Keywords
metabolic syndrome
sheer-wave elastography
MAFLD
How to Cite
Abstract
Background. Non-Alcoholic Fatty Liver Disease (NAFLD), a common chronic liver disease, is often associated with Insulin Resistance (IR), which accelerates fibrosis progression. As NAFLD prevalence rises, understanding IR's role in liver damage is crucial. Non-invasive methods like elastography and FibroTest help assess fibrosis severity but remain underexplored in NAFLD patients with IR.
Aim. To compare liver elastography and FibroTest results in patients with isolated non-alcoholic fatty liver disease and NAFLD with insulin resistance, assessing fibrosis differences and the effect of comorbidity on disease progression.
Materials and Methods. NAFLD patients were divided into two groups: isolated NAFLD, and NAFLD with IR. Liver stiffness was measured via elastography, fibrosis levels via FibroTest, and laboratory markers (including ALanineaminoTransferase (ALT), ASpartateaminoTransferase (AST), protein metabolism) were analyzed to evaluate liver function
Results. Patients with NAFLD and IR had significantly higher elastography values (10.5 kPa vs. 6.2 kPa in isolated NAFLD). ALT and AST levels were elevated in the IR group (ALT 65 U/L, AST 59 U/L), while protein metabolism indicators were lower, reflecting greater liver dysfunction. Strong correlations were found between elastography and ALT (r=0.844) and AST (r=0.822). FibroTest scores were higher in the IR group (0.78 vs. 0.58 in isolated NAFLD), indicating more advanced fibrosis.
Conclusions. IR accelerates fibrosis in NAFLD, with elastography and FibroTest effectively differentiating fibrosis severity. These findings support their use in clinical practice for improved assessment and management, particularly in NAFLD patients with IR. Further research is needed to refine treatment strategies.
Keywords: steatosis, metabolic syndrome, sheer-wave elastography, MAFLD.
Archived: https://doi.org/10.5281/zenodo.15169973
References
Abdelhameed F, Kite C, Lagojda L, Dallaway A, Chatha KK, Chaggar SS, et al. Non-invasive scores and serum biomarkers for fatty liver in the era of metabolic dysfunction-associated steatotic liver disease (MASLD): a comprehensive review from NAFLD to MAFLD and MASLD. Curr Obes Rep. 2024;13(3):510-31. DOI: 10.1007/s13679-024-00574-z. PMID: 38809396.
Riazi K, Azhari H, Charette JH, Underwood FE, King JA, Afshar EE, et al. The prevalence and incidence of NAFLD worldwide: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2022;7(9):851-61. DOI: 10.1016/S2468-1253(22)00165-0. PMID: 35798021.
Caussy C, Aubin A, Loomba R. The relationship between type 2 diabetes, NAFLD, and cardiovascular risk. Curr Diabetes Rep. 2021;21(5):15. DOI: 10.1007/s11892-021-01383-7. PMID: 33742318.
Machado MV, Cortez-Pinto H. NAFLD, MAFLD and obesity: brothers in arms? Nat Rev Gastroenterol Hepatol. 2023;20(2):67-8. DOI: 10.1038/s41575-022-00717-4. PMID: 36470966.
Bloomgarden ZT. The World Congress of Insulin Resistance, Diabetes and Cardiovascular Disease (WCIRDC). J Diabetes. 2023;15(1):4-6. DOI: 10.1111/1753-0407.13349. PMID: 36610044.
Tanase DM, Gosav EM, Costea CF, Ciocoiu M, Lacatusu CM, Maranduca MA, et al. The intricate relationship between type 2 diabetes mellitus (T2DM), insulin resistance (IR), and nonalcoholic fatty liver disease (NAFLD). J Diabetes Res. 2020;2020:3920196. DOI: 10.1155/2020/3920196. PMID: 32832560.
Selvaraj EA, Mozes FE, Jayaswal ANA, Zafarmand MH, Vali Y, Lee JA, et al. Diagnostic accuracy of elastography and magnetic resonance imaging in patients with NAFLD: a systematic review and meta-analysis. J Hepatol. 2021;75(4):770-85. DOI: 10.1016/j.jhep.2021.04.044. PMID: 33991635.
Hadefi A, Degre D, Trepo E, Moreno C. Noninvasive diagnosis in alcohol-related liver disease. Health Sci Rep. 2020;3(1):e146. DOI: 10.1002/hsr2.146. PMID: 32166191.
Moucari R, Asselah T, Cazals-Hatem D, Voitot H, Boyer N, Ripault MP, et al. Insulin resistance in chronic hepatitis C: association with genotypes 1 and 4, serum HCV RNA level, and liver fibrosis. Gastroenterology. 2008;134(2):416-23. DOI: 10.1053/j.gastro.2007.11.010. PMID: 18164296.
Koo DJ, Lee MY, Jung I, Moon SJ, Kwon H, Park SE, et al. Changes in insulin resistance index and the risk of liver fibrosis in patients with nonalcoholic fatty liver disease without diabetes: Kangbuk Samsung Health Study. Endocrinol Metab (Seoul). 2021;36(5):1016-28. DOI: 10.3803/EnM.2021.1110. PMID: 34674510.
Tan J, Hu R, Gong J, Fang C, Li Y, Liu M, et al. Protection against metabolic associated fatty liver disease by protocatechuic acid. Gut Microbes. 2023;15(1):2238959. DOI: 10.1080/19490976.2023.2238959. PMID: 37505920.
Han SK, Seo MJ, Lee T, Kim MY. Effectiveness of the ALT/AST ratio for predicting insulin resistance in a Korean population: a large-scale, cross-sectional cohort study. PLoS One. 2024;19(5):e0303333. DOI: 10.1371/journal.pone.0303333. PMID: 38758828.
Zeng RX, Xu JP, Zhang YZ, Tan JW, Kong YJ, Zhang MZ, Guo LH. Associations of total protein, albumin, and globulin with insulin resistance: an NHANES study. Front Endocrinol. 2024;15:1393137. DOI: 10.3389/fendo.2024.1393137. PMID: 39345890.
Bae JC, Seo SH, Hur KY, Kim JH, Lee MS, Lee MK, et al. Association between serum albumin, insulin resistance, and incident diabetes in nondiabetic subjects. Endocrinol Metab (Seoul). 2013;28(1):26-32. DOI: 10.3803/EnM.2013.28.1.26. PMID: 24396647.
Thong VD, Quynh BTH. Correlation of serum transaminase levels with liver fibrosis assessed by transient elastography in Vietnamese patients with nonalcoholic fatty liver disease. Int J Gen Med. 2021;14:1349-55. DOI: 10.2147/IJGM.S309311. PMID: 33889015.
Teufel-Schafer U, Flechtenmacher C, Fichtner A, Hoffmann GF, Schenk JP, Engelmann G. Transient elastography correlated to four different histological fibrosis scores in children with liver disease. Eur J Pediatr. 2021;180(7):2237-44. DOI: 10.1007/s00431-021-04001-6. PMID: 33704581.
Li G, Zhang X, Lin H, Liang LY, Wong GL, Wong VW. Non-invasive tests of non-alcoholic fatty liver disease. Chin Med J (Engl). 2022;135(5):532-46. DOI: 10.1097/CM9.0000000000002027. PMID: 35089884.
Tamaki N, Ajmera V, Loomba R. Non-invasive methods for imaging hepatic steatosis and their clinical importance in NAFLD. Nat Rev Endocrinol. 2022;18(1):55-66. DOI: 10.1038/s41574-021-00584-0. PMID: 34815553.
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