Impact renaming non-alcoholic fatty liver disease to metabolic associated fatty liver disease in prevalence, characteristics and risk factors

Quantitative ultrasound (QUS) in the evaluation of liver steatosis: data reliability in different respiratory phases and body positions

Liver steatosis is the most common chronic liver disease and affects 10-24% of the general population. As the grade of disease can range from fat infiltration to steatohepatitis and cirrhosis, an early diagnosis is needed to set the most appropriate therapy. Innovative noninvasive radiological techniques have been developed through MRI and US. MRI-PDFF is the reference standard, but it is not so widely diffused due to its cost. For this reason, ultrasound tools have been validated to study liver parenchyma. The qualitative assessment of the brightness of liver parenchyma has now been supported by quantitative values of attenuation and scattering to make the analysis objective and reproducible. We aim to demonstrate the reliability of quantitative ultrasound in assessing liver fat and to confirm the inter-operator reliability in different respiratory phases. We enrolled 45 patients examined during normal breathing at rest, peak inspiration, peak expiration, and semi-sitting position. The highest inter-operator agreement in both attenuation and scattering parameters was achieved at peak inspiration and peak expiration, followed by semi-sitting position. In conclusion, this technology also allows to monitor uncompliant patients, as it grants high reliability and reproducibility in different body position and respiratory phases.

Elevated small dense low-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio is associated with an increased risk of metabolic dysfunction associated fatty liver disease in Chinese patients with type 2 diabetes mellitus

INTRODUCTION

It is demonstrated that elevated small dense low-density lipoprotein cholesterol (sdLDL-C), and reduced high-density lipoprotein cholesterol (HDL-C) is associated with Metabolic dysfunction-associated fatty liver disease (MAFLD). This study aims to explore the relationship between sdLDL-C to HDL-C ratio (SHR) and MAFLD in Chinese patients with type 2 diabetes mellitus (T2DM).

MATERIALS AND METHODS

A cross-sectional study was performed among 1904 patients with T2DM. Weighted multivariable logistic regression analysis was conducted to explore the relationship between the SHR and the risk of MAFLD. In addition, this study used a two-part linear regression model to identify threshold effects. Subgroup analysis, interaction tests and receiver operating characteristic (ROC) curve analysis were also carried out.

RESULTS

The overall MAFLD prevalence reached 48.1%. Multiple logistic regression analysis showed that SHR was positively correlated with the risk of MAFLD (OR = 2.37, 95% CI = 1.80-3.12). Subgroup analysis stratified by age, gender, hypertension and BMI showed that there was a consistent positive correlation. A non-linear relationship and saturation effect between SHR and MAFLD risk were identified, with an inverted L shaped curve and an inflection point at 1.02. The area under the curve (AUC) for SHR in the ROC analysis was significantly greater than sdLDL-C and HDL-C, with a sensitivity of 71.2% and a specificity of 62.1%.

CONCLUSIONS

Elevated levels of SHR is independently associated with an increased risk of MAFLD in patients with T2DM. SHR may be taken as practical indicators to assess the risk of MAFLD in T2DM patients.