The Severity of Ultrasonographic Findings in Nonalcoholic... : Official journal of the American College of Gastroenterology | ACG (original) (raw)

ORIGINAL CONTRIBUTIONS: LIVER AND BILIARY TRACT

The Severity of Ultrasonographic Findings in Nonalcoholic Fatty Liver Disease Reflects the Metabolic Syndrome and Visceral Fat Accumulation

Hamaguchi, Masahide M.D.1; Kojima, Takao M.D.2; Itoh, Yoshito M.D., Ph.D.3; Harano, Yuichi M.D.3; Fujii, Kota M.D.3; Nakajima, Tomoaki M.D.3; Kato, Takahiro M.D.2; Takeda, Noriyuki M.D.4; Okuda, Junichi M.D.2; Ida, Kazunori M.D.2; Kawahito, Yutaka M.D., Ph.D.1; Yoshikawa, Toshikazu M.D., Ph.D.1; Okanoue, Takeshi M.D., Ph.D.3

1Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan, 2Department of Gastroenterology, Murakami Memorial Hospital, Asahi University, Gifu, Japan, 3Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan, 4Department of Endocrinology and Metabolism, Murakami Memorial Hospital, Asahi University, Gifu, Japan

Reprint requests and correspondence: Takao Kojima, M.D., Department of Gastroenterology, Murakami Memorial Hospital, Asahi University, 3–23 Hashimoto-cho, Gifu 500-8523, Japan.

Received January 30, 2007; accepted June 20, 2007.

Abstract

BACKGROUND

Nonalcoholic fatty liver disease (NAFLD) is closely associated with the metabolic syndrome.

AIM

We evaluated the association among the metabolic syndrome, visceral fat accumulation, and the severity of fatty liver with a new scoring system of ultrasonographic findings in apparently healthy Japanese adults.

METHODS

Subjects consisted of 94 patients who received liver biopsy and 4,826 participants who were selected from the general population. Two hepatologists scored the ultrasonographic findings from 0 to 6 points. We calculated Cohen's kappa of within-observer reliability and between-observer reliability. We evaluated the predictive value of the score by the area under a conventional receiver operating characteristic curve (AUC).

RESULTS

Within-observer reliability was 0.95 (95% CI 0.93–0.97, P < 0.001) and between-observer reliability was 0.95 (95% CI 0.93–0.97, P < 0.001). The AUC to diagnose NAFLD was 0.980. The sensitivity was 91.7% (95% CI 87.0–95.1, P < 0.001) and the specificity was 100% (95% CI 95.4–100.0, P < 0.001). The AUC to diagnose visceral obesity was 0.821. The sensitivity was 68.3% (95% CI 51.9–81.9, _P_= 0.028) and the specificity was 95.1% (95% CI 86.3–99.0, P < 0.001). Adjusted odds ratio of the score for the metabolic syndrome was 1.37 (95% CI 1.26–1.49, P < 0.001).

CONCLUSIONS

The scoring system with abdominal ultrasonography could provide accurate information about hepatic steatosis, visceral obesity, and the metabolic syndrome in apparently healthy people who do not consume alcohol.