• Donor weight reduction
• Living-donor liver transplantation
• Postoperative outcomes
• Preoperative weight reduction
• Recipient weight reduction

• Humans
• Liver Transplantation/adverse effects
• Living Donors
• Female
• Male
• Middle Aged
• Weight Loss
• Adult
• Graft Survival
• Postoperative Complications/epidemiology
• Postoperative Complications/etiology
• Postoperative Complications/prevention & control
• Body Mass Index
• Retrospective Studies
• Treatment Outcome
• Transplant Recipients/statistics & numerical data
• Preoperative Period
• Obesity/surgery
• Overweight/complications
• Preoperative Care/methods

• Anthropometric measurements
• Cornus mas L.
• Diet treatment
• Metabolic associated fatty liver disease
• Nutrition therapy

• Adult
• Humans
• Cornus
• Powders
• Body Mass Index
• Body Weight
• Liver Diseases

• alcohol-associated liver disease
• alcoholic cirrhosis
• alcoholic hepatitis
• elastography
• fatty liver
• steatosis
• transient perfusion

• Humans
• Carcinoma, Hepatocellular/pathology
• Pandemics
• Liver Neoplasms/pathology
• Liver Diseases, Alcoholic/complications
• Liver Diseases, Alcoholic/epidemiology
• Liver Diseases, Alcoholic/pathology
• Magnetic Resonance Imaging/adverse effects
• Liver/pathology

• Animal experimentation
• Colitis
• Fatty liver
• Hepatitis
• Tumorigenesis
• Ultrasonography

Shear wave speed (SWS), shear wave dispersion (SWD), and attenuation imaging (ATI) are new diagnostic parameters for non-alcoholic fatty liver disease. To differentiate between non-alcoholic steatohepatitis (NASH) and non-alcoholic fatty liver (NAFL), we developed a clinical index we refer to as the “NASH pentagon” consisting of the 3 abovementioned parameters, body mass index (BMI), and Fib-4 index.

To investigate whether the area of the NASH pentagon we propose is useful in discriminating between NASH and NAFL.

This non-invasive, prospective, observational study included patients diagnosed with fatty liver by abdominal ultrasound between September 2021 and August 2022 in whom shear wave elastography, SWD, and ATI were measured. Histological diagnosis based on liver biopsy was performed in 31 patients. The large pentagon group (LP group) and the small pentagon group (SP group), using an area of 100 as the cutoff, were compared; the NASH diagnosis rate was also investigated. In patients with a histologically confirmed diagnosis, receiver-operating characteristic (ROC) curve analyses were performed.

One hundred-seven patients (61 men, 46 women; mean age 55.1 years; mean BMI 26.8 kg/m²) were assessed. The LP group was significantly older (mean age: 60.8 ± 15.2 years vs 46.4 ± 13.2 years; P < 0.0001). Twenty-five patients who underwent liver biopsies were diagnosed with NASH, and 6 were diagnosed with NAFL. On ROC curve analyses, the areas under the ROC curves for SWS, dispersion slope, ATI value, BMI, Fib-4 index, and the area of the NASH pentagon were 0.88000, 0.82000, 0.58730, 0.63000, 0.59333, and 0.93651, respectively; the largest was that for the area of the NASH pentagon.

The NASH pentagon area appears useful for discriminating between patients with NASH and those with NAFL.

• Non-alcoholic fatty liver disease
• Non-alcoholic steatohepatitis
• Attenuation imaging
• Shear wave elastography
• Shear wave dispersion
• Diagnosis

• Male
• Humans
• Female
• Middle Aged
• Aged
• Non-alcoholic Fatty Liver Disease/pathology
• Body Mass Index
• Prospective Studies
• Ultrasonography
• Elasticity Imaging Techniques/methods
• ROC Curve
• Liver/diagnostic imaging
• Liver/pathology
• Biopsy

• Biomarker
• Liver steatosis
• Non-alcoholic fatty liver disease
• Ultrasonography

• Humans
• Non-alcoholic Fatty Liver Disease/diagnosis
• Non-alcoholic Fatty Liver Disease/diagnostic imaging
• Liver/diagnostic imaging
• Liver/pathology
• Magnetic Resonance Imaging
• Ultrasonography
• Biomarkers

