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Использование контролируемого параметра затухания ультразвукового сигнала для диагностики неалкогольной жировой болезни печени
Использование контролируемого параметра затухания ультразвукового сигнала для диагностики неалкогольной жировой болезни печени
Гончаров А.А., Сасунова А.Н., Пилипенко В.И., Исаков В.А. Использование контролируемого параметра затухания ультразвукового сигнала для диагностики неалкогольной жировой болезни печени. Терапевтический архив. 2023;95(8):641–647. DOI: 10.26442/00403660.2023.08.202348
© ООО «КОНСИЛИУМ МЕДИКУМ», 2023 г.
DOI: 10.26442/00403660.2023.08.202348
© ООО «КОНСИЛИУМ МЕДИКУМ», 2023 г.
________________________________________________
DOI: 10.26442/00403660.2023.08.202348
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
Цель. Изучить эффективность использования транзиентной эластографии с контролируемой вибрацией (VCTE) с контролируемым параметром затухания (CAP) в популяции пациентов с неалкогольной жировой болезнью печени (НАЖБП).
Материалы и методы. Проведен ретроспективный анализ базы данных пациентов с НАЖБП, сформированной в период с 2021 по 2023 г. Оценка VCTE с CAP проводилась при помощи двух эластографов – FibroScan 530® и FibroScan 630 Expert®. Оценивались данные ультразвукового исследования (УЗИ) печени, показатели биохимического анализа крови, липидного и углеводного обмена, вычислялись индексы HSI, FLI, проведена оценка риска НАЖБП согласно шкалам BAAT и NAFLD-LFS.
Результаты. Конечном анализу оказались доступны данные 1081 пациента (385 – в группе простого стеатоза, 274 – в группе неалкогольного стеатогепатита, 422 – контрольная группа). Чувствительность и специфичность УЗИ для диагностики стеатоза печени составили 94,6 и 63,7% соответственно по сравнению с VCTE с CAP. Диагностика стеатоза печени при помощи индексов и шкал показала чувствительность и специфичность HSI: 97,9 и 60,1% (AUROC 0,90), FLI: 92,5 и 85,3% (AUROC 0,93), BAAT: 76,6 и 73,5% (AUROC 0,82), NAFLD-LFS: 56,7 и 81,8% (AUROC 0,85).
Заключение. Подтверждена высокая чувствительность УЗИ в диагностике стеатоза печени, однако его специфичность оказалась низкой по сравнению с VCTE с CAP. Из изученных в исследовании индексов и шкал наилучшими показателями чувствительности и специфичности в отношении диагностики стеатоза печени обладал индекс HSI. Комбинация УЗИ печени и индекса HSI может быть использована для первичного скрининга стеатоза печени, однако для формирования диагноза необходимо использование более точных методов, сочетающих в себе диагностику как стеатоза, так и фиброза печени.
Ключевые слова: CAP, неалкогольная жировая болезнь печени, неалкогольный стеатогепатит, VCTE
Materials and methods. Single center NAFLD patients’ database of 2021–2023 years was retrospectively analysed. Data of VCTE evaluation with CAP (FibroScan 530® and FibroScan 630 Expert®) as well as liver US examination results and values of HSI, FLI, BAAT and NAFLD-LFS were extracted. AUROCs for all methods used were constructed and sensitivity and specificity analysis was performed.
Results. The data of 1081 patients were available for analysis (385 with steatosis, 274 with NASH, 422 without NAFLD as a control). Ultrasound examination in the diagnosis of liver steatosis compared to VCTE with CAP showed sensitivity and specificity of 94.6 and 63.7%, respectively. Diagnosis of liver steatosis using indices and scales showed sensitivity and specificity of HSI: 97.9 and 60.1% (AUROC 0.90), FLI: 92.5 and 85.3% (AUROC 0.93), BAAT: 76.6 and 73.5% (AUROC 0.82), NAFLD-LFS: 56.7 and 81.8% (AUROC 0.85).
Conclusion. The sensitivity of the US of the liver was consistent with previous studies, but the specificity was low. The HSI index had the best indicators of sensitivity and specificity in relation to the diagnosis of liver steatosis. Combination of liver US and HSI can be used in screening of liver steatosis, however, for the complete diagnosis better tools which can simultaneously evaluate liver steatosis and fibrosis should be used.
