NAFLD in clinical practice: can simple blood and anthropometric markers be used to detect change in liver fat measured by 1H-MRS?

Keating, Shelley E., Parker, Helen M., Hickman, Ingrid J., Gomersall, Sjann R., Wallen, Matthew P., Coombes, Jeff S., Macdonald, Graeme A., George, Jacob and Johnson, Nathan A. (2017) NAFLD in clinical practice: can simple blood and anthropometric markers be used to detect change in liver fat measured by 1H-MRS?. Liver International, . doi:10.1111/liv.13488


Author Keating, Shelley E.
Parker, Helen M.
Hickman, Ingrid J.
Gomersall, Sjann R.
Wallen, Matthew P.
Coombes, Jeff S.
Macdonald, Graeme A.
George, Jacob
Johnson, Nathan A.
Title NAFLD in clinical practice: can simple blood and anthropometric markers be used to detect change in liver fat measured by 1H-MRS?
Formatted title
NAFLD in clinical practice: can simple blood and anthropometric markers be used to detect change in liver fat measured by 1H-MRS?
Journal name Liver International   Check publisher's open access policy
ISSN 1478-3231
1478-3223
Publication date 2017-06-29
Year available 2017
Sub-type Article (original research)
DOI 10.1111/liv.13488
Open Access Status Not yet assessed
Total pages 9
Place of publication Chichester, West Sussex United Kingdom
Publisher Wiley-Blackwell Publishing
Language eng
Abstract Research in NAFLD management is commonly based on quantitative assessment of liver fat by proton-magnetic resonance spectroscopy ((1) H-MRS), and translation of this into clinical practice is currently limited by availability and expense. Novel steatosis biomarkers have been proposed for the prediction of liver fatness; however, whether these are suitable for detecting changes in liver fat is unknown. We aimed to determine the accuracy of these indices, and waist circumference (WC), in quantifying longitudinal change in (1) H-MRS-quantified liver fat.

We performed a secondary analysis using data from 97 overweight/obese adults (age: 39.7±11.5 years, body mass index: 30.7±4.4 kg/m(2) , liver fat: 6.0±4.8%, 65% male) who completed either an 8-week exercise or 12-week nutraceutical intervention, with varying degrees of change in liver fat. Baseline and post-intervention measures were liver fat ((1) H-MRS), NAFLD Liver Fat Score, Liver Fat Equation (LFE), Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), the Visceral Adiposity Index (VAI) and WC.

Only the change in HSI, FLI and WC was associated with change in liver fat; however, correlations were weak to moderate. There was no agreement between the LFE and (1) H-MRS for detecting liver fat change. Only change in WC significantly affected change in liver fat (P<.001), and WC AUROC for the presence of steatosis was 0.65 and 0.78 for men and women respectively.

Novel indices are limited in their ability to detect longitudinal change in liver fat. Waist circumference may offer modest utility as a surrogate to infer liver fat change with lifestyle interventions.
Formatted abstract
Background & Aims

Research in NAFLD management is commonly based on quantitative assessment of liver fat by proton-magnetic resonance spectroscopy (1H-MRS), and translation of this into clinical practice is currently limited by availability and expense. Novel steatosis biomarkers have been proposed for the prediction of liver fatness; however, whether these are suitable for detecting changes in liver fat is unknown. We aimed to determine the accuracy of these indices, and waist circumference (WC), in quantifying longitudinal change in 1H-MRS-quantified liver fat.

Methods

We performed a secondary analysis using data from 97 overweight/obese adults (age: 39.7±11.5 years, body mass index: 30.7±4.4 kg/m2, liver fat: 6.0±4.8%, 65% male) who completed either an 8-week exercise or 12-week nutraceutical intervention, with varying degrees of change in liver fat. Baseline and post-intervention measures were liver fat (1H-MRS), NAFLD Liver Fat Score, Liver Fat Equation (LFE), Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), the Visceral Adiposity Index (VAI) and WC.

Results

Only the change in HSI, FLI and WC was associated with change in liver fat; however, correlations were weak to moderate. There was no agreement between the LFE and 1H-MRS for detecting liver fat change. Only change in WC significantly affected change in liver fat (P<.001), and WC AUROC for the presence of steatosis was 0.65 and 0.78 for men and women respectively.

Conclusions

Novel indices are limited in their ability to detect longitudinal change in liver fat. Waist circumference may offer modest utility as a surrogate to infer liver fat change with lifestyle interventions.
Keyword Biomarkers
Intrahepatic triglyceride
Non-alcoholic fatty liver disease
Visceral adiposity
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

 
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