• FibroScan
• controlled attenuation parameter
• fatty liver
• liver fibrosis
• liver stiffness measurement
• prevalence

• type 2 diabetes
• nafld
• nash
• insulin resistance
• metabolic syndrome

• Humans
• Female
• Middle Aged
• Aged
• Male
• Non-alcoholic Fatty Liver Disease/complications
• Non-alcoholic Fatty Liver Disease/epidemiology
• Diabetes Mellitus, Type 2/complications
• Diabetes Mellitus, Type 2/epidemiology
• Cross-Sectional Studies
• Metabolic Syndrome/complications
• Prevalence
• Risk Factors
• Liver Cirrhosis/complications
• Liver Cirrhosis/epidemiology
• Obesity/complications

• bariatric surgery
• celiac disease
• cirrhosis
• gastroesophageal reflux disease
• inflammatory bowel disease
• irritable bowel syndrome
• non-alcoholic fatty liver disease
• obesity
• pancreatitis
• sarcopenic obesity

• Adult
• Celiac Disease
• Child
• Gastroenterology
• Gastroesophageal Reflux/complications
• Gastroesophageal Reflux/diagnosis
• Gastroesophageal Reflux/epidemiology
• Humans
• Inflammatory Bowel Diseases/therapy
• Irritable Bowel Syndrome
• Liver Diseases/complications
• Liver Diseases/diagnosis
• Obesity/complications
• Obesity/diagnosis
• Obesity/epidemiology
• Pancreatitis
• Sarcopenia

• United European Gastroenterology
• European Society for Clinical Nutrition and Metabolism

• Bariatric surgery
• Inflammatory bowel disease
• Non-alcoholic fatty liver disease
• Obesity
• Sarcopenic obesity

• Body positions
• Congestive hepatopathy
• Fibrosis-4 index
• Inferior vena cava diameter
• Liver fibrosis
• Shear wave elastography

The independent association between hepatic steatosis and rheumatoid arthritis is poorly defined.

The presence of moderate to severe steatosis was assessed, using liver ultrasonography, in 364 consecutive non-diabetic subjects (223 patients with rheumatoid arthritis and 141 age- and sex-matched healthy controls). Adjusted multiple regression analysis was performed to explore the association between rheumatoid arthritis and moderate to severe steatosis in the overall sample and identify independent risk factors in the rheumatoid arthritis subgroup.

The prevalence of moderate to severe steatosis in the overall sample was 31.3%, with a significantly higher prevalence in patients with rheumatoid arthritis than healthy controls (38.7% versus 19.7%, p < 0.0001). After adjustment for sex, age, cholesterol, triglycerides, body mass index, waist, hypertension and smoke, rheumatoid arthritis remained significantly associated with moderate to severe steatosis [odds ratio (95% confidence interval) = 2.24 (1.31, 3.84); p = 0.003]. In the rheumatoid arthritis group, male sex, higher body mass index, higher triglycerides concentrations and higher cumulative dosage of methotrexate [odds ratio (95% confidence interval) = 1.11 (1.01, 1.23); p = 0.026] were significantly associated with moderate to severe steatosis, while systemic inflammation, disease activity, use of steroids and biologics were not.

Rheumatoid arthritis is independently associated with moderate to severe steatosis, with male sex, higher body mass index and cumulative dose of methotrexate being predisposing factors. Further prospective studies are warranted to confirm our findings and to investigate the effect of steatosis on liver outcomes in the rheumatoid arthritis population.

• methotrexate
• rheumatoid arthritis
• steatosis
• ultrasound

• Fatty liver
• Liver cirrhosis
• Pathology
• Reye syndrome
• Ultrasonography

To determine the utility of the ultrasound‐guided attenuation parameter (UGAP) for quantifying hepatic steatosis in non‐alcoholic fatty liver disease (NAFLD).

Subjects were 84 patients with NAFLD (53 men, 31 women; mean age 54 [20–81] years) who underwent liver biopsy and ultrasonography using a GE LOGIQ E9 system and C1‐6 probe at our hospital between 2017 and 2020. B‐Mode imaging of segment V in the liver was acquired and echo attenuation was assessed using UGAP. Steatosis score (S0: <5%; S1: 5%–33%; S2: 34%–66%; S3: ≥67%) from liver specimens was compared with the attenuation coefficient (AC; dB/cm/MHz) using UGAP.

