Ecography, diagnostic technique in non-alcoholic hepatic esteatosis

Abstract

Objective. To analyze the ultrasound as a diagnostic test for non-alcoholic liver steatosis.

Method. Observational, descriptive and analytical study, of cross section. For 12 months, 100 patients were selected, with 2 or more cardiovascular risk factors, with no or low alcohol intake, who attended Primary Care. Determinations made. Demographic and biochemical variables: Age. Gender. Alcohol intake.  History of diabetes, systemic arterial hypertension. Weight, height, body mass index (BMI). Blood  pressure measurement Basal glucose levels, glycosylated hemoglobin. Total cholesterol, HDL cholesterol,  LDL cholesterol, triglycerides, AST, ALT, bilirubins and alkaline phosphatase. Personal and family history of  diabetes, HBP, dyslipidemia, drug treatment, figures of other analytical parameters and abdominal  perimeter were also collected. Hepatic evaluation by ultrasonography. Once they met the selection  criteria, they were cited for the realization of the ultrasound of the entire abdomen, prior information on  the purpose of the technique to be performed and providing the signed informed consent. The ultrasound  was performed with the patient on an empty stomach and, if possible, with a bladder  replenished, in order to perform the technique in the best conditions of preparation of the patient, in  order to reduce the ultrasound devices and to assess all the abdominal structures correctly. Statistical  Analysis with SPSS program 23. The qualitative variables are shown as exact value and in percentage, the  quantitative variables as mean and standard deviation (SD). The comparison between means was made  through the Student t test for independent groups or the Mann-Whitney U test if the normal conditions  (application of the Kolmogorov-Smirnoff or Shapiro Willks test) were not met. In qualitative variables, the  chi-square test.

Results. 100 patients participated: 44 men and 56 women, with a mean age of 61.84. 71% of subjects are obese. 23% of the subjects do not have steatosis, and in 58% it is mild and moderate in both genders (p  <0.003). 19% have grade 3 steatosis. The most prevalent risk factors of the patients studied are obesity,  which is presented by 78% of them, hypercholesterolemia 73%, DM 62% and HT 59%.

Conclusions. Ultrasound is the modality of choice for the qualitative determination of steatosis, but it is a subjective and operator-dependent test: it only detects moderate to severe fat infiltration.