Diagnosis of Non-Alcoholic Fatty Liver Disease Based on Clinical and Laboratory Data

Yong-ho Lee

doi:10.4093/jkd.2017.18.2.102

Journal List > J Korean Diabetes > v.18(2) > 1055053

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Lee: Diagnosis of Non-Alcoholic Fatty Liver Disease Based on Clinical and Laboratory Data

Focused Issue

The Journal of Korean Diabetes 2017; 18(2): 102-108.

Published online: 30 June 2017

DOI: https://doi.org/10.4093/jkd.2017.18.2.102

Diagnosis of Non-Alcoholic Fatty Liver Disease Based on Clinical and Laboratory Data

Yong-ho Lee

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Corresponding author: Yong-ho Lee. Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea, yholee@yuhs.ac

Received 4 May 2017 Accepted 16 May 2017

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Non-alcoholic fatty liver disease (NAFLD) is one of the most common metabolic liver disorders, and its incidence is expected to increase rapidly in the future as the rate of obesity increases and populations age. The gold standard for diagnosing NAFLD is liver biopsy, which involves sample error, high cost, and can be complicated due to its invasive nature. Therefore, many studies have been reported to establish accurate and convenient models to detect NAFLD using clinical and laboratory parameters. Most were derived from relatively small number of subjects and lack external validation, especially in the Korean population. This article summarizes the established and emerging risk factors for NAFLD and reviews non-invasive diagnostic algorithms for NAFLD including hepatic fibrosis.

Keywords: Diagnosis, Liver cirrhosis, Non-alcoholic fatty liver disease

Figures and Tables

Table 1

A simple NAFLD score (SNS) Variable

NAFLD, non-alcoholic fatty liver disease; M, male; F, female. Adapted from the article of Lee et al. (PLoS One 2014;9:e107584) [14].

References

1. European Association for the Study of the Liver (EASL). European Association for the Study of Diabetes (EASD). European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016; 64:1388–1402.

2. Yoon HJ, Lee YH, Cha BS. [Causal relationship of nonalcoholic fatty liver disease with obesity and insulin resistance]. J Korean Diabetes. 2014; 15:76–81. Korean.

3. Korean Association for the Study of the Liver (KASL). KASL clinical practice guidelines: management of nonalcoholic fatty liver disease. Clin Mol Hepatol. 2013; 19:325–348.

4. Chalasani N, Younossi Z, Lavine JE, Diehl AM, Brunt EM, Cusi K, Charlton M, Sanyal AJ. The diagnosis and management of non-alcoholic fatty liver disease: practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology. 2012; 55:2005–2023.

5. Lee YH, Jung KS, Kim SU, Yoon HJ, Yun YJ, Lee BW, Kang ES, Han KH, Lee HC, Cha BS. Sarcopaenia is associated with NAFLD independently of obesity and insulin resistance: Nationwide surveys (KNHANES 2008-2011). J Hepatol. 2015; 63:486–493.

6. Kim SK, Choi YJ, Huh BW, Park SW, Lee EJ, Cho YW, Huh KB. Nonalcoholic fatty liver disease is associated with increased carotid intima-media thickness only in type 2 diabetic subjects with insulin resistance. J Clin Endocrinol Metab. 2014; 99:1879–1884.

7. Chang Y, Jung HS, Cho J, Zhang Y, Yun KE, Lazo M, Pastor-Barriuso R, Ahn J, Kim CW, Rampal S, Cainzos-Achirica M, Zhao D, Chung EC, Shin H, Guallar E, Ryu S. Metabolically healthy obesity and the development of nonalcoholic fatty liver disease. Am J Gastroenterol. 2016; 111:1133–1140.

8. Hong HC, Hwang SY, Choi HY, Yoo HJ, Seo JA, Kim SG, Kim NH, Baik SH, Choi DS, Choi KM. Relationship between sarcopenia and nonalcoholic fatty liver disease: the Korean Sarcopenic Obesity Study. Hepatology. 2014; 59:1772–1778.

