLD (61.5%) and significant liver fibrosis of 3.8%.

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References

Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and nonalcoholic steatohepatitis in adults. Aliment Pharmacol Ther 2011;34:274-85. https://doi.org/10.1111/j.1365-2036.2011.04724.x

Bellentani S, Bedogni G, Miglioli L, Tiribelli C. The epidemiology of fatty liver. Eur J Gastroenterol Hepatol 2004;16:1087-93. https://doi.org/10.1097/00042737-200411000-00002

Almeda-Valdes P, Cuevas-Ramos D, AguilarSalinas CA. Metabolic syndrome and nonalcoholic fatty liver disease. Ann Hepatol 2009;8 Suppl 1:S18-24. https://doi.org/10.1016/S1665-2681(19)31822-8

Chen SH, He F, Zhou HL, Wu HR, Xia C, Li YM.Relationship between nonalcoholic fatty liver disease and metabolic syndrome. J Dig Dis 2011;12:125-30. https://doi.org/10.1111/j.1751-2980.2011.00487.x

Neuschwander-Tetri BA, Caldwell SH. Nonalcoholic steatohepatitis: summary of an AASLD Single Topic Conference. Hepatology 2003;37:1202-19. https://doi.org/10.1053/jhep.2003.50193

Bellentani S, Scaglioni F, Marino M, Bedogni G. Epidemiology of non-alcoholic fatty liver disease. Dig Dis 2010;28:155-61. https://doi.org/10.1159/000282080

Nguyen-Khac E, Capron D. Noninvasive diagnosis of liver fibrosis by ultrasonic transient elastography (Fibroscan). Eur J Gastroenterol Hepatol 2006;18:1321-5.

https://doi.org/10.1097/01.meg.0000243884.55562.37

de L édinghen V, Wong GL, Vergniol J, Chan HL, Hiriart JB, Chan AW, et al. Controlled attenuation parameter for the diagnosis of steatosis in non-alcoholic fatty liver disease. J Gastroenterol Hepatol 2016;31:848-55. https://doi.org/10.1111/jgh.13219

Alberti KG, Zimmet P, Shaw J. The metabolic syndrome-a new worldwide definition. Lancet 2005;366:1059-62. https://doi.org/10.1016/S0140-6736(05)67402-8

de L édinghen V, Wong VW, Vergniol J, Wong GL, Foucher J, Chu SH, et al. Diagnosis of liver fibrosis and cirrhosis using liver stiffness measurement: comparison between M and XL probe of FibroScan(R). J Hepatol 2012; 56:833-9. https://doi.org/10.1016/j.jhep.2011.10.017

Wong GL. Update of liver fibrosis and steatosis with transient elastography (Fibroscan). Gastroenterol Rep (Oxf) 2013;1:19-26. https://doi.org/10.1093/gastro/got007

Mikolasevic I, Orlic L, Franjic N, Hauser G, Stimac D, Milic S. Transient elastography (FibroScan((R))) with controlled attenuation parameter in the assessment of liver steatosis and fibrosis in patients with nonalcoholic fatty liver disease - Where do we stand? World J Gastroenterol 2016;22:7236-51.

https://doi.org/10.3748/wjg.v22.i32.7236

Kleiner DE, Brunt EM, Van Natta M, Behling C, Contos MJ, Cummings OW, et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology 2005;41:1313-21.

https://doi.org/10.1002/hep.20701

Bellentani S, Saccoccio G, Masutti F, Croce LS, Brandi G, Sasso F, et al. Prevalence of and risk factors for hepatic steatosis in Northern Italy. Ann Intern Med 2000;132:112-7.

https://doi.org/10.7326/0003-4819-132-2-200001180-00004

Koehler EM, Schouten JN, Hansen BE, van Rooij FJ, Hofman A, Stricker BH, et al. Prevalence and risk factors of non-alcoholic fatty liver disease in the elderly: results from the Rotterdam study. J Hepatol 2012;57: 1305-11. https://doi.org/10.1016/j.jhep.2012.07.028

Rapipongpattana N, Maiprasert M, Teng-Umnuay P. Prevalence of fatty liver and its relationship with metabolic syndrome in Thai adults receiving annual health exam at Pyathai 2 hospital, Bangkok [Internet]. n.d.[cited 2017 Apr 22]. Available from: http://www.mfu.ac. th/school/anti-aging/File_PDF/Research_ PDF54/4.pdf

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Published

2023-08-24

How to Cite

1.
Vanduangden K, Chaiteerakij R, Thanapirom K, Sonsiri K, Treeprasertsuk S. Prevalence of nonalcoholic fatty liver disease (NAFLD) diagnosed by controlled attenuation parameter with transient elastography in subjects with and without metabolic syndrome. Chula Med J [Internet]. 2023 Aug. 24 [cited 2024 Nov. 22];61(4). Available from: https://he05.tci-thaijo.org/index.php/CMJ/article/view/468

Issue

Vol. 61 No. 4 (2017): Chulalongkorn Medical Journal

Section

Modern Medicine

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