I. Barchetta, C. Chiappetta, A. Biasio, F. A. Cimini, L. Bertoccini, S. Dule, D. Capoccia, C. Cristofano, G. Silecchia, F. Leonetti, M. Baroni, A. Lenzi, M. Cavallo
Aim: Takeda G-protein-coupled receptor 5 (TGR5) is a functional receptor which mediates a variety of metabolic and immune processes and is involved in the regulation of adipocyte pathophysiology. Data on TGR5 in human adipose tissue are very limited. Therefore, the aims of this study were to investigate TGR5 expression in visceral adipose tissue (VAT) and explore its association with signs of VAT dysfunction and overt metabolic disease in individuals with obesity. Methods: Fifty obese candidates to bariatric surgery were recruited at Sapienza University, Rome, Italy. The expression of TGR5 and markers of VAT dysfunction were assessed by rt-PCR in omental fragments obtained intraoperatively. Page 2 of Barchetta et al. Metab Target Organ Damage 2021;1:8 https://dx.doi.org/10.20517/mtod.2021.04 12 Results: Individuals with higher VAT TGR5 levels (high-TGR5) had greater fasting glucose (P = 0.027) and worse lipid profile (total-cholesterol, P = 0.014; LDL-cholesterol, P = 0.022) than those with lower TGR5 (low-TGR5) expression. High-TGR5 subjects showed significantly higher expression of markers of AT-specific inflammation and insulin resistance, such as tissue metallopeptidase inhibitor 1 (TIMP1; P = 0.011), poly[ADP-ribose]polymerase 1 (PARP1, P = 0.034), and WNT1-inducible-signaling pathway protein 1 (WISP1, P = 0.05), apoptosis (caspase 7, P = 0.031), and lipid trafficking (ANGPTL4, P < 0.001), compared to low-TGR5 patients. High VAT TGR5 expression predicted the presence of abnormal glucose metabolism with AUROC = 0.925 (95%CI: 0.827-1.00, P = 0.001) for the age-, sex-, and waist circumference-adjusted ROC curve. Conclusion: Our data show that increased VAT TGR5 is associated with VAT dysfunction and impaired lipid trafficking and predicts the presence of metabolic disorders in human obesity, overall adding novel insights to the understanding of TGR5-mediated pathways in the clinical setting.
目的:Takeda g蛋白偶联受体5 (Takeda G-protein-coupled receptor 5, TGR5)是一种介导多种代谢和免疫过程并参与脂肪细胞病理生理调节的功能性受体。关于人体脂肪组织中TGR5的数据非常有限。因此，本研究的目的是研究TGR5在内脏脂肪组织(VAT)中的表达，并探讨其与肥胖个体中VAT功能障碍和显性代谢疾病的关系。方法:在意大利罗马Sapienza大学招募50例肥胖手术候选者。术中获取大网膜碎片，采用rt-PCR检测TGR5及VAT功能障碍标志物的表达。Barchetta等人的第二页。结果:VAT TGR5水平较高(高TGR5)的个体空腹血糖较高(P = 0.027)，血脂状况较差(总胆固醇，P = 0.014;低密度脂蛋白胆固醇(LDL-cholesterol, P = 0.022)比TGR5低表达组(low-TGR5)高。高tgr5水平受试者的at特异性炎症和胰岛素抵抗标志物的表达显著增加，如组织金属肽酶抑制剂1 (TIMP1;P = 0.011)、聚[adp -核糖]聚合酶1 (PARP1, P = 0.034)、wnt1诱导信号通路蛋白1 (WISP1, P = 0.05)、细胞凋亡(caspase 7, P = 0.031)和脂质转运(ANGPTL4, P < 0.001)。高VAT TGR5表达预测糖代谢异常，在年龄、性别和腰围校正的ROC曲线上AUROC = 0.925 (95%CI: 0.827-1.00, P = 0.001)。结论:我们的数据显示，VAT TGR5的增加与VAT功能障碍和脂质运输受损有关，并预测人类肥胖中代谢紊乱的存在，总体上为临床环境中对TGR5介导途径的理解增加了新的见解。
