Possibilities and disadvantages of modern non-invasive methods of diagnostics of metabolic-associated fatty liver disease
https://doi.org/10.31146/1682-8658-ecg-230-10-162-170
Abstract
Metabolic-associated fatty liver disease is a widespread disease whose incidence is increasing worldwide and has become one of the leading causes of terminal stages of liver disease and hepatocellular carcinoma with increased liver-related morbidity and mortality and overall. The new term, fatty liver disease associated with metabolic dysfunction, has a set of positive diagnostic criteria and has been shown to have great clinical utility. Currently, there are no standardized universal screening methods for liver steatosis, despite the fact that this disease has a significant impact on health. Metabolic-associated fatty disease encompasses a wide range of conditions, from simple steatosis and steatohepatitis to fibrosis and hepatocellular carcinoma. It is also accompanied by numerous extrahepatic manifestations such as cardiovascular disease, malignancies outside the liver, and cognitive and respiratory changes. Given the extensive target organs affected and the high prevalence of the disease, it is critical to timely identify individuals at high risk of metabolic dysfunction. Liver biopsy has so far been considered the reference method for assessing the stage of hepatic steatosis and fibrosis. Given the limitations of biopsy for large-scale screening, non-invasive tests to assess the stage of steatosis and fibrosis, including serum-based algorithms and methods based on ultrasound and magnetic resonance imaging, will play an increasing role in the management of patients with MAFLD. This article presents a review of the scientific evidence on non-invasive diagnostic options used in clinical practice to detect hepatic steatosis.
About the Authors
O. O. Karshina
Kyrgyz Russian Slavic University named after the First President of Russia B.N. Yeltsin
Russian Federation
Russian Federation
I. S. Sabirov
Kyrgyz Russian Slavic University named after the First President of Russia B.N. Yeltsin
Russian Federation
Russian Federation
References
1. Younossi Z., Koenig A., Abdelatif D. et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016 Jul;64(1):73-84. doi: 10.1002/hep.28431.
2. Paik J., Golabi P., Younossi Y. et al. Changes in the Global Burden of Chronic Liver Diseases From 2012 to 2017: The Growing Impact of NAFLD. Hepatology. 2020;72(5):1605-1616. doi: 10.1002/hep.31173.
3. Eslam M., Sanyal A., George J.International Consensus Panel. MAFLD: A Consensus-Driven Proposed Nomenclature for Metabolic Associated Fatty Liver Disease. Gastroenterology. 2020;158(7):1999-2014.e1. doi: 10.1053/j.gastro.2019.11.312.
4. Eslam M., Newsome P., Sarin S. et al. A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement. J Hepatol. 2020;73(1):202-209. doi: 10.1016/j.jhep.2020.03.039.
5. Younossi Z., Paik J., Stepanova M. et al. Clinical profiles and mortality rates are similar for metabolic dysfunction-associated steatotic liver disease and non-alcoholic fatty liver disease. J Hepatol. 2024. doi: 10.1016/j.jhep.2024.01.014.
6. Bassal T., Basheer M., Boulos M. et al. Nonalcoholic fatty liver disease - a concise review of noninvasive tests and biomarkers. Metabolites. 2022;12(11):1073. doi: 10.3390/metabo12111073.
7. Ramírez-Mejía M., Jiménez-Gutiérrez C., Eslam M. et al. Breaking new ground: MASLD vs. MAFLD - which holds the key for risk stratification? Hepatol Int. 2024;18(1):168-78. doi: 10.1007/s12072-023-10620-y.
8. Trukhan D.I. Nonalcoholic fatty liver disease: therapeutic and dietary recommendations at the stage of primary health care. Medical Council.2015;17: 78-84. (In Russ.)@@ Трухан Д.И. Неалкогольная жировая болезнь печени: лечебные и диетические рекомендации на этапе оказания первичной медико-санитарной помощи. Медицинский совет. 2015;17: 78-84.
