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Volume 67, Issue 2 (5-2009)
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Methods: Sixty patients with various degrees of
fatty infiltration on liver biopsy and twenty normal subjects without any sign
of hepatic fat infiltration in ultrasonography examined using standard colour
and spectral doppler sonography. The waveforms of Hepatic Vein were classified
into three groups: regular triphasic waveform, biphasic waveform without a
reverse flow, and monophasic or flat waveform. The hepatic artery resistance
index was calculated as the mean of three different measurements.
Results: The mean BMI in Nonalcoholic fatty liver disease group and normal subjects was 26.9(SD=3.3) and 22.4(SD=1.7) Kg/m2, respectively with a
range of 22
up to 44 Kg/m2. Abnormal Hepatic Vein
waveforms (biphasic and monophasic) were found more frequently in doppler
sonography (p<0.001)
in patients with Nonalcoholic fatty liver disease (12 biphasic and 17 monophasic) compared to normal subjects. Hepatic artery resistance
index was significantly lower in Nonalcoholic fatty liver disease patients [0.7(SD=0.1)] compared to normal
ones [0.8(SD=0.0)]
(p<0.001).
Conclusions: The incidence of abnormal hepatic vein waveforms is significantly higher in
patients with fatty infiltration compared to those who had no abnormality in
liver ultrasonography and these patients had a significant lower hepatic artery
resistance index. supportFields]> ADDIN EN.CITE ADDIN EN.CITE.DATA
Volume 72, Issue 1 (4-2014)
Background: Nonalcoholic Fatty Liver Disease (NAFLD) is one of the most wide-spread human diseases that can impair liver function and sometimes progresses to cir-rhosis. Recently NAFLD has been identified as an independent risk factor for cardio-vascular disease. The aim of this study was to investigate the correlation of fatty liver disease and its sonographic severity on the resistance of the intracranial arteries. Methods: This study was a cross-sectional study of 55 patients referred from Gastroen-trology clinic with diagnosis of NAFLD to Sonodoppler department of Iranian Center of Neurological Research. Pulsaltile index as a Hemodynamic parameter of Middle Cerebral (MCA) and basilar Arteries of NAFLD Patients was measured by Trans Cra-nial Doppler (TCD) sonography and the measurements were compared with normal values. Also the association of these indices with serum liver enzymes and sonographic grading of liver involvement was assessed. The analysis was done by SPSS 16. Fre-quency distribution, mean and standard deviation were used in descriptive analysis and statistical test 2 to compare qualitative variables. Results: Pulsatile Index (PI) were normal (MCA, P= 0.166, Basilar, P= 0.053) and there was no significant difference with relation to severity of fatty liver based on so-nography findings (P= 0.789), but serum liver enzyme levels were inversely correlated with basilar artery PI (P= 0.014). Conclusion: Considering the increase of cerebral arteries PI in advanced liver disease, absence of increase in vascular PI of patients in the present study could be attributed to the short duration of disease from diagnosis to perform TCD, lack of advanced liver involvement (absence of liver dysfunction) and the response effect to treatment before the TCD. Therefore, to assess vascular changes over time, repeating the TCD with assess other parameters such as Fibroscan and K18 factor that has more compatibility of liver function, could help to understand the pathophysiology of liver diseases and its effect on vascular resistance.
Volume 74, Issue 5 (8-2016)
Background: Nonalcoholic fatty liver disease (NAFLD) includes steatosis, nonalcoholic steatohepatitis, fibrosis and liver cirrhosis. The oxidative stress enzymes are the diagnostic markers to prediction of histologic status of liver in nonalcoholic steatohepatitis disease. The aim of the study was to assessment of relationship between serum Zinc (Zn) levels with pathologic manifestation in patients with nonalcoholic steatohepatitis.