Steatosis score was S0 for 9 patients, S1 for 40, S2 for 21, and S3 for 14. AC by steatosis score was 0.52 ± 0.07, 0.63 ± 0.07, 0.74 ± 0.06, and 0.78 ± 0.06 dB/cm/MHz for S0, S1, S2, and S3, respectively. AC by UGAP differed significantly between S0 and S1, S0 and S2, S0 and S3, S1 and S2, and S1 and S3 (all P < 0.01), demonstrating a significant increase with steatosis score. Receiver operating characteristic analysis showed good diagnostic performance of UGAP for patients with steatosis score ≥1, ≥2, and ≥3 (AUROC = 0.94, 0.95, and 0.88, respectively). Liver fat content (%) from liver specimens and AC (r = 0.81, P < 0.01) showed a significant positive correlation.

UGAP is useful for quantifying hepatic steatosis in patients with NAFLD.

• attenuation imaging
• hepatic steatosis
• non‐alcoholic fatty liver disease
• ultrasonography

The present study aimed to explore the relationship between non-alcoholic fatty liver disease (NAFLD) and abdominal and pericardial adipose tissue in middle-aged and elderly subjects.

Between July 2019 and July 2020, 471 subjects attending the Health Care Medical Department of Peking Union Medical College Hospital for a medical examination were enrolled in the study. The volume and distribution of abdominal adipose tissue together with the volume of pericardial adipose tissue were calculated according to the results of the abdominal computed tomography. The differences between subjects with NAFLD and the normal population were analyzed.

The volume of pericardial adipose tissue, abdominal visceral and subcutaneous adipose tissue, the total volume of abdominal adipose tissue, and volume of pelvic visceral adipose tissue were all significantly increased in subjects with NAFLD. For every 100 cm³ increase in the volume of abdominal visceral adipose tissue, the incidence of developing NAFLD increased by 9.4%. According to the results of the receiver operating curve, the cut-off point of abdominal visceral adipose tissue for the diagnosis of NAFLD was 2691.1 cm³.

Overall, the risk of NAFLD increases significantly with the increase in the volume of adipose tissue.

• abdominal adipose tissue
• abdominal subcutaneous adipose tissue
• abdominal visceral adipose tissue
• fatty liver

• B-mode
• Fatty liver
• Non-alcoholic fatty liver disease
• Transient elastography
• Ultrasonography

• Complications
• Imaging
• Liver cancer
• Liver fibrosis

• consultants
• knowledge
• non-alcoholic fatty liver disease
• residents

Evaluating liver steatosis and fibrosis is important for patients with non-alcoholic fatty liver disease. Although liver biopsy and pathological assessment is the gold standard for these conditions, this technique has several disadvantages. The evaluation of steatosis and fibrosis using ultrasound B-mode imaging is qualitative and subjective. The liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) determined using FibroScan are the evidence-based non-invasive measures of liver fibrosis and steatosis, respectively. The LSM and CAP measurements are carried out simultaneously, and the median values of more than ten valid measurements are used to quantify liver fibrosis and steatosis. Here, we demonstrate that the reliability of the LSM depends on the interquartile range to median ratio (IQR/Med), but CAP values do not depend on IQR/Med. In addition, the LSM is affected by inflammation, congestion, and cholestasis in addition to fibrosis, while CAP values are affected by the body mass index in addition to steatosis. We also show that the M probe provides higher LSM values but lower CAP values than the XL probe in the same population. However, there was no statistically significant difference between the diagnostic accuracies of the two probes. These findings are important to understand the reliability of FibroScan measurements and the factors influencing measurement values for all patients.

• controlled attenuation parameter
• hepatic inflammation
• hepatic steatosis
• liver stiffness measurement
• non-alcoholic fatty liver disease
• transient elastography

• Acceso vascular
• Biopsia renal
• Central line insertion
• Diagnostic and interventional nephrology
• Ecografía
• Inserción de vías centrales
• Nefrología diagnóstica e intervencionista
• Renal biopsy
• Renal replacement therapy
• Terapia renal sustitutiva
• Ultrasound
• Vascular access

We have developed a diagnostic technique to evaluate hepatic steatosis using the attenuation coefficient (ATT) in ultrasound B mode imaging. A controlled attenuation parameter (CAP) by vibration-controlled transient elastography (VCTE) has also been used to evaluate hepatic steatosis. As that method uses ultrasound A mode, visualizing the liver in real time is difficult. We designed this clinical study to evaluate the diagnostic advantage of our technique using ATT compared to CAP.