9. Byrne C., Targher G. NAFLD: a multisystem disease. J Hepatol. 2015;62(1 Suppl):47-64. doi: 10.1016/j.jhep.2014.12.012.
10. Sumida Y., Nakajima A., Itoh Y. Limitations of liver biopsy and non-invasive diagnostic tests for the diagnosis of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis. World J Gastroenterol. 2014;20:475-485. doi: 10.3748/wjg.v20.i2.475.
11. 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(6):1388-1402. doi: 10.1016/j.jhep.2015.11.004.
12. Maev I.V., Samsonov A.A., Lazebnik L.B. et al. A New NonInvasive Scale for Steatosis Developed Using Real- World Data From Russian Outpatients to Aid in the Diagnosis of Non- Alcoholic Fatty Liver Disease. Adv Ther. 2020;(37):4627-4640. doi: 10.1007/s12325-020-01493-w.
13. Bedogni G., Bellentani S., Miglioli L. et al. The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population. BMC Gastroenterol. 2006;6(33). doi: 10.1186/1471-230X-6-33.
14. Gastaldelli A., Kozakova M., Højlund K. et al. Fatty liver is associated with insulin resistance, risk of coronary heart disease, and early atherosclerosis in a large European population. Hepatology. 2009;49(5):1537-1544. doi: 10.1002/hep.22845.
15. Iwasaki Y., Shiina K., Matsumoto C. et al. Correlation of the Fatty Liver Index with the Pathophysiological Abnormalities Associated with Cardiovascular Risk Markers in Japanese Men without any History of Cardiovascular Disease: Comparison with the Fibrosis-4 Score. J Atheroscler Thromb. 2021;28(5):524-534. doi: 10.5551/jat.56945.
16. Li X., Heiskanen J.S., Ma H. et al. Fatty liver index and left ventricular mass: prospective associations from two independent cohorts. J Hypertens. 2021;39(5):961-969. doi: 10.1097/HJH.0000000000002716.
17. Niu Z., Wu Q., Sun L. et al. Circulating Glycerolipids, Fatty Liver Index, and Incidence of Type 2 Diabetes: A Prospective Study Among Chinese. J Clin Endocrinol Metab. 2021;106(7):2010-2020. doi: 10.1210/clinem/dgab165.
18. Takahashi S., Tanaka M., Furuhashi M. et al. Fatty liver index is independently associated with deterioration of renal function during a 10-year period in healthy subjects. Sci Rep. 2021;11(1):8606. doi: 10.1038/s41598-021-88025-w.
19. Huang X. Xu M. Chen Y. et al. Validation of the Fatty Liver Index for Nonalcoholic Fatty Liver Disease in Middle-Aged and Elderly Chinese. Medicine (Baltimore). 2015;94(40): e1682. doi: 10.1097/MD.0000000000001682.
20. Han A. Lee H.Comparison of the Diagnostic Performance of Steatosis Indices for Discrimination of CT-Diagnosed Metabolic Dysfunction-Associated Fatty Liver Disease. Metabolites.2022.12:664. doi: 10.3390/metabo12070664.
21. Castellana M., Donghia R., Guerra V. et al. Performance of Fatty Liver Index in Identifying Non-Alcoholic Fatty Liver Disease in Population Studies. A Meta-Analysis. J Clin Med. 2021;10(9):1877. doi: 10.3390/jcm10091877.
22. Fedchuk L., Nascimbeni F., Pais R. et al. Performance and limitations of steatosis biomarkers in patients with nonalcoholic fatty liver disease. Aliment Pharmacol Ther. 2014;40(10):1209-1222. doi: 10.1111/apt.12963.
23. Lee J., Kim D, Kim H. et al. Hepatic steatosis index: a simple screening tool reflecting nonalcoholic fatty liver disease. Dig Liver Dis. 2010;42(7):503-508. doi: 10.1016/j.dld.2009.08.002.
24. Kotronen A., Peltonen M., Hakkarainen A. et al. Prediction of non-alcoholic fatty liver disease and liver fat using metabolic and genetic factors. Gastroenterology. 2009;137(3):865-872. doi: 10.1053/j.gastro.2009.06.005.