{"title":"Expression of TGR5 in adipose tissue in relation to metabolic impairment and adipose tissue dysfunction in human obesity","authors":"I. Barchetta, C. Chiappetta, A. Biasio, F. A. Cimini, L. Bertoccini, S. Dule, D. Capoccia, C. Cristofano, G. Silecchia, F. Leonetti, M. Baroni, A. Lenzi, M. Cavallo","doi":"10.20517/mtod.2021.04","DOIUrl":"https://doi.org/10.20517/mtod.2021.04","url":null,"abstract":"Aim: Takeda G-protein-coupled receptor 5 (TGR5) is a functional receptor which mediates a variety of metabolic and immune processes and is involved in the regulation of adipocyte pathophysiology. Data on TGR5 in human adipose tissue are very limited. Therefore, the aims of this study were to investigate TGR5 expression in visceral adipose tissue (VAT) and explore its association with signs of VAT dysfunction and overt metabolic disease in individuals with obesity. Methods: Fifty obese candidates to bariatric surgery were recruited at Sapienza University, Rome, Italy. The expression of TGR5 and markers of VAT dysfunction were assessed by rt-PCR in omental fragments obtained intraoperatively. Page 2 of Barchetta et al. Metab Target Organ Damage 2021;1:8 https://dx.doi.org/10.20517/mtod.2021.04 12 Results: Individuals with higher VAT TGR5 levels (high-TGR5) had greater fasting glucose (P = 0.027) and worse lipid profile (total-cholesterol, P = 0.014; LDL-cholesterol, P = 0.022) than those with lower TGR5 (low-TGR5) expression. High-TGR5 subjects showed significantly higher expression of markers of AT-specific inflammation and insulin resistance, such as tissue metallopeptidase inhibitor 1 (TIMP1; P = 0.011), poly[ADP-ribose]polymerase 1 (PARP1, P = 0.034), and WNT1-inducible-signaling pathway protein 1 (WISP1, P = 0.05), apoptosis (caspase 7, P = 0.031), and lipid trafficking (ANGPTL4, P < 0.001), compared to low-TGR5 patients. High VAT TGR5 expression predicted the presence of abnormal glucose metabolism with AUROC = 0.925 (95%CI: 0.827-1.00, P = 0.001) for the age-, sex-, and waist circumference-adjusted ROC curve. Conclusion: Our data show that increased VAT TGR5 is associated with VAT dysfunction and impaired lipid trafficking and predicts the presence of metabolic disorders in human obesity, overall adding novel insights to the understanding of TGR5-mediated pathways in the clinical setting.","PeriodicalId":91001,"journal":{"name":"Metabolism and target organ damage","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43089050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-01Epub Date: 2021-07-02DOI: 10.20517/mtod.2021.02
Brian J Wentworth, Stephen H Caldwell
Interpretation of diagnostic and surveillance laboratory results and imaging in liver disease is fraught with misinterpretation and/or uncertainty. Nonalcoholic fatty liver disease (NAFLD) represents an ever-growing proportion of liver disease cases but presents unique challenges for the clinician. Given the necessity of excluding other etiologies of liver disease, NAFLD can at times represent a challenging diagnosis as non-invasive assessment and biopsy are imperfect tests with important limitations. Similarly, cautious review of laboratory reports is necessary to avoid missing abnormal pathophysiology. The presence of lab values within the standard reference range may be concerning in the setting of chronic liver disease ("abnormally normal") and conversely results flagged as abnormal may not necessarily be of great concern ("normally abnormal"). This review provides a framework for the clinician to review common diagnostic challenges in NAFLD and enhance patient care.