The study group included 94 patients with chronic liver disease who had undergone both ATT and CAP assessment at the time of liver biopsy. The M-probe and XL-probe were used for CAP measurement. Data for ATT and CAP were compared as a function of the steatosis grade.

The area under the receiver operating characteristic curve (AUC-ROCs) for ATT and PAC as a function of the steatosis grade were as follows: grade 1, 0.74 and 0.81; grade 2, 0.80 and 0.85; and grade 3, 0.96 and 0.98, respectively.

The accuracy of steatosis grade diagnosis using ATT was the same as that using CAP, with no significant differences and with the added advantage of B mode ultrasound being more convenient and rapid, compared to A mode ultrasound, particularly for patients with subcutaneous fat thickness ≥2 cm.

• Aged
• Algorithms
• Area Under Curve
• Fatty Liver/diagnosis
• Fatty Liver/diagnostic imaging
• Female
• Humans
• Male
• ROC Curve
• Time Factors
• Ultrasonography

Moderate alcohol intake is associated with reduced prevalence or incidence of fatty liver. However, whether or not the association is independent of dietary patterns remains unclear. We aimed to evaluate the cross-sectional association of alcohol intake with fatty liver after accounting for dietary patterns and obesity.

We assessed 4579 adults aged 30–79 years who participated in routine clinical examinations in St. Luke's International Hospital, Japan (January to March, 2015). We assessed their habitual diet using diet-history questionnaire, estimated alcohol intake, and derived dietary pattern variables using factor analysis. Fatty liver was ascertained using ultrasonography. Linear and U-shaped associations of alcohol intake with fatty liver were evaluated using Poisson regression, and a post hoc analysis was conducted after detecting potential outliers for alcohol intake and excluding them using sex-specific statistics (median plus 2 × interquartile range).

Fatty liver was ascertained in 1120 participants (24.5%). Whereas no significant association of alcohol intake with fatty liver was observed when potential outliers of alcohol intake were included (p = 0.25), a significant U-shaped association was observed after excluding the outliers with and without adjustment for dietary patterns (p = 0.003 and 0.02, respectively). The lowest prevalence was estimated when alcohol consumption was approximately 7% of energy, with a prevalence ratio of 0.72 (95% confidence interval = 0.59–0.86) compared to non-drinkers. The association became imprecise and attenuated toward the null after further adjustment for body mass index (p = 0.06).

Alcohol intake showed a U-shaped association with fatty liver prevalence. This association was independent of underlying dietary patterns, while it was sensitive to excessive alcohol intake and obesity status, providing clinical implications for the prevention of fatty liver.

• Alcohol intake
• Diet history questionnaire
• Dietary patterns
• Fatty liver

Shear wave speed has been widely applied to quantify a degree of liver fibrosis. However, there is no standardized procedure, which makes it difficult to utilize the speed universally.

To provide procedural standardization of shear wave speed measurement.

Point shear wave elastography (pSWE) was measured in 781 patients, and two-dimensional shear wave elastography (2dSWE) was measured on the same day in 18 cases. Regions-of-interest were placed at 12 sites, and the median and robust coefficient-of-variation (CVR) were calculated. A residual sum-of-square (Σdi²) was computed for bootstrap values of 1000 iterations in 18 cases with each assumption of 1 to 12 measurements. The proportion of the Σdi² (%Σdi²) was calculated as the ratio of Σdi² to pSWE after converting it based on the correlation between pSWE and 2dSWE.

The CVR showed a significantly broader distribution in the left lobe (P < 0.0001), and the smallest CVR in the right anterior segment that covered 95% cases was 40.4%. pSWE was significantly higher in the left lobe than in the right lobe (1.63 ± 0.78 m/s vs 1.61 ± 0.78 m/s, P = 0.0004), and the difference between the lobes became further discrete when the subjects were limited to the cases with a CVR less than 40.4% in any segment (1.76 ± 0.80 m/s vs 1.70 ± 0.82 m/s, P < 0.0001). The highest values of the CVR in every 0.1 m/s interval were plotted in convex upward along pSWE and peaked at 1.93 m/s. pSWE and 2dSWE were significantly correlated (P < 0.0001, r = 0.95). In 216000 resamples from 18 cases, the %Σdi² of 12 sites was 8.0% and gradually increased as the acquisition sites decreased to reach a significant difference with a %Σdi² of 7 sites (P = 0.027).

