The FibroTouch Combined With The Serum Target In The Diagnosis Of Non-Alcoholic Fatty Liver Disease

Objective:Nonalcoholic fatty liver disease has become a global important public health problem in the 21st century,its incidence trends to raise year by year in all countries,it interact with diabetes, obesity, high cholesterol, high blood pressure and other related metabolic disease as both cause and effect, which affect the quality of people’s survival seriously, so the early diagnosis of NAFLD is particularly important. At present,The non-invasive quantitative diagnosis of fatty liver which has become a hot research at home and abroad,and the purpose of this study is to explore the value of which the FibroTouch combined with the serum target in the diagnosis of NAFLD, it can be used to assess the severity of fatty liver in early, it’s benefit to the early period clinical intervention in time.Methods:Adult subjects who selected from our physical examination center between December 2014 and February 2015, all subjects were informed consent. All subjects perform exam by the ordinary ultrasound and FibroTouch,and getting the data which are the liver stiffness value (FT2),fat attenuation parameter and the results of ultrasonic attenuation values. According to the inclusion criteria and exclusion criteria for 216 cases, aged 21 to 68 years old, the average (37.55 10.23) years of age, with reference to the Chinese medical association branch of hepatology fatty liver and alcoholic liver disease group of nonalcoholic fatty liver disease diagnosis and treatment guidelines (2010 edition) of type-B ultrasonic diagnostic criteria, divided these subjects into control group (111 cases), study group (105 cases), while the study group was divided into mild group (76 cases), moderate (29 cases), severe group (0) based on the severity of fatty liver disease, during the samples selection we found no severe fatty liver, so get rid from the group. Measuring height and weight for calculating BMI, and extract the fasting blood to get the TQ TC, HDL, LDL, AST, ALT, ApoA1, Apo B, FPQ UA and other data. Establish a database, using SPSS 19.0 packages to statistical analysis of data, according the normal distribution of data to mean ±standard deviation (x±s) described, using t test; while the other data are indicated with medians (quarttiles), using the Mann-Whitney test. Using spearman to analyze the relationship between the various indicators. Building ROC curve, and assess the the level of diagnosis of fatty liver; To calculate the diagnostic cut-off point of mild and moderate fatty liver, sensitivity and specific degrees. The difference was statistically significant (P< 0.05).Results:1.Study group compare with the control group of TC, TQ HDL, LDL, AST, ALT, ApoB, UA, FPQ BMI, FT1,FT2, all P values less than 0.05, differences are statistically significant; Which the ApoAl of P values more than 0.05, there was no statistically significant difference. The control group and mild group, moderate group of TC, TQ HDL, LDL, AST, ALT, ApoB, UA, FPQ BMI, FT2, all P values less than 0.05, the differences were statistically significant, while the ApoA1, FT1 of P values all more than 0.05, there was no statistically significant difference.2.Analyze all study index by Spearmam, type-B ultrasonic (hepatic steatosis) is positively associated with FT2,TC, TG, LDL, AST, ALT, ApoB, FPQ UA,BMI (rs> 0, P< 0.05), and negatively associated with HDL (rs< 0, P< 0.05), the highest associated with FT2 while the rs is 0.752; TQALT, FPQ UA, BMI were the highest correlation coefficient with FT2,While FT2 is associated highest with BMI of rs 0.754.3.Each index of AUC in the ROC curve in mild group, HDL< 0.50, TC, TQ LDL, AST, ALT, ApoB, FPQ UA, BMI between 0.50 and 0.7, FT2 between 0.7 and 0.9, the P values of TC, TQ LDL, HDL, FPQ UA, BMI, FT2 all less than 0.05, differences were statistically significant. The P values of AST, ApoB were 0.480, 0.430, P> 0.05, there was no statistically significant difference in these two area. FT2’s cut-off point of is 239.50 db/m in mild group, its specificity and sensitivity are 71% and 74%. Each index of AUC in the ROC curve in the moderate group, HDL< 0.5, TC, TG, LDL, ApoB, FPG between 0.5 and 0.7, UA, BMI, AST, ALT between 0.7 and 0.9, FT2 between 0.9 and 1, the P values of TC, TG, ApoB, FPG, UA, BMI, FT2 were less than 0.05, suggesting that the two area differences were statistically significant, the P value of LDL, HDL were 0.241 and 0.232, all P values more than 0.05, there was no statistically significant difference shows that two area. FT2’s cut-off point of is 257.50 db/m in moderate group, its specificity and sensitivity are 81% and 100%.Conclusion:1.In the control group and study group, TC, TG, LDL, FPG, UA, AST, ALT, ApoB, FT2, BMI is significantly higher than the control group, HDL is lower than the control group, so the rise of index of TC, TG, LDL, FPG, UA, AST, ALT, ApoB, FT1, FT2, BMI and the reduce of HDL, ApoAl that contribute to the diagnosis of fatty liver.2.1n the control group, mild and moderate group, TC, TG, AST, ALT, ApoB, UA, BMI, FPG, FT2 those index increased with the increased of fatty liver disease severity, HDL reduced with the increased of fatty liver disease severity, explain the study index volatility can indirectly treflect the severity of fatty liver.3.The indexes of UA, BMI, AST, ALT of AUC lies between 0.5 and 0.7 in mild group,while it between 0.7 and 0.9 in the moderate group, shows that with the increase of the severity of fatty liver disease, the levels of these indicators in the diagnosis of fatty liver disease also increases.4.With fatty liver disease severity increases comes to FPG, UA, TC, TG, BMI, can indirectly shows that the formation of fatty liver may be associated with obesity, insulin resistance, metabolic abnormalities.5.Through the area under the ROC curve, the area under the curve of FT2 is the largest, so its the best diagnosis, in mild, moderate group, the cut-off point of FT2 are 239.5 db/m,257.50 db/m, its specificity and sensitivity are 71%,74% in the mild group, its specificity and sensitivity are 82%,100% respectively in the moderate group, the standard critical value of diagnosis is close to FibroTouch currently used.In the correlation analysis, liver steatosis was positively correlated with FT2, and the correlation coefficient is the largest, rs is 0.752,TQALT, FPQ UA, BMI were the highest correlation coefficient with FT2. Above all,the FibroTouch fat attenuation parameter of the diagnosis accuracy is higher, it available to assess the severity of fatty liver disease, can contribute to the NAFLD patients of condition follow-up, Joint, TQ ALT, FPQ UA, BMI index can be more accurate diagnosis of fatty liver,take active intervention in disease progression.