Keywords: CAP, non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, VCTE
Материалы и методы. Проведен ретроспективный анализ базы данных пациентов с НАЖБП, сформированной в период с 2021 по 2023 г. Оценка VCTE с CAP проводилась при помощи двух эластографов – FibroScan 530® и FibroScan 630 Expert®. Оценивались данные ультразвукового исследования (УЗИ) печени, показатели биохимического анализа крови, липидного и углеводного обмена, вычислялись индексы HSI, FLI, проведена оценка риска НАЖБП согласно шкалам BAAT и NAFLD-LFS.
Результаты. Конечном анализу оказались доступны данные 1081 пациента (385 – в группе простого стеатоза, 274 – в группе неалкогольного стеатогепатита, 422 – контрольная группа). Чувствительность и специфичность УЗИ для диагностики стеатоза печени составили 94,6 и 63,7% соответственно по сравнению с VCTE с CAP. Диагностика стеатоза печени при помощи индексов и шкал показала чувствительность и специфичность HSI: 97,9 и 60,1% (AUROC 0,90), FLI: 92,5 и 85,3% (AUROC 0,93), BAAT: 76,6 и 73,5% (AUROC 0,82), NAFLD-LFS: 56,7 и 81,8% (AUROC 0,85).
Заключение. Подтверждена высокая чувствительность УЗИ в диагностике стеатоза печени, однако его специфичность оказалась низкой по сравнению с VCTE с CAP. Из изученных в исследовании индексов и шкал наилучшими показателями чувствительности и специфичности в отношении диагностики стеатоза печени обладал индекс HSI. Комбинация УЗИ печени и индекса HSI может быть использована для первичного скрининга стеатоза печени, однако для формирования диагноза необходимо использование более точных методов, сочетающих в себе диагностику как стеатоза, так и фиброза печени.
Ключевые слова: CAP, неалкогольная жировая болезнь печени, неалкогольный стеатогепатит, VCTE
________________________________________________
Materials and methods. Single center NAFLD patients’ database of 2021–2023 years was retrospectively analysed. Data of VCTE evaluation with CAP (FibroScan 530® and FibroScan 630 Expert®) as well as liver US examination results and values of HSI, FLI, BAAT and NAFLD-LFS were extracted. AUROCs for all methods used were constructed and sensitivity and specificity analysis was performed.
Results. The data of 1081 patients were available for analysis (385 with steatosis, 274 with NASH, 422 without NAFLD as a control). Ultrasound examination in the diagnosis of liver steatosis compared to VCTE with CAP showed sensitivity and specificity of 94.6 and 63.7%, respectively. Diagnosis of liver steatosis using indices and scales showed sensitivity and specificity of HSI: 97.9 and 60.1% (AUROC 0.90), FLI: 92.5 and 85.3% (AUROC 0.93), BAAT: 76.6 and 73.5% (AUROC 0.82), NAFLD-LFS: 56.7 and 81.8% (AUROC 0.85).
Conclusion. The sensitivity of the US of the liver was consistent with previous studies, but the specificity was low. The HSI index had the best indicators of sensitivity and specificity in relation to the diagnosis of liver steatosis. Combination of liver US and HSI can be used in screening of liver steatosis, however, for the complete diagnosis better tools which can simultaneously evaluate liver steatosis and fibrosis should be used.
