[The assessment of nonalcoholic fatty liver disease detected by computed tomography in cases with obesity and overweight].
The pathogenesis of nonalcoholic fatty liver disease (NAFLD) has not been completely explained yet. There are no clear clinical indicators of the risk of NAFLD's occurrence. By means of computed tomography (CT) quantitative assessment of the fatty liver is possible and CT is therefore a suitable method of monitoring the effectiveness of the treatment in non-alcoholic fatty liver.


OBJECTIVE
The assessment of the influence of the clinical factors, such as: [1] overweight, [2] the fatty tissue distribution type, [3] the lipids profile, on the risk of NAFLD occurrence. INVESTIGATED GROUP AND METHOD. The examined group and the control group comprised 113 persons (59 women and 54 men) with overweight and obesity, who, due to different clinical indications, underwent CT of the abdomen. In the CT examinations the existence of fatty liver was assessed on the basis of the range of attenuation coefficient (in Hounsfield units), that was measured in four previously chosen areas of the liver. Additionally, two measurements of spleen tissue were conducted. The density of tissues, represented in Hounsfield units, once established makes it possible to assess the increase of fat percentage in the liver with respect to the norm. Excursion criteria: [1] ethanol consumption exceeding 20 g per day; [2] existence of other diseases which may cause derivative form of non-alcoholic fatty liver and/or different clinical features of other diseases of the liver; [3] existence of focal changes of the liver that could affect the measurements of the attenuation coefficient. In the group of 59 women in 23 of them (38.9%) the features of fatty liver have been found. The group with fatty liver in comparison with the group without fatty liver was marked by significantly higher WHR index (0.9 vs 0.8; p = 0.029), higher TG concentration (209.9 mg/dl vs 160.9 mg/dl; p = 0.032) and lower HDL-C concentration (37.7 mg/dl vs 46.1 mg/dl; p = 0.004). In the group of 54 men in 22 of them (40.7%) fatty liver has been affirmed. The group with fatty liver in comparison with the group without fatty liver was characterized by higher BMI (29.2.2 vs 27.4 kg/m2; p = 0.002) and, as in women, higher TG concentration and lower HDL-C concentration in serum.


CONCLUSIONS
[1] CT examination with assessment of the range of attenuation coefficient is a useful tool for fatty liver evaluation and may be used in routine diagnostic procedure in patients with NAFLD. [2] The risk factors of NAFLD development are high TG concentration and low HDL-C concentration in serum. [3] In men the risk factor of NAFLD is obesity and overweight, whereas in women fatty liver correlates not only with the BMI value, but above all with central obesity.
Tacikowski
Tadeusz
T
Klinika Chorób Metabolicznych i Gastroenterologii Instytutu Zywności i Zywienia.
Godziemba-Maliszewska
Ewa
E
Dzieniszewski
Jan
J
Nowicka
Grazyna
G
D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood; D016001:Confidence Intervals; D005234:Fatty Liver / Q000000981:diagnostic imaging* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012737:Sex Factors; D014057:Tomography, X-Ray Computed / Q000379:methods
D008076:Cholesterol, HDL