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9 pages, 1176 KiB

Open AccessArticle

Ultrasound Assessment of Sarcopenia in Alcoholic Liver Disease

by Vlad-Teodor Enciu, Priscila Madalina Ologeanu and Carmen Fierbinteanu-Braticevici

Diagnostics 2024, 14(17), 1891; https://doi.org/10.3390/diagnostics14171891 - 28 Aug 2024

Cited by 2 | Viewed by 1166

Malnutrition frequently affects patients with alcoholic liver disease (ALD), with important impacts on disease prognosis. Sarcopenia, the clinical phenotype of malnutrition characterized by skeletal muscle loss, is the major component responsible for adverse events in this population. The aim of this study is to assess the use of ultrasound (US) skeletal muscle performance in stratifying ALD disease severity. We recruited 43 patients with ALD and divided them into two groups: alcoholic hepatitis (AH) and alcoholic cirrhosis (AC). We evaluated disease-specific clinical and biological parameters and their relation to US Rectus Femoris muscle (RFM) measurements, including RFM thickness, stiffness (RFMS) and echogenicity (RFE). A thirty-seconds chairs stand test (30sCST) was used as the sarcopenia surrogate test. RMF thickness correlated with platelet count and serum albumin (p < 0.001). Both RFM and RFMS correlated with disease severity (p < 0.001) and 30sCST (p < 0.001, p = 0.002). Patients with AH had more severe US muscle abnormalities compared to AC (RFMS 1.78 m/s vs. 1.35 m/s, p = 0.001) and the highest prevalence of RFE (χ² = 8.652, p = 0.003). Rectus Femoris US assessment could represent a reliable tool in the diagnosis and severity stratification of ALD-induced sarcopenia. Full article

(This article belongs to the Section Medical Imaging and Theranostics)

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12 pages, 555 KiB

Open AccessArticle

A Comparison of ¹³C-Methacetin and ¹³C-Octanoate Breath Test for the Evaluation of Nonalcoholic Steatohepatitis

by Carmen Fierbinteanu-Braticevici, Vlad-Teodor Enciu, Ana-Maria Calin-Necula, Ioana Raluca Papacocea and Alexandru Constantin Moldoveanu

J. Clin. Med. 2023, 12(6), 2158; https://doi.org/10.3390/jcm12062158 - 10 Mar 2023

Cited by 1 | Viewed by 1606

Abstract

Background: While non-alcoholic fatty liver disease (NAFLD) is a wide-spread liver disease, only some patients progress towards steatohepatitis and cirrhosis. Aim: We comparatively analyzed the methacetin breath test (MBT) for the microsomal function of the liver and the octanoate breath test (OBT) for mitochondrial activity, in detecting patients with steatohepatitis and estimating fibrosis. Methods: 81 patients with histologically proven NAFLD (SAF score) were evaluated. The parameters used for both breath tests were the dose/h and the cumulative dose recovery at multiple timepoints. The statistical association between histological diagnosis and breath test results used Independent Samples t Test. The accuracy for diagnosis was evaluated using area under the receiver operator characteristic (AUROC) and the sensitivity and specificity were assessed using the Youden J method. Results: Both MBT and OBT were able to differentiate patients with simple steatosis from NASH and to stratify patients with significant fibrosis and cirrhosis (p-values < 0.001 for most analyzed timepoints). The best parameter for NASH diagnosis was OBT dose at 30 min. In the case of significant fibrosis, the most accurate test was MBT cumulative dose at 30 min. Conclusions: Both MBR and OBT tests are potentially useful tools in assessing patients with NAFLD. Full article

(This article belongs to the Section Gastroenterology & Hepatopancreatobiliary Medicine)

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12 pages, 899 KiB

Open AccessArticle

The Role of Noninvasive ¹³C-Octanoate Breath Test in Assessing the Diagnosis of Nonalcoholic Steatohepatitis

by Carmen Fierbinteanu-Braticevici, Ana-Maria Calin-Necula, Vlad-Teodor Enciu, Loredana Goran, Anca Pantea Stoian, Ioan Ancuta, Octav Viasu and Alexandru Constantin Moldoveanu

Diagnostics 2022, 12(12), 2935; https://doi.org/10.3390/diagnostics12122935 - 24 Nov 2022

Cited by 2 | Viewed by 4734

Abstract

Background: The diagnosis of NASH needs a liver biopsy, an invasive procedure that is not frequently accepted by patients. The aim of our study was to evaluate the efficacy of the ¹³C-Octanoate breath test (OBT) as a non-invasive surrogate marker to differentiate patients with NASH from patients with simple steatosis (NAFL). Methods: We performed a prospective study on patients with histologically established non-alcoholic steatohepatitis and no other hepatic disease. Each patient underwent a testing protocol, which included a clinical exam, laboratory blood tests, standard abdominal ultrasound, and a ¹³C-Octanoate breath test. Results: The study group included: 82 patients with steatohepatitis, 64 patients with simple steatosis, and 21 healthy volunteers. The univariate and bivariate analysis identified that significant values were the percent dose recovery (PDR) at 15 min—r = 0.65 (AUROC = 0.902) and cumulative percent dose recovery (cPDR) at 120 min—r = 0.69 (AUROC = 0.899). Discussion: Our study showed that ¹³C-OBT had good efficacy for identifying patients with NASH from those with NAFL (steatosis alone) but not those with NAFL from healthy subjects. Considering all these pathogenic steps in NASH we considered that OBT could have the clinical utility to identify patients at risk for NASH, especially “fast progressors”. Full article

(This article belongs to the Special Issue Gastrointestinal and Liver Diseases: New Advances in Diagnosis and Prognosis)

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