Methods: This cohort study was done in patients with nonalcoholic steatohepatitis that had been visited in gastrointestinal clinic of Sina Hospital, Tehran, Iran from April, 2014 to April, 2015. Control group included the patients with no clinical manifestation of nonalcoholic steatohepatitis and normal liver ultrasonography, lab test and liver biopsy. Serum Zn level was measured with atomic absorption spectroscopy. Normal Serum level of Zn was considered 10.7-22.9 µmol/L (70-150 µg/dL) and less than 7 µg/dL was considered as Zn deficiency. Pathological findings were grading according to NAFLD activity score.
Results: One hundred twenty patients were selected for the study in two equal groups. Six and 26 patients were excluded in case and control groups, respectively due to no consent to lab test. Finally, 54 patients (35 male/19 female) and 34 patients (22 male/12 female) in control group were participated in data analysis. The mean age on case and control group was 37.02±9.82 year and 33.24±12.01 year, respectively (P= 0.111). Zn level in case and control groups were 90.82±13.69 and 88.82±13.10, respectively. There were no statistically significant differences between two group in serum Zn level (P= 0.50). Also, there were no statistically significant differences between pathological grading in case group participants (steatosis: P= 0.640; Lobular inflammation: P= 0.882; fibrosis: P= 0.531).
Conclusion: The finding of the study showed no significant association between serum zinc level and hepatic steatosis, lobular inflammation and fibrosis of the liver in nonalcoholic steatohepatitis.
Volume 74, Issue 9 (12-2016)
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Background: Considering the high incidence and prevalence of nonalcoholic fatty liver disease (NAFLD) in the Iranian society and the limited number of studies to investigate its associated risk factors, the current study was designed to identify any relevant risk factor of this disease. Methods: The present case-control study was performed among 150 nonalcoholic fatty liver disease patients and 150 normal liver participants who attended to gastroenterology clinics in Ilam city, Iran during 2014-2015. All demographic data, clinical trials and health behaviors associated with lifestyle such as nutritional status, smoking, physical activities were collected and compared between two groups. Results: Among a total of 300 participants in the current study, the male female ratio was 46.54% and the mean±standard deviation of all participants was 42.13±12.15 years. The mean values of total cholesterol, triglycerides (TG), low density lipoprotein (LDL), alanine transaminase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were significantly higher in cases than controls group (P< 0.0001). A significant relationship was revealed between positive familial history, marriage, and low physical activities with NAFLD (P< 0.05). In the patient's group, consumption of red meat was significantly higher and dairy intake was significantly lower compared to the control group (P< 0.05). Using the multivariate logistic regression analysis, the adjusted odds ratio for variables of waist circumference, triglyceride, ALT and body mass index (BMI) were statistically significant [1.11, (1.04-1.18); 2.58, (1.01-6.67); 5.34, (1.84-15.52) and 7.28,) 1.89-27.99) respectively] (P< 0.05). Also, a significant association was observed among the variables of ALT, AST and BMI with the severity grade of NAFLD (P< 0.05). |
Conclusion: The results of this study showed that waist circumference, BMI, serum level of ALT and TG concentrations can predict the occurrence of non-alcoholic fatty liver disease. BMI, ALT, and AST seem to be associated with the ultrasonography staging of liver in NAFLD. Therefore, these parameters could be used to predict the ultrasonography staging of liver in these patients.
Volume 79, Issue 1 (4-2021)
Methods: In this analytic study, which is done from April to November 2020 in Tehran, ultrasound images of 55 obese people who have undergone laparoscopic surgery have been used and the histological result of a liver biopsy has been employed as a reference for liver fat. First, 88 texture-based features were extracted from the images using the Gray-Level Co-Occurrence Matrix (GLCM) method. In the next step, using the method of minimum redundancy and maximum correlation, the top features were selected from among 88 features and applied to the classifier input. Finally, using the three classifiers of linear discriminant analysis, support vector machine and AdaBoost, the images were classified into 4 groups based on the amount of liver fat.