{"title":"Pearls and pitfalls in nonalcoholic fatty liver disease: tricky results are common.","authors":"Brian J Wentworth, Stephen H Caldwell","doi":"10.20517/mtod.2021.02","DOIUrl":"https://doi.org/10.20517/mtod.2021.02","url":null,"abstract":"<p><p>Interpretation of diagnostic and surveillance laboratory results and imaging in liver disease is fraught with misinterpretation and/or uncertainty. Nonalcoholic fatty liver disease (NAFLD) represents an ever-growing proportion of liver disease cases but presents unique challenges for the clinician. Given the necessity of excluding other etiologies of liver disease, NAFLD can at times represent a challenging diagnosis as non-invasive assessment and biopsy are imperfect tests with important limitations. Similarly, cautious review of laboratory reports is necessary to avoid missing abnormal pathophysiology. The presence of lab values within the standard reference range may be concerning in the setting of chronic liver disease (\"abnormally normal\") and conversely results flagged as abnormal may not necessarily be of great concern (\"normally abnormal\"). This review provides a framework for the clinician to review common diagnostic challenges in NAFLD and enhance patient care.</p>","PeriodicalId":91001,"journal":{"name":"Metabolism and target organ damage","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9455931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33459703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nonalcoholic fatty liver disease (NAFLD) is emerging as the most common etiology for chronic liver disease. Despite this, our understanding of this illness is lacking. The previous paradigm is that central adiposity, hyperlipidemia, hypertension, and insulin resistance, also known as metabolic syndrome, lead to NAFLD, and this relationship is unidirectional. However, recent evidence clearly shows that the clinical burden of this illness extends well beyond liver-related morbidity and mortality and is associated with multiple extrahepatic complications, particularly metabolic consequences. Due to this, the professional consensus has proposed using the term metabolic associated fatty liver disease (MAFLD) to more accurately reflect pathogenesis and help in patient stratification for management. This review discusses the shared pathophysiological mechanisms that link these diseases and how this can be leveraged to prevent these complications in individuals with NAFLD/MAFLD.
{"title":"Risk of cardio-nephro-metabolic disease from NAFLD to MAFLD: fact or fiction?","authors":"R. Hassouneh, M. Siddiqui, C. Bhati","doi":"10.20517/mtod.2021.07","DOIUrl":"https://doi.org/10.20517/mtod.2021.07","url":null,"abstract":"Nonalcoholic fatty liver disease (NAFLD) is emerging as the most common etiology for chronic liver disease. Despite this, our understanding of this illness is lacking. The previous paradigm is that central adiposity, hyperlipidemia, hypertension, and insulin resistance, also known as metabolic syndrome, lead to NAFLD, and this relationship is unidirectional. However, recent evidence clearly shows that the clinical burden of this illness extends well beyond liver-related morbidity and mortality and is associated with multiple extrahepatic complications, particularly metabolic consequences. Due to this, the professional consensus has proposed using the term metabolic associated fatty liver disease (MAFLD) to more accurately reflect pathogenesis and help in patient stratification for management. This review discusses the shared pathophysiological mechanisms that link these diseases and how this can be leveraged to prevent these complications in individuals with NAFLD/MAFLD.","PeriodicalId":91001,"journal":{"name":"Metabolism and target organ damage","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45862247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In this review, we discuss selected topics which are
在这篇综述中，我们讨论的主题是
{"title":"Precision medicine approaches in metabolic disorders and target organ damage: where are we now, and where are we going?","authors":"A. Lonardo, C. Byrne, G. Targher","doi":"10.20517/mtod.2021.03","DOIUrl":"https://doi.org/10.20517/mtod.2021.03","url":null,"abstract":"In this review, we discuss selected topics which are","PeriodicalId":91001,"journal":{"name":"Metabolism and target organ damage","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43604156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Mantovani, Giorgia Beatrice, C. Zusi, A. Dalbeni