9. Lee YH, Kim SU, Song K, Park JY, Kim DY, Ahn SH, Lee BW, Kang ES, Cha BS, Han KH. Sarcopenia is associated with significant liver fibrosis independently of obesity and insulin resistance in nonalcoholic fatty liver disease: nationwide surveys (KNHANES 2008-2011). Hepatology. 2016; 63:776–786.

10. Subramanian V, Johnston RD, Kaye P, Aithal GP. Regional anthropometric measures associated with the severity of liver injury in patients with non-alcoholic fatty liver disease. Aliment Pharmacol Ther. 2013; 37:455–463.

11. Joo EJ, Chang Y, Yeom JS, Ryu S. Hepatitis B virus infection and decreased risk of nonalcoholic fatty liver disease: a cohort study. Hepatology. 2017; 65:828–835.

12. Kwok R, Choi KC, Wong GL, Zhang Y, Chan HL, Luk AO, Shu SS, Chan AW, Yeung MW, Chan JC, Kong AP, Wong VW. Screening diabetic patients for non-alcoholic fatty liver disease with controlled attenuation parameter and liver stiffness measurements: a prospective cohort study. Gut. 2016; 65:1359–1368.

13. Bedogni G, Bellentani S, Miglioli L, Masutti F, Passalacqua M, Castiglione A, Tiribelli C. The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population. BMC Gastroenterol. 2006; 6:33.

14. Lee YH, Bang H, Park YM, Bae JC, Lee BW, Kang ES, Cha BS, Lee HC, Balkau B, Lee WY, Kim DJ. Nonlaboratory-based self-assessment screening score for non-alcoholic fatty liver disease: development, validation and comparison with other scores. PLoS One. 2014; 9:e107584.

15. Poynard T, Ratziu V, Naveau S, Thabut D, Charlotte F, Messous D, Capron D, Abella A, Massard J, Ngo Y, Munteanu M, Mercadier A, Manns M, Albrecht J. The diagnostic value of biomarkers (SteatoTest) for the prediction of liver steatosis. Comp Hepatol. 2005; 4:10.

16. Kotronen A, Peltonen M, Hakkarainen A, Sevastianova K, Bergholm R, Johansson LM, Lundbom N, Rissanen A, Ridderstråle M, Groop L, Orho-Melander M, Yki-Järvinen H. Prediction of non-alcoholic fatty liver disease and liver fat using metabolic and genetic factors. Gastroenterology. 2009; 137:865–872.

17. Lee JH, Kim D, Kim HJ, Lee CH, Yang JI, Kim W, Kim YJ, Yoon JH, Cho SH, Sung MW, Lee HS. Hepatic steatosis index: a simple screening tool reflecting nonalcoholic fatty liver disease. Dig Liver Dis. 2010; 42:503–508.

18. Long MT, Pedley A, Colantonio LD, Massaro JM, Hoffmann U, Muntner P, Fox CS. Development and validation of the framingham steatosis index to identify persons with hepatic steatosis. Clin Gastroenterol Hepatol. 2016; 14:1172–1180.e2.

19. Feldstein AE, Wieckowska A, Lopez AR, Liu YC, Zein NN, McCullough AJ. Cytokeratin-18 fragment levels as noninvasive biomarkers for nonalcoholic steatohepatitis: a multicenter validation study. Hepatology. 2009; 50:1072–1078.

20. Angulo P, Hui JM, Marchesini G, Bugianesi E, George J, Farrell GC, Enders F, Saksena S, Burt AD, Bida JP, Lindor K, Sanderson SO, Lenzi M, Adams LA, Kench J, Therneau TM, Day CP. The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology. 2007; 45:846–854.

21. Vallet-Pichard A, Mallet V, Nalpas B, Verkarre V, Nalpas A, Dhalluin-Venier V, Fontaine H, Pol S. FIB-4: an inexpensive and accurate marker of fibrosis in HCV infection. comparison with liver biopsy and fibrotest. Hepatology. 2007; 46:32–36.

TOOLS

Similar articles