Keywords: CAP, non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, VCTE
Полный текст
Список литературы
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7. Mantovani A, Petracca G, Beatrice G, et al. Non-alcoholic fatty liver disease and increased risk of incident extrahepatic cancers: a meta-analysis of observational cohort studies. Gut. 2022;71(4):778-88. DOI:10.1136/gutjnl-2021-324191
8. European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. Diabetologia. 2016;59(6):1121-40. DOI:10.1007/s00125-016-3902-y
9. Nogami A, Yoneda M, Iwaki M, et al. Diagnostic comparison of vibration-controlled transient elastography and MRI techniques in overweight and obese patients with NAFLD. Sci Rep. 2022;12(1):21925. DOI:10.1038/s41598-022-25843-6
10. Лазебник Л.Б., Голованова Е.В., Туркина С.В., и др. Неалкогольная жировая болезнь печени у взрослых: клиника, диагностика, лечение. Рекомендации для терапевтов, третья версия. Экспериментальная и клиническая гастроэнтерология. 2021;185(1):4-52 [Lazebnik LB, Golovanova EV, Turkina SV, et al. Non-alcoholic fatty liver disease in adults: clinic, diagnostics, treatment. Guidelines for therapists, third version. Experimental and Clinical Gastroenterology. 2021;1(1):4-52 (in Russian)]. DOI:10.31146/1682-8658-ecg-185-1-4-52
11. Ивашкин В.Т., Маевская М.В., Павлов Ч.С., и др. Клинические рекомендации Российского общества по изучению печени и Российской гастроэнтерологической ассоциации по лечению осложнений цирроза печени. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2016;26(4):71-102 [Ivashkin VT, Mayevskaya MV, Pavlov ChS, et al. Treatment of liver cirrhosis complications: Clinical guidelines of the Russian Scientific Liver Society and Russian gastroenterological association. Rossiiskii zhurnal gastroenterolpgii, gepatologii, koloproktologii. 2016;26(4):71-102 (in Russian)]. DOI:10.22416/1382-4376-2016-26-4-71-102
12. Клинические рекомендации от 2021 г. «Хронический вирусный гепатит С». Режим доступа: https://medi.ru/klinicheskie-rekomendatsii/khronicheskij-virusnyj-gepatit-s-khvgs-u-vzroslykh_14028. Ссылка активна на 17.05.2023 [Clinical guidelines from 2021 “Chronic viral hepatitis C”. Available at: https://medi.ru/klinicheskie-rekomendatsii/khronicheskij-virusnyj-gepatit-s-khvgs-u-vzroslykh_14028. Accessed: 17.05.2023 (in Russian)].
13. Jiang W, Huang S, Teng H, et al. Diagnostic accuracy of point shear wave elastography and transient elastography for staging hepatic fibrosis in patients with non-alcoholic fatty liver disease: a meta-analysis. BMJ Open. 2018;8(8):e021787. DOI:10.1136/bmjopen-2018-021787
14. Zhang X, Wong GL, Wong VW. Application of transient elastography in nonalcoholic fatty liver disease. Clin Mol Hepatol. 2020;26(2):128-41. DOI:10.3350/cmh.2019.0001n
15. Sasso M, Beaugrand M, de Ledinghen V, et al. Controlled attenuation parameter (CAP): a novel VCTE™ guided ultrasonic attenuation measurement for the evaluation of hepatic steatosis: preliminary study and validation in a cohort of patients with chronic liver disease from various causes. Ultrasound Med Biol. 2010;36(11):1825-35. DOI:10.1016/j.ultrasmedbio.2010.07.005
16. Pu K, Wang Y, Bai S, et al. Diagnostic accuracy of controlled attenuation parameter (CAP) as a non-invasive test for steatosis in suspected non-alcoholic fatty liver disease: a systematic review and meta-analysis. BMC Gastroenterol. 2019;19(1):51. DOI:10.1186/s12876-019-0961-9
17. Tsochatzis EA, Gurusamy KS, Ntaoula S, et al. Elastography for the diagnosis of severity of fibrosis in chronic liver disease: a meta-analysis of diagnostic accuracy. J Hepatol. 2011;54(4):650-9. DOI:10.1016/j.jhep.2010.07.033
18. Karlas T, Petroff D, Sasso M, et al. Individual patient data meta-analysis of controlled attenuation parameter (CAP) technology for assessing steatosis. J Hepatol.
