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<record>
<TEI>
<teiHeader>
<fileDesc>
<titleStmt>
<title xml:lang="en">Estimating steatosis and fibrosis: Comparison of acoustic structure quantification with established techniques</title>
<author>
<name sortKey="Karlas, Thomas" sort="Karlas, Thomas" uniqKey="Karlas T" first="Thomas" last="Karlas">Thomas Karlas</name>
</author>
<author>
<name sortKey="Berger, Joachim" sort="Berger, Joachim" uniqKey="Berger J" first="Joachim" last="Berger">Joachim Berger</name>
</author>
<author>
<name sortKey="Garnov, Nikita" sort="Garnov, Nikita" uniqKey="Garnov N" first="Nikita" last="Garnov">Nikita Garnov</name>
</author>
<author>
<name sortKey="Lindner, Franziska" sort="Lindner, Franziska" uniqKey="Lindner F" first="Franziska" last="Lindner">Franziska Lindner</name>
</author>
<author>
<name sortKey="Busse, Harald" sort="Busse, Harald" uniqKey="Busse H" first="Harald" last="Busse">Harald Busse</name>
</author>
<author>
<name sortKey="Linder, Nicolas" sort="Linder, Nicolas" uniqKey="Linder N" first="Nicolas" last="Linder">Nicolas Linder</name>
</author>
<author>
<name sortKey="Schaudinn, Alexander" sort="Schaudinn, Alexander" uniqKey="Schaudinn A" first="Alexander" last="Schaudinn">Alexander Schaudinn</name>
</author>
<author>
<name sortKey="Relke, Bettina" sort="Relke, Bettina" uniqKey="Relke B" first="Bettina" last="Relke">Bettina Relke</name>
</author>
<author>
<name sortKey="Chakaroun, Rima" sort="Chakaroun, Rima" uniqKey="Chakaroun R" first="Rima" last="Chakaroun">Rima Chakaroun</name>
</author>
<author>
<name sortKey="Troltzsch, Michael" sort="Troltzsch, Michael" uniqKey="Troltzsch M" first="Michael" last="Tröltzsch">Michael Tröltzsch</name>
</author>
<author>
<name sortKey="Wiegand, Johannes" sort="Wiegand, Johannes" uniqKey="Wiegand J" first="Johannes" last="Wiegand">Johannes Wiegand</name>
</author>
<author>
<name sortKey="Keim, Volker" sort="Keim, Volker" uniqKey="Keim V" first="Volker" last="Keim">Volker Keim</name>
</author>
</titleStmt>
<publicationStmt>
<idno type="wicri:source">PMC</idno>
<idno type="pmid">25945002</idno>
<idno type="pmc">4408461</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4408461</idno>
<idno type="RBID">PMC:4408461</idno>
<idno type="doi">10.3748/wjg.v21.i16.4894</idno>
<date when="2015">2015</date>
<idno type="wicri:Area/Pmc/Corpus">000304</idno>
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<biblStruct>
<analytic>
<title xml:lang="en" level="a" type="main">Estimating steatosis and fibrosis: Comparison of acoustic structure quantification with established techniques</title>
<author>
<name sortKey="Karlas, Thomas" sort="Karlas, Thomas" uniqKey="Karlas T" first="Thomas" last="Karlas">Thomas Karlas</name>
</author>
<author>
<name sortKey="Berger, Joachim" sort="Berger, Joachim" uniqKey="Berger J" first="Joachim" last="Berger">Joachim Berger</name>
</author>
<author>
<name sortKey="Garnov, Nikita" sort="Garnov, Nikita" uniqKey="Garnov N" first="Nikita" last="Garnov">Nikita Garnov</name>
</author>
<author>
<name sortKey="Lindner, Franziska" sort="Lindner, Franziska" uniqKey="Lindner F" first="Franziska" last="Lindner">Franziska Lindner</name>
</author>
<author>
<name sortKey="Busse, Harald" sort="Busse, Harald" uniqKey="Busse H" first="Harald" last="Busse">Harald Busse</name>
</author>
<author>
<name sortKey="Linder, Nicolas" sort="Linder, Nicolas" uniqKey="Linder N" first="Nicolas" last="Linder">Nicolas Linder</name>
</author>
<author>
<name sortKey="Schaudinn, Alexander" sort="Schaudinn, Alexander" uniqKey="Schaudinn A" first="Alexander" last="Schaudinn">Alexander Schaudinn</name>
