Clinical characteristics associated with hepatic steatosis on ultrasonography in patients with elevated alanine aminotransferase

The main causes of hepatic steatosis (HS) are alcoholic liver disease and nonalcoholic fatty liver disease (NAFLD). Although liver biopsy is the gold standard for NAFLD diagnosis, the finding of abnormal aminotransferases in abstinent individuals, without known liver disease, suggests the diagnosis...

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Published in:	São Paulo medical journal Vol. 128; no. 6; pp. 342 - 347
Main Authors:	Narciso-Schiavon, Janaína Luz, Schiavon, Leonardo de Lucca, Carvalho-Filho, Roberto José de, Hayashida, Débora Yumi, Wang, Jenny Hue Jiuan, Souza, Tatiana Santana, Emori, Christini Takemi, Ferraz, Maria Lucia Gomes, Silva, Antonio Eduardo Benedito
Format:	Journal Article
Language:	English
Published:	Brazil Associação Paulista de Medicina - APM 01-12-2010 Associação Paulista de Medicina
Subjects:	Adult Alanine transaminase Alanine Transaminase - blood Blood Donors - statistics & numerical data Body Mass Index Diabetes mellitus Diabetes Mellitus - epidemiology Epidemiologic Methods Fatty liver Fatty Liver - blood Fatty Liver - diagnostic imaging Fatty Liver - enzymology Female Hepatitis B Antibodies - blood Hepatitis C Antibodies - blood Humans Male MEDICINE, GENERAL & INTERNAL Original Risk Factors Ultrasonography Body mass index Fatty liver Índice de massa corporal Alanina transaminase Ultrassonografia Diabetes mellitus Ultrasonography Alanine transaminase Fígado gorduroso
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Summary:	The main causes of hepatic steatosis (HS) are alcoholic liver disease and nonalcoholic fatty liver disease (NAFLD). Although liver biopsy is the gold standard for NAFLD diagnosis, the finding of abnormal aminotransferases in abstinent individuals, without known liver disease, suggests the diagnosis of NAFLD in 80-90% of the cases. Identification of clinical factors associated with HS on abdominal ultrasound may enable diagnoses of fatty liver non-invasively and cost-effectively. The aim here was to identify clinical variables associated with HS in individuals with elevated alanine aminotransferase (ALT) levels. Cross-sectional study in a single tertiary care center. Individuals with elevated ALT, serologically negative for hepatitis B and C, were evaluated by reviewing medical files. Patients who did not undergo abdominal ultrasonography were excluded. Among 94 individuals included, 40% presented HS on ultrasonography. Compared with individuals without HS, those with fatty liver were older (P = 0.043), with higher body mass index (BMI) (P = 0.003), diabetes prevalence (P = 0.024), fasting glucose levels (P = 0.001) and triglycerides (P = 0.003). Multivariate analysis showed that BMI (odds ratio, OR = 1.186; 95% confidence interval, CI: 1.049-1.341; P = 0.006) and diabetes mellitus (OR = 12.721; 95% CI: 1.380-117.247; P = 0.025) were independently associated with HS. Simple clinical findings such as history of diabetes and high BMI may predict the presence of HS on ultrasonography in individuals with elevated ALT and negative serological tests for hepatitis.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Conflict of interest: None
ISSN:	1516-3180 1806-9460 1806-9460 1516-3180
DOI:	10.1590/S1516-31802010000600006