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Prevalence of hepatic steatosis as assessed by controlled attenuation parameter (CAP) in subjects with metabolic risk factors in primary care. A population-based study
BACKGROUND: Primary care is the ideal setting for early identification of patients with non-alcoholic fatty liver disease (NAFLD). NAFLD is a potentially progressive disease that may lead to cirrhosis and liver cancer but is frequently underrecognized because subjects at risk are often not evaluated...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6143232/ https://www.ncbi.nlm.nih.gov/pubmed/30226889 http://dx.doi.org/10.1371/journal.pone.0200656 |
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author | Fabrellas, Núria Hernández, Rosario Graupera, Isabel Solà, Elsa Ramos, Pilar Martín, Natividad Sáez, Gemma Simón, Consuelo Pérez, Almudena Graell, Teresa Larrañaga, Andrea Garcia, Manel de la Arada, Ana Juanola, Adrià Coiduras, Alicia Duaso, Isabel Casado, Angel Martin, Julian Ginès, Marta Moreno, Nuria Gema Perez, Ana Marti, Laia Bernat, Mireia Sola, Montse Olivé, Carmina Solé, Cristina Ginès, Pere |
author_facet | Fabrellas, Núria Hernández, Rosario Graupera, Isabel Solà, Elsa Ramos, Pilar Martín, Natividad Sáez, Gemma Simón, Consuelo Pérez, Almudena Graell, Teresa Larrañaga, Andrea Garcia, Manel de la Arada, Ana Juanola, Adrià Coiduras, Alicia Duaso, Isabel Casado, Angel Martin, Julian Ginès, Marta Moreno, Nuria Gema Perez, Ana Marti, Laia Bernat, Mireia Sola, Montse Olivé, Carmina Solé, Cristina Ginès, Pere |
author_sort | Fabrellas, Núria |
collection | PubMed |
description | BACKGROUND: Primary care is the ideal setting for early identification of patients with non-alcoholic fatty liver disease (NAFLD). NAFLD is a potentially progressive disease that may lead to cirrhosis and liver cancer but is frequently underrecognized because subjects at risk are often not evaluated. Controlled attenuation parameter (CAP) is a reliable method for non-invasive quantification of liver fat. It has the advantage of simultaneous measurement of liver stiffness (LS), an estimate of liver fibrosis. There is no information on CAP in subjects with risk factors from primary care. AIM: To investigate the prevalence of hepatic steatosis, as estimated by CAP, in subjects from the community with metabolic risk factors and correlate findings with clinical and biochemical characteristics and LS. PATIENTS AND METHODS: Population-based study of 215 subjects with metabolic risk factors without known liver disease identified randomly from a primary care center. A control group of 80 subjects matched by age and sex without metabolic risk factors was also studied. CAP and LS were assessed using Fibroscan. RESULTS: Subjects with risk factors had CAP values higher than those of control group (268±64 vs 243±49dB/m,p<0.001). Prevalence of severe steatosis (CAP> 280dB/m) in subjects with risk factors was 43%. In multivariate analysis, fatty liver index (FLI) and HOMA were independent predictive factors of severe steatosis. There was a direct correlation between CAP and FLI values (r = 0.52,p<0.001). Interestingly, prevalence of increased LS was 12.6% in the risk group vs 0% in the control group (p<0.001). Increased LS occurred predominantly in subjects with high CAP values. CONCLUSIONS: A high proportion of subjects with metabolic risk factors seen in primary care have severe steatosis. FLI could be used as a surrogate of CAP. Increased LS was found in a significant proportion of subjects with risk factors but not in control subjects. |
format | Online Article Text |