25. Koot B., van der Baan-Slootweg O., Bohte A. et al. Accuracy of prediction scores and novel biomarkers for predicting nonalcoholic fatty liver disease in obese children. Obesity (Silver Spring). 2013;21(3):583-590. doi: 10.1002/oby.20173.
26. Poynard T., Ratziu V., Naveau S. et al. The diagnostic value of biomarkers (SteatoTest) for the prediction of liver steatosis.Comp Hepatol. 2005;4:10. doi: 10.1186/1476-5926-4-10.
27. Poynard T., Lassailly G., Diaz E. et al. Performance of biomarkers FibroTest, ActiTest, SteatoTest, and NashTest in patients with severe obesity: meta analysis of individual patient data. PLoS ONE. 2012;7(3): e30325. doi: 10.1371/journal.pone.0030325.
28. Kotronen A., Peltonen M., Hakkarainen A. et al. Prediction of non-alcoholic fatty liver disease and liver fat using metabolic and genetic factors. Gastroenterology. 2009;137(3):865-872. doi: 10.1053/j.gastro.2009.06.005.
29. Koneru K., Bhatt V., Kakrani A. et al. A study of non-alcoholic fatty liver disease-liver fat score in overweight and obese individuals. J Family Med Prim Care. 2022;11(8):4368-4374. doi: 10.4103/jfmpc.jfmpc_58_22.
30. Lee C., Li H., Tsoi M. et al. Association between the liver fat score (LFS) and cardiovascular diseases in the national health and nutrition examination survey 1999-2016. Ann Med. 2021;53(1):1065-1073. doi: 10.1080/07853890.2021.1943514.
31. Wang J., Xu C., Xun Y. et al. ZJU index: a novel model for predicting nonalcoholic fatty liver disease in a Chinese population. Sci Rep. 2015;5:16494. doi: 10.1038/srep16494.
32. Amato M., Giordano C., Galia M. et al. Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care. 2010;33(4):920-922. doi: 10.2337/dc09-1825.
33. Ismaiel A., Jaaouani A., Leucuta D. et al. The Visceral Adiposity Index in Non-Alcoholic Fatty Liver Disease and Liver Fibrosis-Systematic Review and Meta-Analysis. Biomedicines. 2021;9(12):1890. doi: 10.3390/biomedicines9121890.
34. Yi X., Zhu S., Zhu L. Diagnostic accuracy of the visceral adiposity index in patients with metabolic-associated fatty liver disease: a meta-analysis. Lipids Health Dis. 2022;21:28. doi: 10.1186/s12944-022-01636-8.
35. Yip T., Ma A., Wong V. et al. Laboratory parameter-based machine learning model for excluding non-alcoholic fatty liver disease (NAFLD) in the general population. Aliment Pharmacol Ther. 2017;46(4):447-456. doi: 10.1111/apt.14172.
36. Saadeh S., Younossi Z.M., Remer E. et al. The Utility of Radiological Imaging in Nonalcoholic Fatty Liver disease. Gastroenterology. 2002;123:745-750. doi: 10.1053/gast.2002.35354.
37. Hernaez R., Lazo M., Bonekamp S. et al. Diagnostic accuracy and reliability of ultrasonography for the detection of fatty liver: a meta-analysis. Hepatology. 2011;54(3):1082-1090. doi: 10.1002/hep.24452.
38. Chalasani N., Younossi Z., Lavine J. et al. The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018;67(1):328-357. doi: 10.1002/hep.29367.
39. De Lucia Rolfe E., Brage S., Sleigh A. et al. Validity of ultrasonography to assess hepatic steatosis compared to magnetic resonance spectroscopy as a criterion method in older adults. PLoS One. 2018;13(11): e0207923. doi: 10.1371/journal.pone.0207923.
40. Park S., Kim P., Kim K. et al. Macrovesicular hepatic steatosis in living liver donors: use of CT for quantitative and qualitative assessment. Radiology. 2006;239(1):105-112. doi: 10.1148/radiol.2391050361.