These data suggest that shear wave speed should be measured at 8 or more sites of spreading in both lobes.

• Liver stiffness
• Ultrasound
• Shear wave elastography
• Acoustic radiation force impulse
• Heterogeneity

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Child
• Child, Preschool
• Elasticity Imaging Techniques/methods
• Feasibility Studies
• Female
• Humans
• Infant
• Liver/diagnostic imaging
• Liver/pathology
• Liver Cirrhosis/diagnosis
• Liver Cirrhosis/pathology
• Male
• Middle Aged
• Reproducibility of Results
• Young Adult

• cohort study
• euthyroidism
• free triiodothyronine
• nonalcoholic fatty liver disease

• Advanced fibrosis
• Glycated hemoglobin A1c
• Non-alcoholic fatty liver disease
• Obesity

• Hepatic steatosis
• Hepatic vein blurring
• Liver
• Reader agreement
• Ultrasound features

• Adiponectin
• NAFLD
• insulin resistance
• prospective

• Aged
• Antirheumatic Agents/adverse effects
• Antirheumatic Agents/therapeutic use
• Arthritis, Rheumatoid/diagnostic imaging
• Arthritis, Rheumatoid/drug therapy
• Arthritis, Rheumatoid/metabolism
• Arthritis, Rheumatoid/pathology
• Biopsy
• Chemical and Drug Induced Liver Injury/diagnostic imaging
• Chemical and Drug Induced Liver Injury/metabolism
• Chemical and Drug Induced Liver Injury/pathology
• Female
• Humans
• Liver/diagnostic imaging
• Liver/drug effects
• Liver/pathology
• Male
• Methotrexate/adverse effects
• Methotrexate/therapeutic use
• Middle Aged
• Non-alcoholic Fatty Liver Disease/chemically induced
• Non-alcoholic Fatty Liver Disease/diagnostic imaging
• Non-alcoholic Fatty Liver Disease/metabolism
• Non-alcoholic Fatty Liver Disease/pathology
• Risk Factors
• Transaminases/metabolism

• National Hospital Organization, Japan

• Cardiovascular disease
• Non-alcoholic fatty liver disease
• Type 2 diabetes mellitus

• Biomarkers/metabolism
• C-Reactive Protein/metabolism
• Cardiovascular Diseases/diagnostic imaging
• Cardiovascular Diseases/epidemiology
• Cardiovascular Diseases/etiology
• Cardiovascular Diseases/metabolism
• Carotid Intima-Media Thickness
• Diabetes Mellitus, Type 2/complications
• Female
• Follow-Up Studies
• Humans
• India/epidemiology
• Male
• Middle Aged
• Non-alcoholic Fatty Liver Disease/diagnostic imaging
• Non-alcoholic Fatty Liver Disease/epidemiology
• Non-alcoholic Fatty Liver Disease/etiology
• Non-alcoholic Fatty Liver Disease/metabolism
• Prevalence
• Prognosis
• Prospective Studies
• Risk Factors
• Ultrasonography

• Acute-on-chronic liver failure
• Hypermetabolism
• Mortality
• Resting energy expenditure

• fatty liver
• intestinal permeability
• obesity
• zonulin

• Extreme learning machine
• Fatty liver disease
• Grayscale features
• Neural network
• Performance
• Reliability
• Support vector machine

To investigate the association of chronic hepatitis B and nonalcoholic steatohepatitis with physical fitness in a Taiwanese military male cohort.

We made a cross-sectional examination of this association using 3669 young adult military males according to cardiorespiratory fitness and hospitalization events recorded in the Taiwan Armed Forces study. Cases of chronic hepatitis B (n = 121) were defined by personal history and positive detection of hepatitis B surface antigen. Cases of nonalcoholic steatohepatitis (n = 129) were defined by alanine transaminase level > 60 U/L, liver ultrasound finding of steatosis, and absence of viral hepatitis A, B or C infection. All other study participants were defined as unaffected (n = 3419). Physical fitness was evaluated by performance in 3000-m run, 2-min sit-ups, and 2-min push-ups exercises, with all the procedures standardized by a computerized scoring system. Multiple linear regression analysis was used to determine the relationship.