id | pubmed-6143232 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-61432322018-10-08 Prevalence of hepatic steatosis as assessed by controlled attenuation parameter (CAP) in subjects with metabolic risk factors in primary care. A population-based study Fabrellas, Núria Hernández, Rosario Graupera, Isabel Solà, Elsa Ramos, Pilar Martín, Natividad Sáez, Gemma Simón, Consuelo Pérez, Almudena Graell, Teresa Larrañaga, Andrea Garcia, Manel de la Arada, Ana Juanola, Adrià Coiduras, Alicia Duaso, Isabel Casado, Angel Martin, Julian Ginès, Marta Moreno, Nuria Gema Perez, Ana Marti, Laia Bernat, Mireia Sola, Montse Olivé, Carmina Solé, Cristina Ginès, Pere PLoS One Research Article BACKGROUND: Primary care is the ideal setting for early identification of patients with non-alcoholic fatty liver disease (NAFLD). NAFLD is a potentially progressive disease that may lead to cirrhosis and liver cancer but is frequently underrecognized because subjects at risk are often not evaluated. Controlled attenuation parameter (CAP) is a reliable method for non-invasive quantification of liver fat. It has the advantage of simultaneous measurement of liver stiffness (LS), an estimate of liver fibrosis. There is no information on CAP in subjects with risk factors from primary care. AIM: To investigate the prevalence of hepatic steatosis, as estimated by CAP, in subjects from the community with metabolic risk factors and correlate findings with clinical and biochemical characteristics and LS. PATIENTS AND METHODS: Population-based study of 215 subjects with metabolic risk factors without known liver disease identified randomly from a primary care center. A control group of 80 subjects matched by age and sex without metabolic risk factors was also studied. CAP and LS were assessed using Fibroscan. RESULTS: Subjects with risk factors had CAP values higher than those of control group (268±64 vs 243±49dB/m,p<0.001). Prevalence of severe steatosis (CAP> 280dB/m) in subjects with risk factors was 43%. In multivariate analysis, fatty liver index (FLI) and HOMA were independent predictive factors of severe steatosis. There was a direct correlation between CAP and FLI values (r = 0.52,p<0.001). Interestingly, prevalence of increased LS was 12.6% in the risk group vs 0% in the control group (p<0.001). Increased LS occurred predominantly in subjects with high CAP values. CONCLUSIONS: A high proportion of subjects with metabolic risk factors seen in primary care have severe steatosis. FLI could be used as a surrogate of CAP. Increased LS was found in a significant proportion of subjects with risk factors but not in control subjects. Public Library of Science 2018-09-18 /pmc/articles/PMC6143232/ /pubmed/30226889 http://dx.doi.org/10.1371/journal.pone.0200656 Text en © 2018 Fabrellas et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Fabrellas, Núria Hernández, Rosario Graupera, Isabel Solà, Elsa Ramos, Pilar Martín, Natividad Sáez, Gemma Simón, Consuelo Pérez, Almudena Graell, Teresa Larrañaga, Andrea Garcia, Manel de la Arada, Ana Juanola, Adrià Coiduras, Alicia Duaso, Isabel Casado, Angel Martin, Julian Ginès, Marta Moreno, Nuria Gema Perez, Ana Marti, Laia Bernat, Mireia Sola, Montse Olivé, Carmina Solé, Cristina Ginès, Pere Prevalence of hepatic steatosis as assessed by controlled attenuation parameter (CAP) in subjects with metabolic risk factors in primary care. A population-based study |
title | Prevalence of hepatic steatosis as assessed by controlled attenuation parameter (CAP) in subjects with metabolic risk factors in primary care. A population-based study |
title_full | Prevalence of hepatic steatosis as assessed by controlled attenuation parameter (CAP) in subjects with metabolic risk factors in primary care. A population-based study |
title_fullStr | Prevalence of hepatic steatosis as assessed by controlled attenuation parameter (CAP) in subjects with metabolic risk factors in primary care. A population-based study |
title_full_unstemmed | Prevalence of hepatic steatosis as assessed by controlled attenuation parameter (CAP) in subjects with metabolic risk factors in primary care. A population-based study |
title_short | Prevalence of hepatic steatosis as assessed by controlled attenuation parameter (CAP) in subjects with metabolic risk factors in primary care. A population-based study |
title_sort | prevalence of hepatic steatosis as assessed by controlled attenuation parameter (cap) in subjects with metabolic risk factors in primary care. a population-based study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6143232/ https://www.ncbi.nlm.nih.gov/pubmed/30226889 http://dx.doi.org/10.1371/journal.pone.0200656 |
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