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Hepatic vessel doppler indices: a study on non- Alcoholic liver disease
Mohammadinia Ar, Bakhtavar K, Ebrahimi-Daryani N, Habibollahi P, Keramati Mr, Fereshtehnejad Sm,
Volume 67, Issue 2 (5-2009)
Abstract

Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 !mso]> ject classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id=ieooui> Background: Duplex Doppler ultrasonography (US) has newly suggested, being an important diagnostic technique in the non-invasive evaluation of hepatic vasculature and some hepatic parenchymal diseases. New findings suggest that diffuse fatty infiltration of liver can alter normal hepatic vein and artery doppler indices. The following study has been performed to evaluate the effect of fatty infiltration on hepatic artery resistance index and hepatic vein waveform patterns.
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 l> 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Correlation of liver enzymes and sonographic findings with pulsatile index of middle cerebral and basilar arteries in nonalcoholic fatty liver
Gholamreza Rezamand , Mojdeh Ghabaee , Naser Ebrahimi Daryani , Hoda Ghadami ,
Volume 72, Issue 1 (4-2014)
Abstract
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.
Serum Zinc level and liver pathological grading correlation in nonalcoholic steatohepatitis, in a university hospital in Tehran
Raika Jamali , Ebrahim Mosavi Jahan Abad, Tayeb Ramim ,
Volume 74, Issue 5 (8-2016)
Abstract

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.


Risk factors of nonalcoholic fatty liver disease: a case-control study
Zeinab Moradi Kohnaki , Khairollah Asadollahi, Ghobad Abangah , Kourosh Sayehmiri ,
Volume 74, Issue 9 (12-2016)
Abstract

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.


Automatic classification of Non-alcoholic fatty liver using texture features from ultrasound images
Amir Reza Naderi Yaghouti , Ahmad Shalbaf, Arash Maghsoudi,
Volume 79, Issue 1 (4-2021)
Abstract
Background: Accurate and early detection of non-alcoholic fatty liver, which is a major cause of chronic diseases is very important and is vital to prevent the complications associated with this disease. Ultrasound of the liver is the most common and widely performed method of diagnosing fatty liver. However, due to the low quality of ultrasound images, the need for an automatic and intelligent classification method based on artificial intelligence methods to accurately detect the amount of liver fat is essential. This paper aims to develop an advanced machine learning model based on texture features to assess liver fat levels based on liver ultrasound images.
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.
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.

Lean individual’s non-alcoholic fatty liver disease: a review article
Naser Ebrahimi Daryani , Mohammad Reza Pashaei ,
Volume 80, Issue 6 (9-2022)
Abstract
Nonalcoholic fatty liver disease (NAFLD) is defined by steatosis in more than 5% of liver cells, in the absence of a secondary cause such as drugs, alcohol, or other causes. The incidence of NAFLD is increasing every day; almost a quarter of the world's adult population is affected by this disease. The burden of NAFLD is affected by the epidemics of obesity and type 2 diabetes (T2DM), and therefore, we do not expect the prevalence of this disease to decrease in the future. The world is now in the process of passing on health to non-chronic diseases, like NAFLD. The most common cause of chronic liver disease worldwide is non-alcoholic fatty liver disease. About 25 percent of the world's population is affected by the disease, and it ranges from simple steatosis to cirrhosis. 1 in 4 individuals with NAFLD is a person with non-alcoholic steatohepatitis, which is associated with complications and significant mortality and morbidity due to complications such as liver cirrhosis and hepatocellular carcinoma. Non-alcoholic fatty liver disease is closely related to metabolic syndrome, and it can be said that the liver is an integral part of obesity. Diagnostic methods for this disease include laboratory tests, imaging studies and liver biopsy. Although NAFLD is observed predominantly in obese persons or type 2 diabetes, an estimated 7% to 20% of people with NAFLD have lean body habitus. Recent studies have shown that fatty liver can occur in lean individuals, even without abdominal and visceral fat. Fatty liver in lean people (Lean NAFLD) is a relatively new concept that has attracted many people to find the differences between lean and obese people. The pathophysiological mechanisms of lean NAFLD are still poorly understood. Studies have shown that NAFLD without obesity is more closely related to factors such as environmental, genetic susceptibility, and epigenetic regulation. In addition to lifestyle modifications such as weight loss, diet and physical activity, only a few NAFLD-specific drug treatment options such as vitamin E and pioglitazone are considered. This article discusses the pathogenesis of fatty liver in lean individuals, its treatment, prognosis, and its relationship with metabolic syndrome.

Investigation of the relationship between the dietary inflammation index and the dietary phytochemical index with non-alcoholic fatty liver diseases
Parastoo Beknejadi, Davoud Vahabzadeh, Esmaeil Yousefi Rad , Somayeh Saboori , Koroush Ghanadi , Mehdi Birjandi,
Volume 81, Issue 12 (2-2024)
Abstract
Background: The increasing prevalence of non-alcoholic fatty liver disease (NAFLD) in recent years has raised concerns about its significant risks for public health. According to previous studies, a diet with low phytochemicals and high inflammatory index is related to non-alcoholic fatty liver disease. In this study, we intend to investigate the relationship between inflammatory diet and phytochemical diet with NAFLD.
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.

Evaluating the Correlation between Liver Size and Fatty Liver Progression in Patients with Non-Alcoholic Fatty Liver Disease
Maryam Behmaram, Mohammad Ghasem Hanafi, Ahmad Fakhri Zadeh , Mahsa Akhavan Sabagh , Elham Farhadi,
Volume 82, Issue 1 (3-2024)
Abstract


Background: Increasing the prevalence of non-contagious and chronic disorders such as Non-alcoholic fatty liver disease (NAFLD) takes the attention of researchers. NAFLD recognized by abnormal accumulation in the liver tissue. The aim of present study is investigating the association between liver size liver enzymes and degree of fatty liver in patients with NAFLD.
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).
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.

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