Sentiment analysis is a technique for exploring a piece of text with the aim to investigate sentiments hidden within it. The use of sentiment analysis in health care could assist in understanding how individuals discuss and feel about a specific topic. Currently, there are scarce data regarding the use of sentiment analysis related to nonalcoholic fatty liver disease (NAFLD), which is the most common chronic liver disease worldwide and is associated with hepatic and extra-hepatic complications. Hence, the aim of this report was to assess the sentiments of NAFLD expressed in messages posted on Twitter, one of the most popular social media platforms worldwide. We chose the hashtags #FattyLiver, #NAFLD, #NASH, and #MAFLD as terms to identify the messages related to NAFLD on Twitter. Messages containing at least one of these hashtags were collected using the standard Application Programming Interface provided by Twitter. The sentiment analysis revealed that sentiments hidden within messages related to NAFLD were substantially neutral and that “breastcancer” and “cancer” were two of the most common words used, suggesting that a large part of messages focused on the relationship between NAFLD and extra-hepatic cancers. Conversely, the association between NAFLD and cardiovascular disease seems to be less relevant for Twitter community. These observations might be useful for developing better public health strategies and for promoting a constructive attitude among subjects that read and discuss about NAFLD (and its complications) on social media. Page 2 of Mantovani et al. Metab Target Organ Damage 2021;1:6 https://dx.doi.org/10.20517/mtod.2021.09 5
{"title":"Nonalcoholic fatty liver disease on Twitter: a sentiment analysis","authors":"A. Mantovani, Giorgia Beatrice, C. Zusi, A. Dalbeni","doi":"10.20517/mtod.2021.09","DOIUrl":"https://doi.org/10.20517/mtod.2021.09","url":null,"abstract":"Sentiment analysis is a technique for exploring a piece of text with the aim to investigate sentiments hidden within it. The use of sentiment analysis in health care could assist in understanding how individuals discuss and feel about a specific topic. Currently, there are scarce data regarding the use of sentiment analysis related to nonalcoholic fatty liver disease (NAFLD), which is the most common chronic liver disease worldwide and is associated with hepatic and extra-hepatic complications. Hence, the aim of this report was to assess the sentiments of NAFLD expressed in messages posted on Twitter, one of the most popular social media platforms worldwide. We chose the hashtags #FattyLiver, #NAFLD, #NASH, and #MAFLD as terms to identify the messages related to NAFLD on Twitter. Messages containing at least one of these hashtags were collected using the standard Application Programming Interface provided by Twitter. The sentiment analysis revealed that sentiments hidden within messages related to NAFLD were substantially neutral and that “breastcancer” and “cancer” were two of the most common words used, suggesting that a large part of messages focused on the relationship between NAFLD and extra-hepatic cancers. Conversely, the association between NAFLD and cardiovascular disease seems to be less relevant for Twitter community. These observations might be useful for developing better public health strategies and for promoting a constructive attitude among subjects that read and discuss about NAFLD (and its complications) on social media. Page 2 of Mantovani et al. Metab Target Organ Damage 2021;1:6 https://dx.doi.org/10.20517/mtod.2021.09 5","PeriodicalId":91001,"journal":{"name":"Metabolism and target organ damage","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67659032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In a time of food abundance and waste, and when sedentarism is the norm, metabolic-associated fatty liver disease (MAFLD) has become a major health threat in the Western world. While research is committed to finding a pharmacological treatment for MAFLD, it is time to go back to the basis and address the behavioral pathogenesis of MAFLD. All patients with MAFLD, irrespective of body weight, should be submitted to thorough dietary counseling. Diet is a learned behavior and should be addressed holistically and in a personalized fashion. The benefits of a suitable diet surpass an improvement of liver disease, having the potential to improve cardiovascularand cancer-related mortality, in patients with MAFLD. This review summarizes the current state of the art of diet on MAFLD, presenting straightforward recommendations for everyday practice.
