The Severity of Ultrasonographic Findings in Nonalcoholic Fatty Liver Disease Reflects the Metabolic Syndrome and Visceral Fat Accumulation

• Published in: The American journal of gastroenterology Vol. 102; no. 12; pp. 2708 - 2715
• Main Authors: HAMAGUCHI, Masahide, KOJIMA, Takao, KAWAHITO, Yutaka, YOSHIKAWA, Toshikazu, OKANOUE, Takeshi, ITOH, Yoshito, HARANO, Yuichi, FUJII, Kota, NAKAJIMA, Tomoaki, KATO, Takahiro, TAKEDA, Noriyuki, OKUDA, Junichi, IDA, Kazunori
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell Publishing 01.12.2007; Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
• Subjects: Adolescent; Adult; Aged; Area Under Curve; Biological and medical sciences; Biopsy; Cross-Sectional Studies; Digestive system; Fatty Liver - diagnostic imaging; Fatty Liver - epidemiology; Fatty Liver - etiology; Female; Gastroenterology; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Intra-Abdominal Fat - diagnostic imaging; Investigative techniques, diagnostic techniques (general aspects); Japan - epidemiology; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Logistic Models; Male; Medical sciences; Metabolic diseases; Metabolic Syndrome - complications; Metabolic Syndrome - diagnostic imaging; Metabolic Syndrome - epidemiology; Middle Aged; Miscellaneous; Other diseases. Semiology; Other metabolic disorders; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Severity of Illness Index; Ultrasonography; Endocrinopathy; Sonography; Human; Liver biopsy; Metabolic diseases; Cardiovascular disease; Hepatic disease; Metabolic syndrome; Accumulation; Visceral obesity; Abdomen; Sensitivity; Specificity; Fatty liver; Non alcoholic steatohepatitis; Echography; Fat; Digestive diseases; Adult; Diagnosis; Predictive factor
• ISSN: 0002-9270; 1572-0241
• DOI: 10.1111/j.1572-0241.2007.01526.x

Nonalcoholic fatty liver disease (NAFLD) is closely associated with the metabolic syndrome. We evaluated the association among the metabolic syndrome, visceral fat accumulation, and the severity of fatty liver with a new scoring system of ultrasonographic findings in apparently healthy Japanese adults. Subjects consisted of 94 patients who received liver biopsy and 4,826 participants who were selected from the general population. Two hepatologists scored the ultrasonographic findings from 0 to 6 points. We calculated Cohen's kappa of within-observer reliability and between-observer reliability. We evaluated the predictive value of the score by the area under a conventional receiver operating characteristic curve (AUC). Within-observer reliability was 0.95 (95% CI 0.93-0.97, P<0.001) and between-observer reliability was 0.95 (95% CI 0.93-0.97, P<0.001). The AUC to diagnose NAFLD was 0.980. The sensitivity was 91.7% (95% CI 87.0-95.1, P<0.001) and the specificity was 100% (95% CI 95.4-100.0, P<0.001). The AUC to diagnose visceral obesity was 0.821. The sensitivity was 68.3% (95% CI 51.9-81.9, P=0.028) and the specificity was 95.1% (95% CI 86.3-99.0, P<0.001). Adjusted odds ratio of the score for the metabolic syndrome was 1.37 (95% CI 1.26-1.49, P<0.001). The scoring system with abdominal ultrasonography could provide accurate information about hepatic steatosis, visceral obesity, and the metabolic syndrome in apparently healthy people who do not consume alcohol.