Instrumental features of the differential diagnosis of metabolically associated and non-alcoholic fatty liver diseases
Taking into account the lack of consensus between different scientific groups on the nature and unity of the pathomorphological substrate of non-alcoholic and metabolically associated fatty liver diseases, there is a need to find new instrumental methods for their differential diagnosis in order to develop the correct treatment and monitoring tactics.Aim: To assess the possibilities of using the complex application of instrumental diagnostic methods for the differential diagnosis of metabolically associated and non-alcoholic fatty liver disease.Methodology and Methods. The study involved 94 patients of a multidisciplinary hospital with a combination of ultrasound signs of liver steatosis according to the B-mode. As part of the two stages of the diagnostic examination, clinical, laboratory and instrumental methods were used, including a block of ultrasound diagnostics (assessment of the thickness of visceral fat, quantitative liver steatometry, two-dimensional elastography of shear waves of the liver), dual-energy X-ray absorptiometry in the “Whole body” mode. The control group included 78 patients without signs of hepatic steatosis according to B-mode ultrasound.Results. All patients were divided into groups according to signs of metabolic syndrome, with subsequent distribution into conditional groups of patients with non-alcoholic and metabolically associated fatty liver disease, highlighting the main signs of both diseases. Metabolic syndrome was detected in 24 women (29.27%), 18 men (21.95%). In 53 patients (64.63%), the presence of hepatic steatosis was quantitatively confirmed, of which 39 patients were found to be overweight or obese (47.56%).Conclusion. Indicators of the instrumental assessment of the metabolic status and a complex diagnostic algorithm were determined, allowing for differential diagnosis between non-alcoholic and metabolically associated fatty liver disease with a quantitative assessment of liver steatosis.