Results: The accuracy of the automatic liver fat prediction model from ultrasound images for AdaBoost classification was 92.72%. However, the accuracies obtained for support vector machine and linear discriminant analysis classification were 87.88% and 75.76%, respectively.
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Conclusion: The proposed approach based on texture features using the GLCM and the AdaBoost classification from ultrasound images automatically detects the amount of liver fat with high accuracy and can help physicians and radiologists in the final diagnosis.
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Volume 80, Issue 6 (9-2022)
Volume 81, Issue 12 (3-2024)
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Methods: In this case control study, 112 newly diagnosed patients with NAFLD referred to the Shahid Rahimi Hospital clinic in Khorramabad between January 1400 and April 1401 and 112 healthy individuals without NAFLD and any other chronic diseases as the control group, with the range 23-59 years old were selected. General information, demographics, physical activity level and food intake were collected using general information questionnaire, physical activity questionnaire and valid semi-quantitative food frequency questionnaire (FFQ). The energy received between the people of the two groups was adjusted. People's diet was divided into two anti-inflammatory and pro-inflammatory groups based on the DII index based on the score quartiles.
Results: The results showed a significant relationship between DII score and NAFLD in the crude model (OR: 2.22, 95% CI: 1.04 -4.73), model I (adjusted for energy and age classification) (OR: 2.4, 95% CI:1.07-5.58), model II (adjusted for model I+physical activity, sex, education) (OR:2.77, 95% CI:1.14-6.77) and model III (model II+BMI) (OR: 2.16, 95% CI: 0.81-5.71) and DPI score and NAFLD the crude model (OR: 0.69, 95% CI: 0.32-1.47), model I (adjusted for energy and age classification) (OR: 0.56, 95% CI: 1.29-5.58), model II (adjusted for model I+physical activity, sex, education) (OR:0.58, 95% CI: 0.23-1.44) and model III (model II+BMI) (OR: 0.65, 95% CI: 0.24-1.75). Conclusion: The results obtained from this study showed an inverse relationship between following an anti-inflammatory diet and the risk of NAFLD. However, there was no correlation between receiving a diet with a high phytochemical index and NAFLD. |
Volume 82, Issue 1 (4-2024)
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Methods: Based on the inclusion criteria, 100 Patients were selected from those referred to the radiology and ultrasonography clinic in Golestan Hospital, Ahvaz, for fatty liver evaluation. The study was carried out during May 2022 to April 2023. Liver enzymes, including alanine aminotransaminase (ALT) and Aspartate aminotransferase (AST), were measured. Based on the ultrasonography results, patients were divided into four groups: healthy, mild fatty liver, moderate fatty liver, and severe fatty liver. Ultrasonography was carried out by an experienced expert. All demographic information of patients was collected. Data were analyzed by SPSS (V25).
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Results: According to ultrasonography results, the mean of span was 148.4 ± 14.7 cm, which was significantly higher in patients with grade II of NAFLD (P<0.001). Further analysis revealed the highest difference between grades I and II (P<0.001). Also, a significant difference between grades II and III and grades III and I were found (P<0.001). Our data showed a significant relationship between body mass index (BMI) and NAFLD grades (P<0.001). The mean of BMI in grade I was significantly lower than in grades II and III (P<0.05). Our findings demonstrated that the mean of ALT in grade I was significantly lower than in grades II and III (P<0.05). In this line, the highest AST level was seen in grade III (P<0.001).
Conclusion: Our study showed that as NAFLD progresses, the enzymes and size of the liver increase. Based on ultrasound findings, the increasing liver size suggests NAFLD grade II, while the rise in AST and BMI suggests NAFLD grade II -III and progression of cirrhosis. |
Volume 82, Issue 10 (1-2025)
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Background: Nonalcoholic fatty liver disease (NAFLD) represents a growing global health burden, strongly associated with rising rates of obesity, diabetes, and metabolic syndrome. This study introduces a machine learning framework to precisely diagnose NAFLD, classify disease severity, and stratify risk using routine clinical data. Our model improves early detection and risk prediction, supporting evidence-based clinical decisions. Leveraging predictive analytics, this scalable approach identifies high-risk patients and enables personalized interventions. The data-driven strategy optimizes NAFLD management by extracting maximal value from standard healthcare records, delivering both clinical and operational advantages.