{"title":"What should we advise MAFLD patients to eat and drink?","authors":"M. Machado","doi":"10.20517/mtod.2021.11","DOIUrl":"https://doi.org/10.20517/mtod.2021.11","url":null,"abstract":"In a time of food abundance and waste, and when sedentarism is the norm, metabolic-associated fatty liver disease (MAFLD) has become a major health threat in the Western world. While research is committed to finding a pharmacological treatment for MAFLD, it is time to go back to the basis and address the behavioral pathogenesis of MAFLD. All patients with MAFLD, irrespective of body weight, should be submitted to thorough dietary counseling. Diet is a learned behavior and should be addressed holistically and in a personalized fashion. The benefits of a suitable diet surpass an improvement of liver disease, having the potential to improve cardiovascularand cancer-related mortality, in patients with MAFLD. This review summarizes the current state of the art of diet on MAFLD, presenting straightforward recommendations for everyday practice.","PeriodicalId":91001,"journal":{"name":"Metabolism and target organ damage","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67659046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Lonardo, S. Ballestri, G. Bedogni, S. Bellentani, C. Tiribelli
The Fatty Liver Index (FLI) is a non-invasive biomarker proposed, in 2006, by Bedogni’s group, to aid in identifying patients with suspected nonalcoholic fatty liver disease (NAFLD) to be submitted to liver ultrasonography to confirm steatosis. Criteria of Assessment of Narrative Review Articles, a scale for the assessment of quality of narrative review articles, inspired our review article, which aims at evaluating the scope of published articles on FLI issued over the last 15-year period. The analysis of retrieved data identified the following conclusions. First, given that FLI and NAFLD share the same risk factors, FLI can be used to identify NAFLD among populations at risk to be submitted to screening. Second, FLI is able to identify the hazard of atherosclerosis, both at a subclinical stage and as an overt disease. Third, FLI detects incident diabetes and chronic kidney disease. However, evidence supporting the notion that FLI also predicts the metabolic syndrome, some endocrine disorders, certain tumor types, and overall and cause-specific mortality appears to be more limited. In conclusion, 15 years after its first publication, FLI has been validated as a robust biomarker of both steatosis and NAFLD. Moreover, the scope of FLI has been expanded to previously unexpected areas. Finally, we discuss FLI limitations and a research agenda aimed at further improving the accuracy of FLI scores in predicting liver-related outcomes, endocrine-metabolic disorders, cancer risk, and survival. Page 2 of Lonardo et al. Metab Target Organ Damage 2021;1:10 https://dx.doi.org/10.20517/mtod.2021.08 20
{"title":"The Fatty liver Index (FLI) 15 years later: a reappraisal","authors":"A. Lonardo, S. Ballestri, G. Bedogni, S. Bellentani, C. Tiribelli","doi":"10.20517/mtod.2021.08","DOIUrl":"https://doi.org/10.20517/mtod.2021.08","url":null,"abstract":"The Fatty Liver Index (FLI) is a non-invasive biomarker proposed, in 2006, by Bedogni’s group, to aid in identifying patients with suspected nonalcoholic fatty liver disease (NAFLD) to be submitted to liver ultrasonography to confirm steatosis. Criteria of Assessment of Narrative Review Articles, a scale for the assessment of quality of narrative review articles, inspired our review article, which aims at evaluating the scope of published articles on FLI issued over the last 15-year period. The analysis of retrieved data identified the following conclusions. First, given that FLI and NAFLD share the same risk factors, FLI can be used to identify NAFLD among populations at risk to be submitted to screening. Second, FLI is able to identify the hazard of atherosclerosis, both at a subclinical stage and as an overt disease. Third, FLI detects incident diabetes and chronic kidney