A new noninvasive technique for estimating hepatic triglyceride: will liver biopsy become redundant in diagnosing non-alcoholic fatty liver disease?

BMC Medicine

Joost PH Drenth¹  Bark Betzel² 

[1] Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen 6500 HB, the Netherlands;Department of General Surgery, Rijnstate Hospital, Wagnerlaan 55, Arnhem 6815 AD, the Netherlands

关键词: Non-alcoholic steatohepatitis;    Non-alcoholic fatty liver disease;    Metabolic syndrome;    Magnetic resonance imaging;    Hepatic fat concentration;    Bariatric surgery;   

Others  :  1121504
DOI  :  10.1186/s12916-014-0152-z

 received in 2014-08-08, accepted in 2014-08-12,  发布年份 2014

【 摘 要 】

Obesity and metabolic syndrome are healthcare problems that continue to rise in frequency worldwide. Both phenotypes are a strong predictor for development of liver steatosis in the context of non-alcoholic fatty liver disease or non-alcoholic steatohepatitis. Ultrasound may detect steatosis, but its sensitivity is limited and liver biopsy is still considered to be the gold standard. Less invasive techniques that accurately quantify liver steatosis are warranted. Jiménez-Agüero and colleagues propose that multi-echo magnetic resonance imaging might be such a diagnostic tool. They validated multi-echo magnetic resonance imaging with measured hepatic triglyceride concentration. Their results show that this innovative technique measures the grade of steatosis in different clinical situations. Therefore, multi-echo magnetic resonance imaging might be considered for monitoring liver steatosis as an intermediate endpoint. Wide clinical applicability is limited though, as it does not allow differentiation between non-alcoholic fatty liver disease and non-alcoholic steatohepatitis.

【 授权许可】

   
2014 Betzel and Drenth; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Bellentani S, Scaglioni F, Marino M, Bedogni G: Epidemiology of non-alcoholic fatty liver disease. Dig Dis 2010, 28:155-161.
• [2]Dyson JK, Anstee QM, McPherson S: Non-alcoholic fatty liver disease: a practical approach to diagnosis and staging. Frontline Gastroenterol 2014, 5:211-218.
• [3]Seeff LB, Everson GT, Morgan TR, Curto TM, Lee WM, Ghany MG, Shiffman ML, Fontana RJ, Di Bisceglie AM, Bonkovsky HL, Dienstag JL: Complication rate of percutaneous liver biopsies among persons with advanced chronic liver disease in the HALT-C trial. Clin Gastroenterol Hepatol 2010, 8:877-883.
• [4]Festi D, Schiumerini R, Marzi L, Di Biase AR, Mandolesi D, Montrone L, Scaioli E, Bonato G, Marchesini-Reggiani G, Colecchia A: Review article: the diagnosis of non-alcoholic fatty liver disease – availability and accuracy of non-invasive methods. Aliment Pharmacol Therapeut 2013, 37:392-400.
• [5]Permutt Z, Le TA, Peterson MR, Seki E, Brenner DA, Sirlin C, Loomba R: Correlation between liver histology and novel magnetic resonance imaging in adult patients with non-alcoholic fatty liver disease - MRI accurately quantifies hepatic steatosis in NAFLD. Aliment Pharmacol Therapeut 2012, 36:22-29.
• [6]Raul Jiménez-Agüero JIE, Adolfo B, Luis B, Alustiza JM, Eli G, Elizabeth H, Lander G, Javier S, Perugorria MJ, Asensio JI, Santiago L, Maddi G, Mikel L, Portillo MP, Leixuri A, Banales JM: 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 Med 2014, 12.
• [7]Chalasani N, Younossi Z, Lavine JE, Diehl AM, Brunt EM, Cusi K, Charlton M, Sanyal AJ: The diagnosis and management of non-alcoholic fatty liver disease: practice guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology 2012, 55:2005-2023.
• [8]Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Brethauer SA, Navaneethan SD, Aminian A, Pothier CE, Kim ES, Nissen SE, Kashyap SR: Bariatric surgery versus intensive medical therapy for diabetes–3-year outcomes. N Engl J Med 2014, 370:2002-2013.
• [9]Chavez-Tapia NC, Tellez-Avila FI, Barrientos-Gutierrez T, Mendez-Sanchez N, Lizardi-Cervera J, Uribe M: Bariatric surgery for non-alcoholic steatohepatitis in obese patients. Cochrane Database Syst Rev 2010., 1
• [10]Mathurin P, Hollebecque A, Arnalsteen L, Buob D, Leteurtre E, Caiazzo R, Pigeyre M, Verkindt H, Dharancy S, Louvet A, Romon M, Pattou F: Prospective study of the long-term effects of bariatric surgery on liver injury in patients without advanced disease. Gastroenterology 2009, 137:532-540.
• [11]Promrat K, Kleiner DE, Niemeier HM, Jackvony E, Kearns M, Wands JR, Fava JL, Wing RR: Randomized controlled trial testing the effects of weight loss on nonalcoholic steatohepatitis. Hepatology 2010, 51:121-129.