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1330 NON-INVASIVE MEASUREMENT OF LIVER STEATOSIS BY CONTROLLED ATTENUATION PARAMETER (CAP) USING Fibroscan® IN PATIENTS WITH NONALCOHOLIC FATTY LIVER DISEASE (NAFLD)

2013; Elsevier BV; Volume: 58; Linguagem: Inglês

10.1016/s0168-8278(13)61330-6

1600-0641

Kenichiro Enooku, Ryosuke Tateishi, Naoto Fujiwara, Shinji Mikami, Takaomi Minami, Motoya Sato, Koji Uchino, Yuji Kondo, Hiromu Yoshida, Hitoshi Ikeda, K Koike,

Liver Disease Diagnosis and Treatment

Objectives: To describe the prevalence of and factors associated with hepatic steatosis among lean population.Methods: The 2012 liver disease detection survey conducted at the Muniz Hospital in Buenos Aires was a population based crosssectional study of non institutionalized residents aged 15 years or older.Anthropometric features were analyzed.Hepatic steatosis was detected by ultrasonography (US); measurements of prehepatic (in a longitudinal view of the caudal lobe, measured in the anterior surface of the liver, 1cm distal to the diaphragm) and subcutaneous fat were performed.Fasting blood glucose, ALT, AST were measured.Liver stiffness was evaluated by transient elastography.We conducted logistic regression analysis to identify factors associated with liver steatosis in a subgroup of lean patients defined as BMI <25 and waist circumference lower than 88cm in women/102 cm in men.Patients with viral hepatitis or alcohol consumption (more than 140gr/females and 210gr/males) were excluded.Results: 966 patients were surveyed from July to August 2012; of them 165 were excluded for further analysis.Of this population, 183 (22.8%) patients fitted our lean patient definition; n = 126 (68.8%) were female.The median age was 41±16 years old.NAFLD was present in n = 13 (7.1%)patients.Lean patients with NAFLD were older (49±21 vs 41±16 years p = 0.20), had similar fasting blood glucose (94±10 vs 92±20 mg/dL p = 0.20), TGO values (25±8 vs 25±20 UI p = 0.27), transient elastography (4.9±0.8 vs 4.9±2.2Kpa p = 0.25) and subcutaneous fat (8.3±4 vs 6.6±4 mm p = 0.08).However, NAFLD lean patients had higher TGP values, 24 (18-38) vs 17 (14-22) UI/dL p = 0.006; and visceral fat (10.4±4 vs 6.3±3 mm p = 0.001).Three patients had high blood pressure, non were diabetic.The only independent predictors identified for NAFLD in lean patients was visceral fat above 10.4 mm OR= 10 (IC95%: 2.99-33.89)p ≤ 0.001. Conclusions:The presence of NAFLD in lean patients positively correlates with prehepatic fat.Having more than 10 mm of prehepatic fat increases tenfold the risk for NAFLD.A specific role of visceral fat in the pathogenesis of NAFLD should be further analyzed.