Methods: This study examined 181 NAFLD patients across disease stages. The dataset was compiled from February 2010 to January 2019 at Eheim University Hospital, comprising general volunteers who were diagnosed with or without fatty liver based on histopathological evaluation of liver biopsy samples. Forward selection and mutual information identified predictive features, applied in classification models (e.g., random forest) to assess steatosis severity. Explainable AI (XAI) improved model interpretability. Combining robust feature selection, machine learning, and XAI ensured accurate, clinically actionable NAFLD severity evaluation. Results: The XGBoost classifier with forward feature selection attained a classification accuracy of 69.23%±5.5% for steatosis severity. Interpretability analysis highlighted age, Body Mass Index (BMI), High-Density Lipoprotein (HDL), Low-Density Lipoprotein (LDL), A1c Hemoglobin (HbA1c), and glutamate pyruvate transaminase (GPT) as the most impactful variables across three severity classes. Furthermore, GPT, age, BMI, HDL, HbA1c, LDL, triglycerides, and cholesterol were critical to model performance, emphasizing their diagnostic significance in NAFLD progression. These findings suggest their utility in clinical assessments and risk stratification. Conclusion: This study developed a machine learning model for accurate NAFLD diagnosis and severity stratification using routine clinical data. Accessible biomarkers reliably predicted disease progression, enabling gastroenterologists to facilitate early intervention. This cost-effective approach reduces healthcare costs while improving outcomes through precision medicine. Implementing such predictive tools in clinical practice could optimize resource allocation and enhance long-term NAFLD management. The framework supports timely diagnostics and targeted therapies, advancing patient-centered care. |
Volume 83, Issue 7 (10-2025)
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Background: Nonalcoholic fatty liver disease (NAFLD) is one of the most prevalent chronic liver diseases worldwide and is closely associated with metabolic syndrome and insulin resistance. Growing evidence suggests a link between NAFLD and cardiovascular diseases, independent of traditional risk factors. Coronary computed tomography angiography (CCTA) is a reliable noninvasive method for evaluating coronary artery disease (CAD) and identifying high-risk coronary plaque characteristics. However, data regarding the association between NAFLD and high-risk coronary plaques remain limited, particularly in Iran. This study aimed to evaluate the prevalence of NAFLD in patients with high-risk coronary plaques detected by CCTA. Methods: In this cross-sectional study, 200 patients who underwent CCTA for the evaluation of coronary plaques in outpatient clinics or the emergency department of Golestan Hospital in ahvaz ,1403 ,were enrolled. Demographic data, including age, sex, weight, and body mass index (BMI), along with clinical characteristics and cardiovascular risk factors such as hypertension, diabetes mellitus, dyslipidemia, smoking status, and medical history were collected. Patients with a history of alcohol consumption or known liver disease were excluded. NAFLD was assessed based on imaging findings. Statistical analyses were performed to compare variables between patients with and without NAFLD. Results: The mean age of patients with NAFLD was 57.89 ± 9.72 years, compared with 55.77 ± 8.97 years in patients without NAFLD, with no statistically significant difference. The prevalence of NAFLD was slightly higher in women than men; however, this difference was not significant. Patients with NAFLD had a significantly higher mean weight than those without NAFLD (85.21 ± 12.12 kg vs. 79.62 ± 11.85 kg; p = 0.001). Additionally, the prevalence of NAFLD increased significantly with higher BMI categories, particularly in obese individuals. Conclusion: Age and gender were not significantly associated with NAFLD prevalence in patients with high-risk coronary plaques. In contrast, increased body weight and higher BMI, especially obesity, were independently associated with a higher risk of NAFLD in this population. |
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