Chronic hepatitis B negatively correlated with 2-min push-up numbers (β = -2.49, P = 0.019) after adjusting for age, service specialty, body mass index, systolic and diastolic blood pressures, current cigarette smoking, alcohol intake status, serum hemoglobin, and average weekly exercise times. Nonalcoholic steatohepatitis was borderline positively correlated with 3000-m running time (β = 11.96, P = 0.084) and negatively correlated with 2-min sit-up numbers (β = -1.47, P = 0.040).

Chronic hepatitis B viral infection and nonalcoholic steatohepatitis affects different physical performances in young adult military males, and future study should determine the underlying mechanism.

• Chronic hepatitis B
• Military cohort
• Physical fitness
• Nonalcoholic steatohepatitis

• Adult
• Alanine Transaminase/blood
• Body Mass Index
• Cross-Sectional Studies
• Exercise
• Hepacivirus/isolation & purification
• Hepatitis A Virus, Human/isolation & purification
• Hepatitis B Surface Antigens/isolation & purification
• Hepatitis B virus/immunology
• Hepatitis B, Chronic/epidemiology
• Hepatitis B, Chronic/physiopathology
• Hepatitis B, Chronic/virology
• Humans
• Liver/pathology
• Male
• Military Personnel/statistics & numerical data
• Non-alcoholic Fatty Liver Disease/blood
• Non-alcoholic Fatty Liver Disease/diagnostic imaging
• Non-alcoholic Fatty Liver Disease/epidemiology
• Non-alcoholic Fatty Liver Disease/physiopathology
• Physical Fitness/physiology
• Prevalence
• Retrospective Studies
• Taiwan/epidemiology
• Ultrasonography
• Young Adult

• fatty liver
• gastrointestinal ultrasound
• hepatitis B virus
• liver biopsy
• sonography

• Fatty Liver/complications
• Fatty Liver/diagnostic imaging
• Female
• Hepatitis B, Chronic/complications
• Humans
• Liver/diagnostic imaging
• Male
• Middle Aged
• Predictive Value of Tests
• Reproducibility of Results
• Retrospective Studies
• Sensitivity and Specificity
• Severity of Illness Index
• Ultrasonography/methods

Non- Alcoholic Fatty Liver (NAFL) is a spectrum of liver diseases (LD) that ranges from benign fatty infiltration of the liver to cirrhosis and hepatic failure. Hepatic ultrasound (US) and serum alanine aminotransferase (ALT) are often used as markers of NAFL. Our aim is to describe prevalence of NAFL and associated findings on ultrasound (US) and biochemical parameters in a population of children and adolescents with obesity at the Children’s Hospital of Eastern Ontario.

Children with Obesity (BMI >95th percentile) ages 8–17 years presenting to the Endocrinology and Gastroenterology clinics, without underlying LD were prospectively recruited from 2009 to 2012. Fasting lipid profile, HOMA IR) and serum adiponectin levels were measured. NAFL was defined as ALT > 25 and >22 IU/mL (males and females respectively) and/or evidence of fatty infiltration by US. Logistic regression was performed to assess associations.

97 children with obesity included in the study (Male 43%). Mean age was 12.9 ± 3.2 years (84% were older than 10 y). Mean BMI-Z score was 3.8 ± 1.4. NAFL was identified in 85%(82/97) of participants. ALT was elevated in 61% of patients. Median triglyceride (TG) level was higher in children with NAFL(1.5 ± 0.9 vs. 1.1 ± 0.5 mmol/L, p = 0.01). Total cholesterol, HDL, LDL and Non HDL cholesterol were similar in both groups(p = 0.63, p = 0.98, p = 0.72 and p = 0.37 respectively). HOMA IR was ≥3.16 in 53% of children(55% in those with NAFL and 40% in those without NAFL). Median serum adiponectin was 11.2 μg/ml(IQR 7.3–18.3) in children with NAFL vs. 16.1 μg/ml(IQR 9.0–21.9) in those without NAFL(p = 0.23). Liver US was reported as normal in 30%, mild fatty infiltration in 38%, moderate in 20% and severe in 12%. TG were significantly higher(1.5 mmol/L vs. 1.0 mmol/L, p < 0.01) and HDL-C was lower(1.0 mmol/L vs. 1.1 mmol/L, p = 0.05) in children with moderate and severe NAFL by US. BMI-Z score, HOMA IR, serum adiponectin and HDL levels were not associated with NAFL, however TG were significantly associated(OR = 3.22 (95% CI: 1.01–10.25, p = 0.04)).