2017;66(5):1022-30. DOI:10.1016/j.jhep.2016.12.022
19. Contreras D, González-Rocha A, Clark P, et al. Diagnostic accuracy of blood biomarkers and non-invasive scores for the diagnosis of NAFLD and NASH: Systematic review and meta-analysis. Ann Hepatol. 2023;28(1):100873. DOI:10.1016/j.aohep.2022.100873
20. Fedchuk L, Nascimbeni F, Pais R, et al. Performance and limitations of steatosis biomarkers in patients with nonalcoholic fatty liver disease. Aliment Pharmacol Ther. 2014;40(10):1209-22. DOI:10.1111/apt.12963
21. Hernaez R, Lazo M, Bonekamp S, et al. Diagnostic accuracy and reliability of ultrasonography for the detection of fatty liver: a meta-analysis. Hepatology. 2011;54(3):1082-90. DOI:10.1002/hep.24452
22. Leivas G, Maraschin CK, Blume CA, et al. Accuracy of ultrasound diagnosis of nonalcoholic fatty liver disease in patients with classes II and III obesity: A pathological image study. Obes Res Clin Pract. 2021;15(5):461-5. DOI:10.1016/j.orcp.2021.09.002
2. Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64(1):73-84. DOI:10.1002/hep.28431
3. Le MH, Yeo YH, Li X, et al. 2019 Global NAFLD Prevalence: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol. 2021;S1542-3565(21):01280-5. DOI:10.1016/j.cgh.2021.12.002
4. Mitra S, De A, Chowdhury A. Epidemiology of non-alcoholic and alcoholic fatty liver diseases. Transl Gastroenterol Hepatol. 2020;5:16. DOI:10.21037/tgh.2019.09.08
5. Ciardullo S, Grassi G, Mancia G, Perseghin G. Nonalcoholic fatty liver disease and risk of incident hypertension: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol. 2022;34(4):365-71. DOI:10.1097/MEG.0000000000002299
6. Alon L, Corica B, Raparelli V, et al. Risk of cardiovascular events in patients with non-alcoholic fatty liver disease: a systematic review and meta-analysis. Eur J Prev Cardiol. 2022;29(6):938-46. DOI:10.1093/eurjpc/zwab212
7. Mantovani A, Petracca G, Beatrice G, et al. Non-alcoholic fatty liver disease and increased risk of incident extrahepatic cancers: a meta-analysis of observational cohort studies. Gut. 2022;71(4):778-88. DOI:10.1136/gutjnl-2021-324191
8. European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. Diabetologia. 2016;59(6):1121-40. DOI:10.1007/s00125-016-3902-y
9. Nogami A, Yoneda M, Iwaki M, et al. Diagnostic comparison of vibration-controlled transient elastography and MRI techniques in overweight and obese patients with NAFLD. Sci Rep. 2022;12(1):21925. DOI:10.1038/s41598-022-25843-6
10. Lazebnik LB, Golovanova EV, Turkina SV, et al. Non-alcoholic fatty liver disease in adults: clinic, diagnostics, treatment. Guidelines for therapists, third version. Experimental and Clinical Gastroenterology. 2021;1(1):4-52 (in Russian). DOI:10.31146/1682-8658-ecg-185-1-4-52
11. Ivashkin VT, Mayevskaya MV, Pavlov ChS, et al. Treatment of liver cirrhosis complications: Clinical guidelines of the Russian Scientific Liver Society and Russian gastroenterological association. Rossiiskii zhurnal gastroenterolpgii, gepatologii, koloproktologii. 2016;26(4):71-102 (in Russian). DOI:10.22416/1382-4376-2016-26-4-71-102
12. Clinical guidelines from 2021 “Chronic viral hepatitis C”. Available at: https://medi.ru/klinicheskie-rekomendatsii/khronicheskij-virusnyj-gepatit-s-khvgs-u-vzroslykh_14028. Accessed: 17.05.2023 (in Russian).
13. Jiang W, Huang S, Teng H, et al. Diagnostic accuracy of point shear wave elastography and transient elastography for staging hepatic fibrosis in patients with non-alcoholic fatty liver disease: a meta-analysis. BMJ Open. 2018;8(8):e021787. DOI:10.1136/bmjopen-2018-021787
14. Zhang X, Wong GL, Wong VW. Application of transient elastography in nonalcoholic fatty liver disease. Clin Mol Hepatol. 2020;26(2):128-41. DOI:10.3350/cmh.2019.0001n
15. Sasso M, Beaugrand M, de Ledinghen V, et al. Controlled attenuation parameter (CAP): a novel VCTE™ guided ultrasonic attenuation measurement for the evaluation of hepatic steatosis: preliminary study and validation in a cohort of patients with chronic liver disease from various causes. Ultrasound Med Biol. 2010;36(11):1825-35. DOI:10.1016/j.ultrasmedbio.2010.07.005
16. Pu K, Wang Y, Bai S, et al. Diagnostic accuracy of controlled attenuation parameter (CAP) as a non-invasive test for steatosis in suspected non-alcoholic fatty liver disease: a systematic review and meta-analysis. BMC Gastroenterol. 2019;19(1):51. DOI:10.1186/s12876-019-0961-9
17. Tsochatzis EA, Gurusamy KS, Ntaoula S, et al. Elastography for the diagnosis of severity of fibrosis in chronic liver disease: a meta-analysis of diagnostic accuracy. J Hepatol. 2011;54(4):650-9. DOI:10.1016/j.jhep.2010.07.033
18. Karlas T, Petroff D, Sasso M, et al. Individual patient data meta-analysis of controlled attenuation parameter (CAP) technology for assessing steatosis. J Hepatol.