</author>
<author>
<name sortKey="Relke, Bettina" sort="Relke, Bettina" uniqKey="Relke B" first="Bettina" last="Relke">Bettina Relke</name>
</author>
<author>
<name sortKey="Chakaroun, Rima" sort="Chakaroun, Rima" uniqKey="Chakaroun R" first="Rima" last="Chakaroun">Rima Chakaroun</name>
</author>
<author>
<name sortKey="Troltzsch, Michael" sort="Troltzsch, Michael" uniqKey="Troltzsch M" first="Michael" last="Tröltzsch">Michael Tröltzsch</name>
</author>
<author>
<name sortKey="Wiegand, Johannes" sort="Wiegand, Johannes" uniqKey="Wiegand J" first="Johannes" last="Wiegand">Johannes Wiegand</name>
</author>
<author>
<name sortKey="Keim, Volker" sort="Keim, Volker" uniqKey="Keim V" first="Volker" last="Keim">Volker Keim</name>
</author>
</analytic>
<series>
<title level="j">World Journal of Gastroenterology : WJG</title>
<idno type="ISSN">1007-9327</idno>
<idno type="eISSN">2219-2840</idno>
<imprint>
<date when="2015">2015</date>
</imprint>
</series>
</biblStruct>
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<front>
<div type="abstract" xml:lang="en">
<p>AIM: To compare ultrasound-based acoustic structure quantification (ASQ) with established non-invasive techniques for grading and staging fatty liver disease.</p>
<p>METHODS: Type 2 diabetic patients at risk of non-alcoholic fatty liver disease (
<italic>n</italic>
= 50) and healthy volunteers (
<italic>n</italic>
= 20) were evaluated using laboratory analysis and anthropometric measurements, transient elastography (TE), controlled attenuation parameter (CAP), proton magnetic resonance spectroscopy (
<sup>1</sup>
H-MRS; only available for the diabetic cohort), and ASQ. ASQ parameters mode, average and focal disturbance (FD) ratio were compared with: (1) the extent of liver fibrosis estimated from TE and non-alcoholic fatty liver disease (NAFLD) fibrosis scores; and (2) the amount of steatosis, which was classified according to CAP values.</p>
<p>RESULTS: Forty-seven diabetic patients (age 67.0 ± 8.6 years; body mass index 29.4 ± 4.5 kg/m²) with reliable CAP measurements and all controls (age 26.5 ± 3.2 years; body mass index 22.0 ± 2.7 kg/m²) were included in the analysis. All ASQ parameters showed differences between healthy controls and diabetic patients (
<italic>P</italic>
< 0.001, respectively). The ASQ FD ratio (logarithmic) correlated with the CAP (
<italic>r</italic>
= -0.81,
<italic>P</italic>
< 0.001) and
<sup>1</sup>
H-MRS (
<italic>r</italic>
= -0.43,
<italic>P</italic>
= 0.004) results. The FD ratio [CAP < 250 dB/m: 107 (102-109), CAP between 250 and 300 dB/m: 106 (102-114); CAP between 300 and 350 dB/m: 105 (100-112), CAP ≥ 350 dB/m: 102 (99-108)] as well as mode and average parameters, were reduced in cases with advanced steatosis (ANOVA
<italic>P</italic>
< 0.05). However, none of the ASQ parameters showed a significant difference in patients with advanced fibrosis, as determined by TE and the NAFLD fibrosis score (
<italic>P</italic>
> 0.08, respectively).</p>
<p>CONCLUSION: ASQ parameters correlate with steatosis, but not with fibrosis in fatty liver disease. Steatosis estimation with ASQ should be further evaluated in biopsy-controlled studies.</p>
</div>
</front>
</TEI>
<pmc article-type="research-article">
<pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">World J Gastroenterol</journal-id>
<journal-id journal-id-type="iso-abbrev">World J. Gastroenterol</journal-id>
<journal-id journal-id-type="publisher-id">WJG</journal-id>
<journal-title-group>
<journal-title>World Journal of Gastroenterology : WJG</journal-title>
</journal-title-group>
<issn pub-type="ppub">1007-9327</issn>
