Yury Marakhouski
Belarusian Medical Academy , Belarus
Title: New Non-Invasive Technology that Increases Confidence in Suspicion of Liver Steatosis and Fibrosis
Biography
Biography: Yury Marakhouski
Abstract
Liver steatosis is a highly common pathology in the population, in many countries. It is significant practical importance in such situation, to identify individuals with the steatosis possible presence.
Aims. To identify bioimpedancemetries indicators that increase the degree of confidence in the presence liver steatosis and fibrosis in practically healthy individuals and those with hepatomegaly.
Methods. All study participants in this prospective study were Caucasian. 20 practically healthy persons with chronological age (Chr-age) = mean 40.4 (95% CI=30.8-49.9), median 39 (Q25/75=28-51). M/F = 6/20 (30.0%/70.0%), and 31 patients with hepatomegaly referred for transient elastography (FibroTouch in iLivtouch FT 100). Steatosis(S) and Fibrosis (F) was measured in each patient according to the manufacturer's recommendations. Steatosis and fibrosis staging sections recommended by the manufacturer were used. Additionally, each participant underwent bioimpedancemetry (BIM) (tetrapolar, multifrequency and vector analysis) with the determination of body mass composition. Proper parameter reference values are calculated based on previous studies by centile tables of sex and age variability of traits according to health centers for 2010-2012. (n=819808, age 5-85) and each patient assessment according to the manufacturer's recommendations as due and in actual. The methabolic age (Met-age) was determined with BIM, based on 40 parameters. Feature of the used BIM method is the calculation of the due indicator for the differentiation between Met-age and Chr-age(Age-diff). All subjects are randomly selected without examination and immediately tested by transient elastography and BIM. Statistical analyzes performed with chi-square and t-test (p <0.05).
Results.
Practically healthy persons. S- median = 276,0 dB/m (Q25/75=250,0-324,0); F - median = 6,1kPa (Q25/75=5,7-6,4). As follows from the presented data, there is not fibrosis(F=0) in group, but there is moderate steatosis (S=2). Analysis of individual values: only 6 people (30% at 95% CI = 11.9 - 54.3) did not have steatosis and Controlled attenuation parameter in decibels per meter (CAP) equal to or less than 244 dB/m. Severe steatosis was found in 9 people (45% at 95% CI = 23.1 - 68.5), the CAP index was more than 296 dB/m. Age-diff on 2 years was found in the subgroup with severe steatosis(S=3) in 88,9% (8 of 9)(95%CI= 51,8 – 99,7) and in 1 of 11 individuals with mild steatosis (S0+S1): 9,1% at 95%CI= 0,2 – 41,3. Single Binary Sample Diagnostic Test (for Age Diff): sensitivity- 86% (95%CI= 49 – 97); specificity-83% (95%CI= 44 – 97); Likelihood ratio for positive test = 5,14 (95% C.I. = 1,34 – 87,52); for negative test = 0,17% (95% C.I. = 0,05 – 0,71).
Persons with hepatomegaly. S- median = 313,5 dB/m (Q25/75=260,0-352,0); F - median = 8,8 kPa (Q25/75=7,0-12,9). As follows from the presented data, there is fibrosis (from F1 to F2-3) in group, and there is severe steatosis (S=3). Analysis of individual values: only 5 people (15,6% at 95% CI = 5,3 - 32.8) did not have steatosis, CAP equal to or less than 244 dB/m). Severe steatosis was found in 18 people (56,3% at 95% CI = 37.7 – 73,6), the CAP index was more than 296 dB/m. In 11 persons (35,5% (95%CI =19,2-54,6) indicated fibrosis F3-4 (more than 12 kPa), from its 3 persons have cirrhosis (F4, more than 18 kPa). Cut-off value of 6.0 in the Age-diff in order to establish the threat of fibrosis in individuals with hepatomegaly. Exposed to risk factor: 46.15% (calculated). Odds Ratio (cases/controls) = 19.80 ([reciprocal = 0.05), Fisher's exact confidence intervals: 95%: 1.67 - 944.21. Sensitivity = 81.25% (95% C.I. = 56.99 - 93.41%). Specificity = 80.00% (95% C.I. = 54.81% - 92.95%). Likelihood ratio: for positive test = 4.06 (95% C.I. = 1.44 - 11.48); for negative test = 0.23 (95% C.I. = 0.08 - 0.67).
Conclusion
Presented the possibility using a new Non-Invasive Technology that Increases Confidence in Suspicion of Liver Steatosis and Fibrosis. More alder metabolic ages can predict the presence of steatosis in practically healthy individuals and steatosis with fibrosis in individuals with hepatomegaly and it has been shown for the first time.