Predictive Factors for Ultrasonographic Grading of Nonalcoholic Fatty Liver Disease

BACKGROUND There are several studies in the literature investigating factors which can induce non-alcoholic fatty liver disease (NAFLD) in different populations. However, the existing literature lacks powerful studies addressing the factors which may predict the severity of NAFLD. OBJECTIVES In the current study, we aimed to evaluate factors independently associated with liver echogenicity in an Iranian NAFLD patient population. PATIENTS AND METHODS A total of 393 patients attending as outpatients at the Hepatology Clinic of Baqiyatallah University of Medical Sciences were entered into this analysis. Univariate and multivariable linear regression models were performed to evaluate the effects of the study variables on the NAFLD grade, defined by ultrasound hepatic echogenicity. RESULTS Univariate linear analyses revealed a significant relationship between; the ultrasonographic grading of NAFLD and body weight (P < 0.001), abdominal girth (P = 0.007), pelvic girth (P = 0.032), fasting blood glucose (FBS) (P = 0.005), serum insulin (P = 0.035), hemoglobin A1c (HbA1c) (P = 0.012), triglycerides (P = 0.049), aspartate aminotransferase (AST) (P = 0.015), alanin aminotransferase (ALT) (P = 0.026), and homeostasis model assessment (HOMA) (P = 0.002). Multivariable linear regression models left only; HbA1C (P = 0.011, β = 0.133), body weight (P = 0.001; β = 0.176) and serum triglyceride (P = 0.034; β = 0.112) as factors independently associated with liver echogenicity. CONCLUSIONS Diabetic patients can reduce liver damage of NAFLD with control of their HbA1C through the lower ranges. Hypertriglyceridemia and body weight are the other implicated factors, which worsen hepatic echogenicity in the NAFLD patient population. We recommend future prospective studies and clinical trials to confirm our findings.