Novel equation to determine the hepatic triglyceride concentration in humans by MRI: diagnosis and monitoring of NAFLD in obese patients before and after bariatric surgery

BMC Medicine

Jesús M Banales²  Leixuri Aguirre¹  María P Portillo¹  Mikel Larzabal⁴  Maddi Garmendia⁴  Santiago Larburu⁶  José I Asensio⁶  María J Perugorria²  Javier Sánchez-González⁸  Lander Gallego⁶  Elizabeth Hijona⁵  Elisabeth García³  José M Alustiza³  Luis Bujanda⁵  Adolfo Beguiristain⁶  José I Emparanza⁷  Raúl Jiménez-Agüero⁷ 

[1] Department of Nutrition and Food Science, Faculty of Pharmacy, UPV/EHU, CIBER-obn, Vitoria, Spain;IKERBASQUE, Basque Foundation for Science, Bilbao, Spain;Osatek SA, San Sebastian, Spain;Department of Pathology, HUD, San Sebastian, Spain;National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd), Barcelona, Spain;Department of Liver and Gastrointestinal Diseases, Biodonostia Research Institute, Donostia University Hospital (HUD), University of the Basque Country (UPV/EHU), San Sebastian, Spain;Clinical Epidemiology Unit, CASPe, CIBER-ESP, Biodonostia Research Institute – HUD, San Sebastian, Spain;Philips Healthcare, Iberia, Madrid, Spain

关键词: Diagnosis;    Bariatric surgery;    Obesity;    Hepatic fat concentration;    Magnetic resonance imaging;    Non-alcoholic fatty liver disease;   

Others  :  1123208
DOI  :  10.1186/s12916-014-0137-y

 received in 2014-04-25, accepted in 2014-07-23,  发布年份 2014

【 摘 要 】

Background

Non-alcoholic fatty liver disease (NAFLD) is caused by abnormal accumulation of lipids within liver cells. Its prevalence is increasing in developed countries in association with obesity, and it represents a risk factor for non-alcoholic steatohepatitis (NASH), cirrhosis and hepatocellular carcinoma. Since NAFLD is usually asymptomatic at diagnosis, new non-invasive approaches are needed to determine the hepatic lipid content in terms of diagnosis, treatment and control of disease progression. Here, we investigated the potential of magnetic resonance imaging (MRI) to quantitate and monitor the hepatic triglyceride concentration in humans.

Methods

A prospective study of diagnostic accuracy was conducted among 129 consecutive adult patients (97 obesity and 32 non-obese) to compare multi-echo MRI fat fraction, grade of steatosis estimated by histopathology, and biochemical measurement of hepatic triglyceride concentration (that is, Folch value).

Results

MRI fat fraction positively correlates with the grade of steatosis estimated on a 0 to 3 scale by histopathology. However, this correlation value was stronger when MRI fat fraction was linked to the Folch value, resulting in a novel equation to predict the hepatic triglyceride concentration (mg of triglycerides/g of liver tissue = 5.082 + (432.104 * multi-echo MRI fat fraction)). Validation of this formula in 31 additional patients (24 obese and 7 controls) resulted in robust correlation between the measured and estimated Folch values. Multivariate analysis showed that none of the variables investigated improves the Folch prediction capacity of the equation. Obese patients show increased steatosis compared to controls using MRI fat fraction and Folch value. Bariatric surgery improved MRI fat fraction values and the Folch value estimated in obese patients one year after surgery.

Conclusions

Multi-echo MRI is an accurate approach to determine the hepatic lipid concentration by using our novel equation, representing an economic non-invasive method to diagnose and monitor steatosis in humans.

【 授权许可】

   
2014 Jiménez-Agüero et al.; licensee BioMed Central Ltd.

【 图 表 】

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