<issn pub-type="epub">2219-2840</issn>
<publisher>
<publisher-name>Baishideng Publishing Group Inc</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">25945002</article-id>
<article-id pub-id-type="pmc">4408461</article-id>
<article-id pub-id-type="other">jWJG.v21.i16.pg4894</article-id>
<article-id pub-id-type="doi">10.3748/wjg.v21.i16.4894</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Case Control Study</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Estimating steatosis and fibrosis: Comparison of acoustic structure quantification with established techniques</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Karlas</surname>
<given-names>Thomas</given-names>
</name>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Berger</surname>
<given-names>Joachim</given-names>
</name>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Garnov</surname>
<given-names>Nikita</given-names>
</name>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Lindner</surname>
<given-names>Franziska</given-names>
</name>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Busse</surname>
<given-names>Harald</given-names>
</name>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Linder</surname>
<given-names>Nicolas</given-names>
</name>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Schaudinn</surname>
<given-names>Alexander</given-names>
</name>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Relke</surname>
<given-names>Bettina</given-names>
</name>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Chakaroun</surname>
<given-names>Rima</given-names>
</name>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Tröltzsch</surname>
<given-names>Michael</given-names>
</name>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Wiegand</surname>
<given-names>Johannes</given-names>
</name>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Keim</surname>
<given-names>Volker</given-names>
</name>
</contrib>
<aff>Thomas Karlas, Nikita Garnov, IFB Adiposity Diseases, Leipzig University Medical Center, 04103 Leipzig, Germany</aff>
<aff>Thomas Karlas, Joachim Berger, Franziska Lindner, Michael Tröltzsch, Johannes Wiegand, Volker Keim, Department of Medicine, Neurology and Dermatology, Division of Gastroenterology and Rheumatology, University Hospital Leipzig, 04103 Leipzig, Germany</aff>
<aff>Nikita Garnov, Harald Busse, Nicolas Linder, Alexander Schaudinn, Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, 04103 Leipzig, Germany</aff>
<aff>Bettina Relke, Internistische Hausarzt- und Diabetologische Schwerpunktpraxis Dr. Relke, 04249 Leipzig, Germany</aff>
<aff>Rima Chakaroun, Department of Medicine, Neurology and Dermatology, Division of Endocrinology and Nephrology, University Hospital Leipzig, 04103 Leipzig, Germany</aff>
</contrib-group>
<author-notes>
<fn>
<p>Author contributions: Karlas T and Berger J contributed equally to this work; Karlas T, Berger J, Garnov N, Wiegand J and Keim V designed the research; Karlas T, Berger J, Garnov N, Lindner F, Busse H, Linder N, Schaudinn A, Relke B, Chakaroun R, Tröltzsch M, Wiegand J and Keim V performed the research; Karlas T, Berger J, Garnov N, Busse H, Linder N, Schaudinn A, Wiegand J and Keim V analyzed the data; Karlas T, Berger J, Garnov N, Wiegand J and Keim V wrote the manuscript; Lindner F, Busse H, Linder N, Schaudinn A, Relke B, Chakaroun R and Tröltzsch M revised the manuscript.</p>
<p>Correspondence to: Thomas Karlas, MD, Department of Medicine, Neurology and Dermatology, Division of Gastroenterology and Rheumatology, University Hospital Leipzig, Liebigstrasse 20, 04103 Leipzig, Germany.
