Higher cut-off values of non-invasive methods might be needed to detect moderate-to-severe steatosis in morbid obese patients: a pilot study - PubMed (original) (raw)

Higher cut-off values of non-invasive methods might be needed to detect moderate-to-severe steatosis in morbid obese patients: a pilot study

Daniella Braz Parente et al. Sci Rep. 2020.

Abstract

To evaluate the diagnostic value of described thresholds of controlled attenuation parameter (CAP) and biomarker scores for liver steatosis and to evaluate new cut-offs to detect moderate-to-severe steatosis (S2-3) in patients with morbid obesity. In this prospective study, 32 patients with morbid obesity with indications for bariatric surgery (15 women and 17 men, mean age = 36 years, median BMI = 40.2 kg/m2) underwent CAP, magnetic resonance spectroscopy (MRS), three biomarker scores (Steato-ELSA, Fatty Liver Index (FLI), and Hepatic Steatosis Index (HSI)), and liver biopsy. Subjects were divided into an exploratory cohort (reliable CAP and liver biopsy) and a confirmatory cohort (reliable CAP and MRS) to evaluate new thresholds for CAP and biomarker scores to detect S2-3. Receiver operator characteristic (ROC) curves analyses were performed and the optimal cut-off points were identified using the maximal Youden index. A total of 22 patients had CAP measure and liver biopsy (exploratory cohort) and 24 patients had CAP measure with MRS (confirmatory cohort). New cut-offs were identified for detection of S2-3 by the non-invasive tests using liver biopsy as the reference standard (exploratory cohort). Considering the new proposed cut-offs for detection of S2-3 for CAP (≥ 314 dB/m), Steato-ELSA (≥ 0.832), FLI (≥ 96), and HSI (≥ 53), for the exploratory and confirmatory cohorts sensitivities were: 71-75%, 86-81%, 85-81%, and 71-69% and specificities were: 94-89%, 75-63%, 63-63%, and 75-88%, respectively. Higher cut-offs for CAP and biomarker scores may be better to diagnose moderate-to-severe steatosis in patients with morbid obesity.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1

Area under the receiver operator characteristic (AUROC) curves for detection of moderate-to-severe steatosis of Controlled Attenuation Parameter (CAP) (A), Steato-ELSA (B), Fatty Liver Index (FLI) (C), and Hepatic Steatosis Index (HSI) (D) in the exploratory cohort using liver biopsy as the reference.

Figure 2

Area under the receiver operator characteristic (AUROC) curves for detection of moderate-to-severe steatosis of Controlled Attenuation Parameter (CAP) (A), Steato-ELSA (B), Fatty Liver Index (FLI) (C), and Hepatic Steatosis Index (HSI) (D) in the confirmatory cohort using magnetic resonance spectroscopy (MRS) as the reference.

References

1. Parente DB, et al. Intravoxel incoherent motion diffusion weighted MR imaging at 3.0 T: Assessment of steatohepatitis and fibrosis compared with liver biopsy in type 2 diabetic patients. PLoS ONE. 2015;10:e0125653. doi: 10.1371/journal.pone.0125653. - DOI - PMC - PubMed
1. Angulo P. Nonalcoholic fatty liver disease. N. Engl. J. Med. 2002;346:1221–1231. doi: 10.1056/NEJMra011775346/16/1221. - DOI - PubMed
1. Farrell GC, Larter CZ. Nonalcoholic fatty liver disease: From steatosis to cirrhosis. Hepatology. 2006;43:S99–S112. doi: 10.1002/hep.20973. - DOI - PubMed
1. Vernon G, Baranova A, Younossi ZM. Systematic review: The epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol. Ther. 2011;34:274–285. doi: 10.1111/j.1365-2036.2011.04724.x. - DOI - PubMed
1. Silverman JF, et al. Liver pathology in morbidly obese patients with and without diabetes. Am. J. Gastroenterol. 1990;85:1349–1355. - PubMed

Higher cut-off values of non-invasive methods might be needed to detect moderate-to-severe steatosis in morbid obese patients: a pilot study - PubMed (original) (raw)