2017;66(5):1022-30. DOI:10.1016/j.jhep.2016.12.022
19. Contreras D, González-Rocha A, Clark P, et al. Diagnostic accuracy of blood biomarkers and non-invasive scores for the diagnosis of NAFLD and NASH: Systematic review and meta-analysis. Ann Hepatol. 2023;28(1):100873. DOI:10.1016/j.aohep.2022.100873
20. Fedchuk L, Nascimbeni F, Pais R, et al. Performance and limitations of steatosis biomarkers in patients with nonalcoholic fatty liver disease. Aliment Pharmacol Ther. 2014;40(10):1209-22. DOI:10.1111/apt.12963
21. Hernaez R, Lazo M, Bonekamp S, et al. Diagnostic accuracy and reliability of ultrasonography for the detection of fatty liver: a meta-analysis. Hepatology. 2011;54(3):1082-90. DOI:10.1002/hep.24452
22. Leivas G, Maraschin CK, Blume CA, et al. Accuracy of ultrasound diagnosis of nonalcoholic fatty liver disease in patients with classes II and III obesity: A pathological image study. Obes Res Clin Pract. 2021;15(5):461-5. DOI:10.1016/j.orcp.2021.09.002
2. Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64(1):73-84. DOI:10.1002/hep.28431
3. Le MH, Yeo YH, Li X, et al. 2019 Global NAFLD Prevalence: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol. 2021;S1542-3565(21):01280-5. DOI:10.1016/j.cgh.2021.12.002
4. Mitra S, De A, Chowdhury A. Epidemiology of non-alcoholic and alcoholic fatty liver diseases. Transl Gastroenterol Hepatol. 2020;5:16. DOI:10.21037/tgh.2019.09.08
5. Ciardullo S, Grassi G, Mancia G, Perseghin G. Nonalcoholic fatty liver disease and risk of incident hypertension: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol. 2022;34(4):365-71. DOI:10.1097/MEG.0000000000002299
6. Alon L, Corica B, Raparelli V, et al. Risk of cardiovascular events in patients with non-alcoholic fatty liver disease: a systematic review and meta-analysis. Eur J Prev Cardiol. 2022;29(6):938-46. DOI:10.1093/eurjpc/zwab212
7. Mantovani A, Petracca G, Beatrice G, et al. Non-alcoholic fatty liver disease and increased risk of incident extrahepatic cancers: a meta-analysis of observational cohort studies. Gut. 2022;71(4):778-88. DOI:10.1136/gutjnl-2021-324191
8. European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. Diabetologia. 2016;59(6):1121-40. DOI:10.1007/s00125-016-3902-y
9. Nogami A, Yoneda M, Iwaki M, et al. Diagnostic comparison of vibration-controlled transient elastography and MRI techniques in overweight and obese patients with NAFLD. Sci Rep. 2022;12(1):21925. DOI:10.1038/s41598-022-25843-6
10. Лазебник Л.Б., Голованова Е.В., Туркина С.В., и др. Неалкогольная жировая болезнь печени у взрослых: клиника, диагностика, лечение. Рекомендации для терапевтов, третья версия. Экспериментальная и клиническая гастроэнтерология. 2021;185(1):4-52 [Lazebnik LB, Golovanova EV, Turkina SV, et al. Non-alcoholic fatty liver disease in adults: clinic, diagnostics, treatment. Guidelines for therapists, third version. Experimental and Clinical Gastroenterology. 2021;1(1):4-52 (in Russian)]. DOI:10.31146/1682-8658-ecg-185-1-4-52
11. Ивашкин В.Т., Маевская М.В., Павлов Ч.С., и др. Клинические рекомендации Российского общества по изучению печени и Российской гастроэнтерологической ассоциации по лечению осложнений цирроза печени. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2016;26(4):71-102 [Ivashkin VT, Mayevskaya MV, Pavlov ChS, et al. Treatment of liver cirrhosis complications: Clinical guidelines of the Russian Scientific Liver Society and Russian gastroenterological association. Rossiiskii zhurnal gastroenterolpgii, gepatologii, koloproktologii. 2016;26(4):71-102 (in Russian)]. DOI:10.22416/1382-4376-2016-26-4-71-102
12. Клинические рекомендации от 2021 г. «Хронический вирусный гепатит С». Режим доступа: https://medi.ru/klinicheskie-rekomendatsii/khronicheskij-virusnyj-gepatit-s-khvgs-u-vzroslykh_14028. Ссылка активна на 17.05.2023 [Clinical guidelines from 2021 “Chronic viral hepatitis C”. Available at: https://medi.ru/klinicheskie-rekomendatsii/khronicheskij-virusnyj-gepatit-s-khvgs-u-vzroslykh_14028. Accessed: 17.05.2023 (in Russian)].