41. Pickhardt P.J., Graffy P.M., Reeder S. et al. Quantification of Liver Fat Content With Unenhanced MDCT: Phantom and Clinical Correlation With MRI Proton Density Fat Fraction. AJR Am J Roentgenol. 2018;211(3):151-157. doi: 10.2214/AJR.17.19391.
42. Springer F., Machann J., Claussen C. et al. Liver fat content determined by magnetic resonance imaging and spectroscopy. World J Gastroenterol. 2010;16(13):1560-1566. doi: 10.3748/wjg.v16.i13.1560.
43. Dulai P.S., Sirlin C.B., Loomba R. MRI and MRE for non-invasive quantitative assessment of hepatic steatosis and fibrosis in NAFLD and NASH: Clinical trials to clinical practice. J Hepatol. 2016;65(5):1006-1016. doi: 10.1016/j.jhep.2016.06.005.
44. Tang A., Tan J., Sun M. et al. Nonalcoholic fatty liver disease: MR imaging of liver proton density fat fraction to assess hepatic steatosis. Radiology. 2013;267(2):422-431. doi: 10.1148/radiol.12120896.
45. Bassal T., Basheer M., Boulos M., Assy N. Nonalcoholic fatty liver disease - a concise review of noninvasive tests and biomarkers. Metabolites. 2022;12(11):1073. doi: 10.3390/metabo12111073.
46. Feldstein A., Wieckowska A., Lopez A. et al. Cytokeratin-18 fragment levels as noninvasive biomarkers for nonalcoholic steatohepatitis: a multicenter validation study. Hepatology (Baltimore, Md.). 2009 Oct;50(4):1072-1078. doi: 10.1002/hep.23050.
47. Kwok R., Tse Y., Wong G. et al. Systematic review with meta-analysis: non-invasive assessment of non-alcoholic fatty liver disease-the role of transient elastography and plasma cytokeratin-18 fragments. Aliment Pharmacol Ther. 2014;39(3):254-69. doi: 10.1111/apt.12569.
48. Musso G., Gambino R., Cassader M., Pagano G. Meta-analysis: natural history of non-alcoholic fatty liver disease (NAFLD) and diagnostic accuracy of non-invasive tests for liver disease severity. Ann Med. 2011;43(8):617-49. doi: 10.3109/07853890.2010.518623.
49. Grigorescu M. Crisan D., Radu C. et al. A novel pathophysiological-based panel of biomarkers for the diagnosis of nonalcoholic steatohepatitis. J Physiol pharmacol. 2012;63(4):347-53. PMID: 23070083.
50. Qi S., Xu D., Li K. et al. Metabonomic screening of serum identifies pyroglutamate as a diagnostic biomarker of nonalcoholic steatohepatitis. Clin Chim Act. 2017; 473: 89-95. doi: 10.1016/j.cca.2017.08.022.
51. Poynard T., Ratziu V., Charlotte F. et al. Diagnostic value of biochemical markers (NashTest) for the prediction of non alcoholo steato hepatitis in patients with non-alcoholic fatty liver disease. BMC Gastroenterol. 2006;6:34. doi: 10.1186/1471-230X-6-34.
52. Kleiner D., Brunt E., Van Natta M. et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology. 2005;41(6):1313-1321. doi: 10.1002/hep.20701.
53. Zhou Y, Orešič M, Leivonen M. et al. Noninvasive Detection of Nonalcoholic Steatohepatitis Using Clinical Markers and Circulating Levels of Lipids and Metabolites. Clin Gastroenterol Hepatol. 2016;14(10):1463-1472.e6. doi: 10.1016/j.cgh.2016.05.046.
Review
For citations:
Karshina O.O., Sabirov I.S. Possibilities and disadvantages of modern non-invasive methods of diagnostics of metabolic-associated fatty liver disease. Experimental and Clinical Gastroenterology. 2024;(10):162-170. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-230-10-162-170
Views:
27
Email this article 