Fatty Liver ; diagnosis ; epidemiology ; Humans ; Liver Diseases, Alcoholic ; diagnosis ; epidemiology ; Non-alcoholic Fatty Liver Disease

Diagnosis, Differential ; Humans ; Liver Diseases, Alcoholic ; diagnosis ; Non-alcoholic Fatty Liver Disease ; diagnosis

No abstract available.
Coronary Disease/*diagnosis ; Fatty Liver, Alcoholic/*diagnosis ; Female ; Humans ; Male ; Non-alcoholic Fatty Liver Disease/*diagnosis/*epidemiology

Humans ; Non-alcoholic Fatty Liver Disease ; diagnosis ; therapy

Fatty Liver ; diagnosis ; therapy ; Humans ; Non-alcoholic Fatty Liver Disease ; Practice Guidelines as Topic ; United States

No abstract available.
Carcinoma, Hepatocellular/*diagnosis ; Female ; Humans ; Liver Neoplasms/*diagnosis ; Male ; Non-alcoholic Fatty Liver Disease/*diagnosis

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.
Biopsy ; Diagnosis* ; Fibrosis ; Incidence ; Liver ; Liver Cirrhosis ; Non-alcoholic Fatty Liver Disease* ; Obesity ; Risk Factors

BACKGROUND: Liver biopsy for the diagnosis of non-alcoholic steatohepatitis (NASH) is limited by its inherent invasiveness and possible sampling errors. Some studies have shown that cytokeratin-18 (CK-18) concentrations may be useful in diagnosing NASH, but results across studies have been inconsistent. We aimed to identify the utility of CK-18 M30 concentrations as an alternative to liver biopsy for non-invasive identification of NASH. METHODS: Individual data were collected from 14 registry centers on patients with biopsy-proven non-alcoholic fatty liver disease (NAFLD), and in all patients, circulating CK-18 M30 levels were measured. Individuals with a NAFLD activity score (NAS) ≥5 with a score of ≥1 for each of steatosis, ballooning, and lobular inflammation were diagnosed as having definite NASH; individuals with a NAS ≤2 and no fibrosis were diagnosed as having non-alcoholic fatty liver (NAFL). RESULTS: A total of 2571 participants were screened, and 1008 (153 with NAFL and 855 with NASH) were finally enrolled. Median CK-18 M30 levels were higher in patients with NASH than in those with NAFL (mean difference 177 U/L; standardized mean difference [SMD]: 0.87 [0.69-1.04]). There was an interaction between CK-18 M30 levels and serum alanine aminotransferase, body mass index (BMI), and hypertension ( P  < 0.001, P  = 0.026 and P  = 0.049, respectively). CK-18 M30 levels were positively associated with histological NAS in most centers. The area under the receiver operating characteristics (AUROC) for NASH was 0.750 (95% confidence intervals: 0.714-0.787), and CK-18 M30 at Youden's index maximum was 275.7 U/L. Both sensitivity (55% [52%-59%]) and positive predictive value (59%) were not ideal. CONCLUSION This large multicenter registry study shows that CK-18 M30 measurement in isolation is of limited value for non-invasively diagnosing NASH.
Humans ; Non-alcoholic Fatty Liver Disease/diagnosis* ; Keratin-18 ; Biomarkers ; Biopsy ; Hepatocytes/pathology* ; Apoptosis ; Liver/pathology*

Adult ; Fatty Liver ; diagnosis ; drug therapy ; Female ; Humans ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; Waist-Hip Ratio

PURPOSE: The incidence of non-alcoholic fatty liver disease (NAFLD) in children is gradually increasing. The aim of this study was to investigate the use of serum adiponectin and soluble adiponectin receptor 2 (soluble Adipo R2) levels for the diagnosis of fatty liver disease in obese and overweight children. METHODS: The study included 51 obese and overweight children between the ages of 6 and 18 years diagnosed with NAFLD using ultrasonography and 20 children without fatty liver disease. Patients whose alanine transaminase level was two times higher than normal (≥80 U/L) were included in the non-alcoholic steatohepatitis (NASH) group. RESULTS: NASH was observed in 11 (21.6%) of the patients with NAFLD. The incidence of obesity was higher in patients with NASH (80% and 45%, p=0.021). While the adiponectin levels were similar in patients with NAFLD and those without, they were below the normal level in the whole study group. Adiponectin and soluble Adipo R2 levels of patients with NASH were lower than those in patients without NASH; however, this difference was not statistically significant (p=0.064 and p=0.463). Soluble Adipo R2 levels in obese patients with NAFLD were higher than those in obese children without NAFLD (p<0.001). CONCLUSION: Soluble adiponectin receptor 2 level is a noninvasive marker that can be used for the diagnosis of NAFLD in obese children.
Adiponectin ; Alanine Transaminase ; Child ; Diagnosis ; Fatty Liver ; Humans ; Incidence ; Non-alcoholic Fatty Liver Disease ; Obesity ; Overweight ; Receptors, Adiponectin ; Ultrasonography