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      Confounding factors of non-invasive tests for nonalcoholic fatty liver disease

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          Abstract

          Nonalcoholic fatty liver disease (NAFLD) affects at least 25% of the general adult population worldwide. Because only a fraction of the patients would develop liver-related complications, it is preferable to perform non-invasive tests as the initial assessment. This review summarizes the known and potential confounding factors that affect the performance of non-invasive tests of hepatic steatosis and fibrosis in patients with NAFLD. Clinicians may apply the knowledge and exercise caution in selecting investigations and interpreting test results when confounding factors are present.

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          Noninvasive Assessment of Liver Disease in Patients With Nonalcoholic Fatty Liver Disease

          Laurent Castéra, Mireen Friedrich-Rust, Rohit Loomba (2019)
          Nonalcoholic fatty liver disease (NAFLD) is estimated to afflict approximately 1 billion individuals worldwide. In a subset of NAFLD patients, who have the progressive form of NAFLD termed nonalcoholic steatohepatitis (NASH), it can progress to advanced fibrosis, cirrhosis, hepatocellular carcinoma, and liver-related morbidity and mortality. NASH is typically characterized by a specific pattern on liver histology, including steatosis, lobular inflammation, and ballooning with or without peri-sinusoidal fibrosis. Thus, key issues in NAFLD patients are the differentiation of NASH from simple steatosis and identification of advanced hepatic fibrosis. Until now, liver biopsy has been the gold standard for identifying these 2 critical end points, but has well-known limitations, including invasiveness; rare but potentially life-threatening complications; poor acceptability; sampling variability; and cost. Furthermore, due to the epidemic proportion of individuals with NAFLD worldwide, liver biopsy evaluation is impractical, and noninvasive assessment for the diagnosis of NASH and fibrosis is needed. Although much of the work remains to be done in establishing cost-effective strategies for screening for NASH, advanced fibrosis, and cirrhosis, in this review, we summarize the current state of the noninvasive assessment of liver disease in NAFLD, and we provide an expert synthesis of how these noninvasive tools could be utilized in clinical practice. Finally, we also list the key areas of research priorities in this area to move forward clinical practice.
          Article 0 comments Cited 442 times – based on 0 reviews     Review now
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            Prevalence, incidence, and outcome of non-alcoholic fatty liver disease in Asia, 1999–2019: a systematic review and meta-analysis

            Jie Li, Biyao Zou, Yee Yeo … (2019)
            Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease worldwide. Asia is a large, heterogeneous area with substantial variation in socioeconomic status and prevalence of obesity. We estimated the prevalence, incidence, and outcomes of NAFLD in the Asian population to assist stakeholders in understanding NAFLD disease burden.
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              Magnetic Resonance Imaging More Accurately Classifies Steatosis and Fibrosis in Patients With Nonalcoholic Fatty Liver Disease Than Transient Elastography.

              Wataru Tomeno, Yuji Ogawa, Hironori Mawatari … (2016)
              Noninvasive methods have been evaluated for the assessment of liver fibrosis and steatosis in patients with nonalcoholic fatty liver disease (NAFLD). We compared the ability of transient elastography (TE) with the M-probe, and magnetic resonance elastography (MRE) to assess liver fibrosis. Findings from magnetic resonance imaging (MRI)-based proton density fat fraction (PDFF) measurements were compared with those from TE-based controlled attenuation parameter (CAP) measurements to assess steatosis.
              Article 0 comments Cited 259 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Vincent Wai-Sun Wong: wongv@cuhk.edu.hk
                Journal
                Journal ID (nlm-ta): J Gastroenterol
                Journal ID (iso-abbrev): J. Gastroenterol
                Title: Journal of Gastroenterology
                Publisher: Springer Singapore (Singapore )
                ISSN (Print): 0944-1174
                ISSN (Electronic): 1435-5922
                Publication date (Electronic): 25 May 2020
                Publication date PMC-release: 25 May 2020
                Publication date (Print): 2020
                Volume: 55
                Issue: 8
                Pages: 731-741
                Affiliations
                [1 ]GRID grid.10784.3a, ISNI 0000 0004 1937 0482, Department of Medicine and Therapeutics, , The Chinese University of Hong Kong, ; 9/F, Prince of Wales Hospital, 30-32 Ngan Shing Street, Hong Kong, China
                [2 ]GRID grid.10784.3a, ISNI 0000 0004 1937 0482, State Key Laboratory of Digestive Disease, , The Chinese University of Hong Kong, ; Hong Kong, China
                Article
                Publisher ID: 1686
                DOI: 10.1007/s00535-020-01686-8
                PMC ID: 7376510
                PubMed ID: 32451628
                SO-VID: acb80977-c629-4f27-b609-cae2a46e90d9
                Copyright © © The Author(s) 2020
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                Date received : 27 February 2020
                Date accepted : 27 March 2020
                Categories
                Subject: Review
                Custom metadata
                issue-copyright-statement © Japanese Society of Gastroenterology 2020

                ScienceOpen disciplines: Gastroenterology & Hepatology
                Keywords: nonalcoholic fatty liver disease,nonalcoholic steatohepatitis,liver fibrosis,cirrhosis,transient elastography
                Data availability:
                ScienceOpen disciplines: Gastroenterology & Hepatology
                Keywords: nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, liver fibrosis, cirrhosis, transient elastography

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