The prevalence of nonalcoholic fatty liver disease in Chinese adults screened by vibration controlled transient elastography and its diagnostic discrepancy compared with ultrasound - 01/10/22
, Ci Song a, b, ⁎ Highlights |
• | What is already known on this subject? Ultrasound and vibration controlled transient elastography (VCTE) are more commonly used for non-alcoholic fatty liver disease (NAFLD) screening. |
• | What are the new findings? VCTE can identify participants who were older, fatter, had a worse metabolic and biochemical profile when compared with ultrasound. |
• | How might it impact on clinical practice in the foreseeable future? VCTE is suggested as a more practical non-invasive tool for the screening and follow-up of NAFLD in China. |
Abstract |
Background |
The prevalence of non-alcoholic fatty liver disease (NAFLD) in China as assessed using vibration-controlled transient elastography (VCTE) and its consistency with ultrasound is still unknown. We aimed to conduct a head-to-head comparison of consecutive measurements of NAFLD with ultrasound or VCTE to evaluate the discrepancy in the prevalence and distribution of NAFLD screened by two non-invasive techniques.
Methods |
We collected VCTE and ultrasound examination data from 4,388 participants who underwent health check-ups at the Health Promotion Center of Jiangsu Province Hospital between January 2017 and December 2019. The major outcome was the presence of hepatic steatosis, which was defined as a median controlled attenuation parameter (CAP) ≥ 248 dB/m by VCTE or the definition of steatosis by ultrasound.
Results |
Among the 4,388 participants, 2,214 were diagnosed with NAFLD by VCTE (CAP ≥ 248 dB/m, 50.46%). Participants with severe steatosis (CAP ≥ 280 dB/m) were commonly male (77.94% vs. 50.38%, P < 0.001), were obese (45.09% vs. 1.79%, P < 0.001), had a worse metabolic profile, had elevated liver enzyme levels, and had advanced fibrosis. The prevalence of ultrasound-diagnosed NAFLD was 56.42%. After consistency analysis, VCTE and ultrasound showed moderate agreement regarding the diagnosis of NAFLD (κ = 0.475). We then compared the characteristics and clinical features of the four groups classified by the diagnosis results of the two techniques. NAFLD participants diagnosed by VCTE only were older, more obese, and had worse metabolic and biochemical profiles than NAFLD participants diagnosed by ultrasound only; in particular, the former had a higher proportion of abnormal alanine aminotransferase and aspartate aminotransferase levels and a higher proportion of advanced fibrosis than the latter.
Conclusions |
More than half of Chinese adults were affected by NAFLD according to VCTE. Screening based on VCTE is more likely to identify NAFLD patients with severe clinical features than ultrasound. Therefore, VCTE is a more practical non-invasive tool for the screening and follow-up of NAFLD in China.
Le texte complet de cet article est disponible en PDF.Keywords : NAFLD, Prevalence, VCTE, Ultrasound
Abbreviations : NAFLD, VCTE, CAP, LSM, BMI, HbA1c, ALT, AST, GGT, FIB-4, APRI, LDL, HDL, ALP, AFP, IQR, SD
Plan
Vol 46 - N° 8
Article 101951- octobre 2022 Retour au numéro
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