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Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...

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Phosphorus-31 Magnetic Resonance Spectroscopy: A Tool for Measuring In Vivo Mitochondrial Oxidative Phosphorylation Capacity in Human Skeletal Muscle

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Predictors of controlled attenuation parameter in metabolic dysfunction.

Cristiana Bianco¹, Serena Pelusi¹, Sara Margarita¹

¹Precision Medicine Lab, Biological Resource Center and Department of Transfusion Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

United European Gastroenterology Journal

|December 23, 2023

Summary

This summary is machine-generated.

Metabolic dysfunction increases hepatic fat, estimated by controlled attenuation parameter (CAP). Abdominal adiposity and insulin resistance are key predictors, suggesting improved risk stratification for fatty liver disease.

Keywords:

CAP LSM abdominal circumference controlled attenuation parameter fasting insulin fibroscan liver stiffness measurement metabolic syndrome steatosis thyroid transient elastography

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Area of Science:

Hepatology
Metabolic Syndrome
Non-invasive Liver Assessment

Background:

Hepatic fat content is crucial for metabolic dysfunction assessment.
Controlled Attenuation Parameter (CAP) offers non-invasive estimation of liver fat.
Understanding CAP determinants is vital for managing metabolic dysfunction.

Purpose of the Study:

To identify determinants and predictors of CAP values in individuals with metabolic dysfunction.
To explore factors influencing non-invasive hepatic fat estimation.
To enhance risk stratification for steatotic liver disease in metabolic dysfunction.

Main Methods:

Enrolled 1230 individuals with metabolic dysfunction (Liver-Bible-2022 cohort).
Measured CAP using Fibroscan and identified determinants via backward stepwise analysis.
Utilized generalized linear models for predictor analysis.

Main Results:

Fasting insulin, abdominal circumference, BMI, age, diabetes, triglycerides, ferritin, HDL, and TSH were significant CAP determinants.
A clinical CAP score (age, BMI, AC, HbA1c, ALT, HDL) predicted steatosis (CAP ≥ 275 dB/m) with AUROC 0.73.
Higher free triiodothyronine levels correlated with CAP, independent of TSH.

Conclusions:

Abdominal adiposity and insulin resistance severity are primary CAP determinants in metabolic dysfunction.
CAP modulation by the hypophysis-thyroid axis warrants further investigation.
These findings can improve steatotic liver disease risk stratification.