NAFL is highly prevalent in obese children and youth. Elevated TG levels are associated with NAFL; these findings may serve as a noninvasive screening tool to help clinicians identify children with obesity needing liver biopsy and/or more aggressive therapeutic interventions.

• Dyslipidemia
• Non-alcoholic fatty liver
• Obesity

To determine the effects of omega‐3 supplementation on liver fat and carotid intima–media thickness (IMT) and to assess accuracy of ultrasound (US) for grading liver steatosis.

In this one‐way crossover pilot study, we assigned children with obesity and liver steatosis to receive 1.2 g daily of omega‐3 supplementation vs. inactive sunflower oil for 24 or 12 weeks. Liver fat content was assessed by magnetic resonance spectroscopy (MRS), magnetic resonance imaging (MRI) and US, and common carotid IMT by US. Statistical analysis included Chi‐square, Student's t‐tests, ANOVA tests and receiver operating characteristic (ROC) curves.

Omega‐3 supplementation was associated with a trend towards decrease in MRS‐determined liver fat fraction (0.7% and 2.1% decrease in the 24‐week and 12‐week omega‐3 group, respectively) compared with the sunflower oil group (1.0% increase). These changes were not significant, whether assessed by MRS (P = 0.508), MRI (P = 0.508) or US (P = 0.678). Using US, the area under the ROC curves were 0.964, 0.817 and 0.783 for distinguishing inferred steatosis grades 0 vs. 1–2–3, 0–1 vs. 2–3 and 0–1–2 vs. 3, respectively, indicating good accuracy of US‐based fat grading. Omega‐3 supplementation was associated with a decrease in US‐determined IMT (0.05‐mm decrease in the 24‐week omega‐3 group. A 0.015‐mm increase was found in the 12‐week omega‐3 group, and a 0.007‐mm decrease in the sunflower oil group (P = 0.003).

Omega‐3 supplementation had no significant effect on liver fat fraction, but led to carotid IMT decrease in children with obesity and liver steatosis.

• Carotid intima–media thickness (IMT)
• MRI‐proton density fat fraction (PDFF)
• liver steatosis
• omega‐3 fatty acids

• Adiposity
• Carotid intimal-medial thickness
• India
• Liver fat
• Metabolic disease

To further observe and verify the effect of nonalcoholic fatty liver disease (NAFLD) on the response to antiviral therapy in patients with chronic hepatitis B (CHB) and investigate the relationship between the virologic response and insulin resistance.

A retrospective study was adopted and 61 NAFLD patients with HBeAg-positive CHB were included as the observation group (group A), and 64 patients with simple CHB were included as the control group (group B).

After 12 weeks of treatment with entecavir, the total virologic response rate in group A was statistically significantly lower than that in group B (P<0.05). During weeks 24–96, the difference was not statistically significant (P>0.05). In weeks 48 and 96, there was no significant difference in the HBeAg seroconversion rates between the two groups (P>0.05). In weeks 12 and 24, there was also no significant difference in the alanine transaminase (ALT) normalization rate between the two groups (P>0.05). Then, in weeks 48 and 96, the ALT normalization rate of group A was obviously lower than that of group B (P<0.05). Group A patients were divided into group A1 (≤M) and group A2 (>M) according to the median value (M=2.79) of the baseline homeostatic model assessment method insulin resistance levels. In weeks 48 and 96, the ALT normalization rate of group A1 was significantly higher than that of group A2 (P<0.05). The correlation coefficient (r) of the baseline homeostatic model assessment method insulin resistance level and the severity of fatty liver in group A was 0.426 (P=0.001).

NAFLD cannot affect the long-term total virologic response rate and HBeAg seroconversion rate in CHB patients treated with entecavir but can reduce the long-term biochemical response rate, which has a positive correlation with the severity of fatty liver and the insulin resistance index.

• chronic
• entecavir
• fatty liver
• hepatitis B virus
• insulin resistance index