disease. However, evidence supporting the notion that FLI also predicts the metabolic syndrome, some endocrine disorders, certain tumor types, and overall and cause-specific mortality appears to be more limited. In conclusion, 15 years after its first publication, FLI has been validated as a robust biomarker of both steatosis and NAFLD. Moreover, the scope of FLI has been expanded to previously unexpected areas. Finally, we discuss FLI limitations and a research agenda aimed at further improving the accuracy of FLI scores in predicting liver-related outcomes, endocrine-metabolic disorders, cancer risk, and survival. Page 2 of Lonardo et al. Metab Target Organ Damage 2021;1:10 https://dx.doi.org/10.20517/mtod.2021.08 20","PeriodicalId":91001,"journal":{"name":"Metabolism and target organ damage","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67658977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Ballestri, A. Mantovani, C. Byrne, A. Lonardo, G. Targher
Aim: We examined the diagnostic accuracy of ultrasonography to detect any HS (defined as steatotic hepatocytes ≥ 5% on histology) and moderate-severe HS (defined as steatotic hepatocytes ≥ 30% on histology) by performing a systematic review and meta-analysis. Methods: We systematically searched PubMed, Web of Science, and Scopus databases, from January 2011 to February 2021, to identify studies conducted in adults investigating the diagnostic accuracy of ultrasonography vs . histology for detecting either ≥ 5% histologically defined HS or moderate-severe HS ( ≥ 30%). Meta-analysis was performed using random-effects modeling. Results: Twelve studies were included involving a total of 2921 individuals, 1710 (58.5%) of whom had HS ≥ 5% by histology. The overall sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of ultrasonography for the detection of ≥ 5% histologically defined HS, compared to histology, were 82% (95%
目的:我们通过系统回顾和meta分析，检查超声检查任何HS(定义为组织学上脂肪变性肝细胞≥5%)和中重度HS(定义为组织学上脂肪变性肝细胞≥30%)的诊断准确性。方法:从2011年1月到2021年2月，我们系统地检索了PubMed、Web of Science和Scopus数据库，以确定在成人中进行的研究，调查超声检查与组织学诊断≥5% HS或中重度HS(≥30%)的诊断准确性。采用随机效应模型进行meta分析。结果:12项研究共纳入2921例患者，其中组织学HS≥5%的患者1710例(58.5%)。超声检测≥5%组织学定义的HS的总体敏感性、特异性、阳性似然比和阴性似然比与组织学相比为82% (Ballestri et al.页2 95%)。Metab靶器官损伤2021;1:7 https://dx.doi.org/10.20517/mtod.2021.05 15置信区间分别为76%-86%，80%(72%-86%)，4.0(2.90-5.70)，0.23(0.18-0.30)。汇总分析7项研究，超声检查组织学定义≥30%的HS的总体敏感性为85%(72% ~ 92%)，特异性为85%(73% ~ 93%)，阳性似然比为5.72(3.06 ~ 10.7)，阴性似然比为0.18(0.10 ~ 0.33)。漏斗图未显示任何显著的发表偏倚。结论:与组织学检查相比，常规超声检查可可靠、准确地检测出≥5%的组织学定义的HS。这些发现要求在临床领域广泛使用常规超声检查。
{"title":"Diagnostic accuracy of ultrasonography for the detection of hepatic steatosis: an updated meta-analysis of observational studies","authors":"S. Ballestri, A. Mantovani, C. Byrne, A. Lonardo, G. Targher","doi":"10.20517/mtod.2021.05","DOIUrl":"https://doi.org/10.20517/mtod.2021.05","url":null,"abstract":"Aim: We examined the diagnostic accuracy of ultrasonography to detect any HS (defined as steatotic hepatocytes ≥ 5% on histology) and moderate-severe HS (defined as steatotic hepatocytes ≥ 30% on histology) by performing a systematic review and meta-analysis. Methods: We systematically searched PubMed, Web of Science, and Scopus databases, from January 2011 to February 2021, to identify studies conducted in adults investigating the diagnostic accuracy of ultrasonography vs . histology for detecting either ≥ 5% histologically defined HS or moderate-severe HS ( ≥ 30%). Meta-analysis was performed using random-effects modeling. Results: Twelve studies were included involving a total of 2921 individuals, 1710 (58.5%) of whom had HS ≥ 5% by histology. The overall sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of ultrasonography for the detection of ≥ 5% histologically defined HS, compared to histology, were 82% (95%","PeriodicalId":91001,"journal":{"name":"Metabolism and target organ damage","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67658967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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