Ultrasonographic score for noninvasive diagnostic of steatosis in chronic viral hepatitis

Abstract

Introduction: Liver steatosis is defined as fatty infiltration affecting greater than 5% of hepatocytes. Liver steatosis is associated with insulin resistance and the metabolic syndrome. Over 90% of patients with nonalcoolic liver steatosis have one or more features of the metabolic syndrome and 30- 40% have the foil syndrome. The noninvasive methods of detection and quantification of steatosis includes ultrasonography, computed tomography and magnetic resonance imaging. Purpose and objectives: To establish correlations between clinical, biochemical and imaging parameters in patients with liver steatosis, and to evaluate association between metabolic syndrome and severity of steatosis according to the ultrasonography score. Materials and methods: The study involved 38 patients with hepatic steatosis determined by ultrasound methods. All patients were evaluated anthropometrically, with biological and immunological methods. The degree of steatosis in all patients was assessed according to ultrasound score Hamaguchi. We scored the ultrasonography findings from 0 to 6 points and evaluated the correlation with all components of the metabolic syndrome. Results: The study involved 38 subjects, 18 men (47%) and 20 women (53%). The mean age was 50.2±12.3 year. A total of 27 patients have had chronic viral hepatitis type C (71%) and 8 patients were infected with hepatic virus type B (21%). Among them, 3 patients have had chronic hepatitis type C and B (8%). The mean waist circumference and body mass index were 89.47±7.70 cm and 28±3.37 kg/m2, respectively. We diagnosed liver steatosis of score 2 in 18 (47%), of score 4 in 9 (24%), of score 5 in 7 (18%), of score 6 in 4 (11%) patients. Visceral obesity was diagnosed in 14 (37%) patients. Metabolic syndrome was diagnosed in 23 (68%) of 38 subjects. The correlation between the score and waist circumference was statistically significant, p<0,001. The score significantly correlated with all components of the metabolic syndrome, including waist circumference, blood pressure, fasting plasma sugar, HDL cholesterol and serum triglycerides, p<0,001. Conclusion: The majority of patients included in this study was infected with hepatic virus C. Ultrasound is widely available, non-invasive and cost efficient method for diagnosis of liver steatosis. In case of patients with chronic viral hepatitis C and B, the ultrasonography scoring system could provide accurate information about hepatic steatosis which correlates with metabolic syndrome.