13. Jiang W, Huang S, Teng H, et al. Diagnostic accuracy of point shear wave elastography and transient elastography for staging hepatic fibrosis in patients with non-alcoholic fatty liver disease: a meta-analysis. BMJ Open. 2018;8(8):e021787. DOI:10.1136/bmjopen-2018-021787
14. Zhang X, Wong GL, Wong VW. Application of transient elastography in nonalcoholic fatty liver disease. Clin Mol Hepatol. 2020;26(2):128-41. DOI:10.3350/cmh.2019.0001n
15. Sasso M, Beaugrand M, de Ledinghen V, et al. Controlled attenuation parameter (CAP): a novel VCTE™ guided ultrasonic attenuation measurement for the evaluation of hepatic steatosis: preliminary study and validation in a cohort of patients with chronic liver disease from various causes. Ultrasound Med Biol. 2010;36(11):1825-35. DOI:10.1016/j.ultrasmedbio.2010.07.005
16. Pu K, Wang Y, Bai S, et al. Diagnostic accuracy of controlled attenuation parameter (CAP) as a non-invasive test for steatosis in suspected non-alcoholic fatty liver disease: a systematic review and meta-analysis. BMC Gastroenterol. 2019;19(1):51. DOI:10.1186/s12876-019-0961-9
17. Tsochatzis EA, Gurusamy KS, Ntaoula S, et al. Elastography for the diagnosis of severity of fibrosis in chronic liver disease: a meta-analysis of diagnostic accuracy. J Hepatol. 2011;54(4):650-9. DOI:10.1016/j.jhep.2010.07.033
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2017;66(5):1022-30. DOI:10.1016/j.jhep.2016.12.022
19. Contreras D, González-Rocha A, Clark P, et al. Diagnostic accuracy of blood biomarkers and non-invasive scores for the diagnosis of NAFLD and NASH: Systematic review and meta-analysis. Ann Hepatol. 2023;28(1):100873. DOI:10.1016/j.aohep.2022.100873
20. Fedchuk L, Nascimbeni F, Pais R, et al. Performance and limitations of steatosis biomarkers in patients with nonalcoholic fatty liver disease. Aliment Pharmacol Ther. 2014;40(10):1209-22. DOI:10.1111/apt.12963
21. Hernaez R, Lazo M, Bonekamp S, et al. Diagnostic accuracy and reliability of ultrasonography for the detection of fatty liver: a meta-analysis. Hepatology. 2011;54(3):1082-90. DOI:10.1002/hep.24452
22. Leivas G, Maraschin CK, Blume CA, et al. Accuracy of ultrasound diagnosis of nonalcoholic fatty liver disease in patients with classes II and III obesity: A pathological image study. Obes Res Clin Pract. 2021;15(5):461-5. DOI:10.1016/j.orcp.2021.09.002
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7. Mantovani A, Petracca G, Beatrice G, et al. Non-alcoholic fatty liver disease and increased risk of incident extrahepatic cancers: a meta-analysis of observational cohort studies. Gut. 2022;71(4):778-88. DOI:10.1136/gutjnl-2021-324191
8. European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. Diabetologia. 2016;59(6):1121-40. DOI:10.1007/s00125-016-3902-y
9. Nogami A, Yoneda M, Iwaki M, et al. Diagnostic comparison of vibration-controlled transient elastography and MRI techniques in overweight and obese patients with NAFLD. Sci Rep. 2022;12(1):21925. DOI:10.1038/s41598-022-25843-6
10. Lazebnik LB, Golovanova EV, Turkina SV, et al. Non-alcoholic fatty liver disease in adults: clinic, diagnostics, treatment. Guidelines for therapists, third version. Experimental and Clinical Gastroenterology. 2021;1(1):4-52 (in Russian). DOI:10.31146/1682-8658-ecg-185-1-4-52
11. Ivashkin VT, Mayevskaya MV, Pavlov ChS, et al. Treatment of liver cirrhosis complications: Clinical guidelines of the Russian Scientific Liver Society and Russian gastroenterological association. Rossiiskii zhurnal gastroenterolpgii, gepatologii, koloproktologii. 2016;26(4):71-102 (in Russian). DOI:10.22416/1382-4376-2016-26-4-71-102
12. Clinical guidelines from 2021 “Chronic viral hepatitis C”. Available at: https://medi.ru/klinicheskie-rekomendatsii/khronicheskij-virusnyj-gepatit-s-khvgs-u-vzroslykh_14028. Accessed: 17.05.2023 (in Russian).
