title: Noninvasive detection of hepatic steatosis in patients without ultrasonographic evidence of fatty liver using the controlled attenuation parameter evaluated with transient elastography.
abstract: OBJECTIVE
  Although ultrasound is a useful technique for detecting hepatic steatosis, it cannot provide a precise determination of hepatic fat content. A novel attenuation parameter named controlled attenuation parameter (CAP) has been developed to process the raw ultrasonic signals acquired by Fibroscan. The aim of this study was to determine the percentage of hepatic steatosis in apparently healthy Turkish individuals using the proposed diagnostic cut-off points for CAP. In addition, we sought to investigate the association of CAP with the traditional risk factors for nonalcoholic fatty liver disease in a screening setting.
  
  
  METHODS
  In the present study, 102 Turkish individuals without evidence of fatty liver on ultrasound and normal aminotransferase levels underwent CAP measurements by means of Fibroscan.
  
  
  RESULTS
  The mean (SD), median (minimum-maximum), and 5th and 95th percentile values of CAP values in this cohort of 102 individuals were 206.99 (48.12), 210.5 (100.0-314.0), 113.4 and 280.2 dB/m, respectively. Using the cut-offs of 222, 238, and 283 dB/m for CAP, there were 39 (38.2%), 23 (22.5%), and five (4.9%) individuals out of 102 who had at least 10% steatosis despite normal liver findings on ultrasound. After allowance for potential confounders, CAP was independently associated with BMI (β=0.39, t=3.5, P<0.001) and the number of metabolic syndrome criteria (β=0.24, t=2.1, P<0.05).
  
  
  CONCLUSIONS
  These results hold promise for early noninvasive detection of hepatic steatosis on the basis of CAP assessment.
authors: Departments of aGastroenterology bRadiology, School of Medicine cInstitute of Gastroenterology, Marmara University, Istanbul, Turkey.
authors: Yusuf
authors: Y
authors: Yilmaz
authors: Rabia
authors: R
authors: Ergelen
authors: Hakan
authors: H
authors: Akin
authors: Nese
authors: N
authors: Imeryuz
mesh_terms: D000293:Adolescent; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005188:False Negative Reactions; D005234:Fatty Liver / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008403:Mass Screening / Q000379:methods; D024821:Metabolic Syndrome / Q000150:complications; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D012307:Risk Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D000410:Alanine Transaminase