The Prevalence Of Fatty Liver And Status Of Liver Fibrosis Evaluated By Controlled Attenuation Parameter And Liver Stiffness Measurement

Objective:To investigate the prevalence of fatty liver and status of liver fibrosis,controlled attenuation parameter(CAP) and liver stiffness measurement(LSM) were used within fatty liver patients who visit Department of Gastroenterology and Hepatology in a major hospital.Patients and Methods:A total of 1512 patients were involved in this study in Department of Gastroenterology and Hepatology, Union Hospital of Tongji Medical Colloge, Huangzhong University of Science and Technology from September, 2014 to September, 2015. The degree of fatty liver was evaluated by CAP. The prevalence of fatty liver and status of liver fibrosis was compared according to age, gender and body mass index(BMI) of the patients. LSM evaluated by transient elastrography, NAFLD fibrosis score(NAFLDFS), AST-to-PLT ratio index(APRI), fibrosis index based on the 4 factor(FIB-4) and red cell distribution width-to-platelet ratio(RPR) was calculated in fatty liver patients. F0-2 and F3 or greater diseases were compared by the best LSM cutoff.Results:(1)The prevalence of fatty liver of the 1512 patients was 35.05%, including248 patients at light grade(16.40%), 160 patients at moderate grade(10.58%) with rest of them at severe grade(8.07%) patients. The prevalence of fatty liver in male patients(39.66%) was significantly higher than that of female patients(25.75%)(P<0.01). It is the same as in all sub-groups less than 60 years, but in over 60 years old groups, there is no significance between males and females.The prevalence of fatty liver in males decreased with the increasing age(p < 0.01), while it has no statistical significance in females in all age groups.(2)The prevalence of fatty liver increased with the increasing BMI(p<0.01). There was no significant difference in light-weight and normal-weight groups regardless of gender or age difference; while in overweight group, the prevalence of fatty liver in males was significantly higher than that of females and highest incidence occurred in young generation less than 30 years and lowest in groups at their fiftieth.(3)According to LSM, NAFLDFS, APRI,RPR and FIB-4, there was no statistically significant difference in the detection of liver fibrosis among the 530 fatty liver patients. Based on LSM standard,138 liver fibrosis patients were detected. There was no statistically significant difference between males(25.44%) and females(27.91%). For different age groups with fatty liver, the liver fibrosis detection rate increased with the increasing age and BMI.(4)Age, BMI, ALT, AST and globulin in advanced liver fibrosis were significantly higher than the others, while platelets, red blood cells and albumin were lower.Logistic regression analysis revealed that elevated AST and BMI(OR : 1.027,95%CI:1.012-1.043;OR:1.107,95%CI:1.006-1.219,respectively)were risk factors of advanced liver fibrosis.Conclusion:The prevalence of fatty liver among patients who visit Department of Gastroenterology and Hapatology in a major hospital is relatively high. The incidence increased with increasing BMI while higher incidence occurred in males than in females. it is also associated with age in overweight group. Elevated BMI and AST may be the influence factors for F3 or greater diseases in fatty liver disease.As a convenient and noninvasive diagnosis approach, Fibrotouch can be applied in fatty liver and liver fibrosis simultaneously by CAP and LSM.