13. Jiang W, Huang S, Teng H, et al. Diagnostic accuracy of point shear wave elastography and transient elastography for staging hepatic fibrosis in patients with non-alcoholic fatty liver disease: a meta-analysis. BMJ Open. 2018;8(8):e021787. DOI:10.1136/bmjopen-2018-021787
14. Zhang X, Wong GL, Wong VW. Application of transient elastography in nonalcoholic fatty liver disease. Clin Mol Hepatol. 2020;26(2):128-41. DOI:10.3350/cmh.2019.0001n
15. Sasso M, Beaugrand M, de Ledinghen V, et al. Controlled attenuation parameter (CAP): a novel VCTE™ guided ultrasonic attenuation measurement for the evaluation of hepatic steatosis: preliminary study and validation in a cohort of patients with chronic liver disease from various causes. Ultrasound Med Biol. 2010;36(11):1825-35. DOI:10.1016/j.ultrasmedbio.2010.07.005
16. Pu K, Wang Y, Bai S, et al. Diagnostic accuracy of controlled attenuation parameter (CAP) as a non-invasive test for steatosis in suspected non-alcoholic fatty liver disease: a systematic review and meta-analysis. BMC Gastroenterol. 2019;19(1):51. DOI:10.1186/s12876-019-0961-9
17. Tsochatzis EA, Gurusamy KS, Ntaoula S, et al. Elastography for the diagnosis of severity of fibrosis in chronic liver disease: a meta-analysis of diagnostic accuracy. J Hepatol. 2011;54(4):650-9. DOI:10.1016/j.jhep.2010.07.033
18. Karlas T, Petroff D, Sasso M, et al. Individual patient data meta-analysis of controlled attenuation parameter (CAP) technology for assessing steatosis. J Hepatol.
2017;66(5):1022-30. DOI:10.1016/j.jhep.2016.12.022
19. Contreras D, González-Rocha A, Clark P, et al. Diagnostic accuracy of blood biomarkers and non-invasive scores for the diagnosis of NAFLD and NASH: Systematic review and meta-analysis. Ann Hepatol. 2023;28(1):100873. DOI:10.1016/j.aohep.2022.100873
20. Fedchuk L, Nascimbeni F, Pais R, et al. Performance and limitations of steatosis biomarkers in patients with nonalcoholic fatty liver disease. Aliment Pharmacol Ther. 2014;40(10):1209-22. DOI:10.1111/apt.12963
21. Hernaez R, Lazo M, Bonekamp S, et al. Diagnostic accuracy and reliability of ultrasonography for the detection of fatty liver: a meta-analysis. Hepatology. 2011;54(3):1082-90. DOI:10.1002/hep.24452
22. Leivas G, Maraschin CK, Blume CA, et al. Accuracy of ultrasound diagnosis of nonalcoholic fatty liver disease in patients with classes II and III obesity: A pathological image study. Obes Res Clin Pract. 2021;15(5):461-5. DOI:10.1016/j.orcp.2021.09.002
Авторы
А.А. Гончаров*, А.Н. Сасунова, В.И. Пилипенко, В.А. Исаков
ФГБУН «Федеральный исследовательский центр питания, биотехнологии и безопасности пищи», Москва, Россия
*thisalexis@gmail.com
Federal Research Center of Nutrition, Biotechnology and Food Safety, Moscow, Russia
*thisalexis@gmail.com
ФГБУН «Федеральный исследовательский центр питания, биотехнологии и безопасности пищи», Москва, Россия
*thisalexis@gmail.com
________________________________________________
Federal Research Center of Nutrition, Biotechnology and Food Safety, Moscow, Russia
*thisalexis@gmail.com
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.