<email>thomas.karlas@medizin.uni-leipzig.de</email>
</p>
<p>Telephone: +49-341-9712200 Fax: +49-341-9712209</p>
</fn>
</author-notes>
<pub-date pub-type="ppub">
<day>28</day>
<month>4</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub">
<day>28</day>
<month>4</month>
<year>2015</year>
</pub-date>
<volume>21</volume>
<issue>16</issue>
<fpage>4894</fpage>
<lpage>4902</lpage>
<history>
<date date-type="received">
<day>26</day>
<month>10</month>
<year>2014</year>
</date>
<date date-type="rev-recd">
<day>8</day>
<month>1</month>
<year>2015</year>
</date>
<date date-type="accepted">
<day>11</day>
<month>2</month>
<year>2015</year>
</date>
</history>
<permissions>
<copyright-statement>©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.</copyright-statement>
<copyright-year>2015</copyright-year>
</permissions>
<abstract>
<p>AIM: To compare ultrasound-based acoustic structure quantification (ASQ) with established non-invasive techniques for grading and staging fatty liver disease.</p>
<p>METHODS: Type 2 diabetic patients at risk of non-alcoholic fatty liver disease (
<italic>n</italic>
= 50) and healthy volunteers (
<italic>n</italic>
= 20) were evaluated using laboratory analysis and anthropometric measurements, transient elastography (TE), controlled attenuation parameter (CAP), proton magnetic resonance spectroscopy (
<sup>1</sup>
H-MRS; only available for the diabetic cohort), and ASQ. ASQ parameters mode, average and focal disturbance (FD) ratio were compared with: (1) the extent of liver fibrosis estimated from TE and non-alcoholic fatty liver disease (NAFLD) fibrosis scores; and (2) the amount of steatosis, which was classified according to CAP values.</p>
<p>RESULTS: Forty-seven diabetic patients (age 67.0 ± 8.6 years; body mass index 29.4 ± 4.5 kg/m²) with reliable CAP measurements and all controls (age 26.5 ± 3.2 years; body mass index 22.0 ± 2.7 kg/m²) were included in the analysis. All ASQ parameters showed differences between healthy controls and diabetic patients (
<italic>P</italic>
< 0.001, respectively). The ASQ FD ratio (logarithmic) correlated with the CAP (
<italic>r</italic>
= -0.81,
<italic>P</italic>
< 0.001) and
<sup>1</sup>
H-MRS (
<italic>r</italic>
= -0.43,
<italic>P</italic>
= 0.004) results. The FD ratio [CAP < 250 dB/m: 107 (102-109), CAP between 250 and 300 dB/m: 106 (102-114); CAP between 300 and 350 dB/m: 105 (100-112), CAP ≥ 350 dB/m: 102 (99-108)] as well as mode and average parameters, were reduced in cases with advanced steatosis (ANOVA
<italic>P</italic>
< 0.05). However, none of the ASQ parameters showed a significant difference in patients with advanced fibrosis, as determined by TE and the NAFLD fibrosis score (
<italic>P</italic>
> 0.08, respectively).</p>
<p>CONCLUSION: ASQ parameters correlate with steatosis, but not with fibrosis in fatty liver disease. Steatosis estimation with ASQ should be further evaluated in biopsy-controlled studies.</p>
</abstract>
<kwd-group>
<kwd>Transient elastography</kwd>
<kwd>Non-alcoholic fatty liver disease</kwd>
<kwd>Liver stiffness</kwd>
<kwd>Non-alcoholic fatty liver disease</kwd>
<kwd>Fibrosis score</kwd>
<kwd>Controlled attenuation parameter</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>

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