title: The severity of ultrasonographic findings in nonalcoholic fatty liver disease reflects the metabolic syndrome and visceral fat accumulation.
abstract: BACKGROUND
  Nonalcoholic fatty liver disease (NAFLD) is closely associated with the metabolic syndrome.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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).
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors: Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Masahide
authors: M
authors: Hamaguchi
authors: Takao
authors: T
authors: Kojima
authors: Yoshito
authors: Y
authors: Itoh
authors: Yuichi
authors: Y
authors: Harano
authors: Kota
authors: K
authors: Fujii
authors: Tomoaki
authors: T
authors: Nakajima
authors: Takahiro
authors: T
authors: Kato
authors: Noriyuki
authors: N
authors: Takeda
authors: Junichi
authors: J
authors: Okuda
authors: Kazunori
authors: K
authors: Ida
authors: Yutaka
authors: Y
authors: Kawahito
authors: Toshikazu
authors: T
authors: Yoshikawa
authors: Takeshi
authors: T
authors: Okanoue
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001706:Biopsy; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008875:Middle Aged; D012720:Severity of Illness Index; D014463:Ultrasonography