Detection Of Hepatic Steatosis And Fibrosis In Patients With MAFLD By Transient Elastography And Their Relationship With Liver Function And Glucolipid Metabolism

Objective: To detect controlled attenuation parameter(CAP value)and liver stiffness(E value)in patients with metabolic-associated fatty liver disease(MAFLD)by Fibro Scan noninvasive transient elastography.Meanwhile,the related clinical data and biochemical indexes such as liver function,blood glucose and blood lipid of MAFLD patients were collected to explore the characteristics and correlation of liver function,glucose and lipid metabolism in MAFLD patients with different degrees of steatosis and liver stiffness(fibrosis),so as to provide real reference for further clinical diagnosis and treatment of MAFLD.Methods:1.158 patients with MAFLD who were admitted and confirmed in Xiangxi Autonomous Prefecture People’s Hospital from July 2020 to November 2021 were selected prospectively as the research objects,and the clinical data and biochemical indexes related to liver function and glucose and lipid metabolism of each patient were collected.2.Fibro Scan noninvasive steatosis and liver stiffness test were performed in each patient,and liver steatosis value(CAP value)and liver stiffness value(E value)were obtained quantitatively.3.According to the severity of steatosis(CAP value),the patients were divided into mild fatty liver group(31 cases),moderate fatty liver group(49 cases)and severe fatty liver group(78 cases).4.According to liver stiffness(E value),the patients were divided into non-fibrosis group(106 cases),early fibrosis group(38 cases),advanced fibrosis and cirrhosis group(14 cases).5.The characteristics and correlation of liver function,glucose and lipid metabolism in MAFLD patients with different degrees of steatosis and liver stiffness(fibrosis)were compared.Statistical methods:SPSS23.0 statistical software was used to analyze the data,and the data that met normal distribution were expressed in the form of mean ± standard deviation(x ± s),and the data conforming to normal distribution were compared among multiple groups by one-way ANOVA;the data of non-normal distribution were expressed by the distance between median and quartile [M(P25,P75)].Kruskal-Wallis rank sum test was used for comparison of data that met non-normal distribution between multiple groups,Chi-square test was used for the enumeration data,and Pearson correlation analysis was used for correlation analysis.P < 0.05 was considered statistically significant.Results:1.The BMI of MAFLD patients with different degree of steatosis was compared among 3 groups.Among them,there was significant difference between mild fatty liver group and moderate fatty liver group(P < 0.05);there was significant difference between mild fatty liver group and severe fatty liver group(P < 0.05).In addition,the fatter the patient was,the larger the BMI was,the more severe the steatosis was.BMI of MAFLD patients with different degrees of liver fibrosis in non-fibrosis group was significantly lower than that in early fibrosis group(P < 0.05).2.Among the MAFLD patients with different degrees of steatosis in 3 groups,AST in severe fatty liver group was significantly higher than that in moderate fatty liver group,with statistical difference(P < 0.05);ALB in severe fatty liver group was significantly higher than that in mild fatty liver group(P < 0.05);DBIL in moderate fatty liver group was significantly higher than that in mild fatty liver group and severe fatty liver group(P < 0.05).There were no statistical significances in the related indexes of glucose metabolism among 3 groups.TG,CHOL and LDL in severe fatty liver group were significantly higher than those in mild fatty liver group(all P < 0.05);TG and LDL in moderate fatty liver group were higher than those in mild fatty liver group(all P <0.05),suggesting that the indexes of lipid metabolism are obviously abnormal with the aggravation of liver steatosis.3.Among MAFLD patients with different degrees of liver fibrosis in 3 groups,the levels of ALT,AST and GGT in advanced fibrosis and cirrhosis group were significantly higher than those in non-fibrosis group(P < 0.05).The levels of ALT in advanced fibrosis and cirrhosis group were significantly higher than those in early fibrosis group(P < 0.05).The levels of AST and GGT in early fibrosis group were significantly higher than those in non-fibrosis group(P < 0.05).There was no statistical significance in the related indexes of glucose metabolism among the three groups.The level of TG in early fibrosis group was significantly higher than that in advanced fibrosis and cirrhosis group(P < 0.05).4.The degree of steatosis(CAP value)in MAFLD patients was positively correlated with BMI,ALT,ALB and LDL(P < 0.05,r > 0),and negatively correlated with AGE(P < 0.05,r < 0).5.Hepatic hardness and fibrosis value(E value)were positively correlated with BMI,AST,GGT,ALP,DBIL(P < 0.05,r > 0),and negatively correlated with ALB,CHOL,LDL(P < 0.05,r < 0)in MAFLD patients.Conclusion:1.With the increase of steatosis degree(CAP value),BMI of patients increases,which is positively correlated with obesity,suggesting that fatty liver is more serious,while steatosis degree(CAP value)is negatively correlated with age,suggesting that patients with fatty liver are younger and younger.2.The levels of AST,ALB,DBIL in liver function and TG,CHOL,LDL in lipid metabolism increase with the increase of the degree of steatosis(CAP value),suggesting that attention should be paid to the changes of liver function and lipid metabolism in the early stage of steatosis in MAFLD.3.The levels of ALT,AST and GGT in liver function increase with the increase of fibrosis degree(E value),while the level of lipid metabolism index TG decrease.ALB is positively correlated with CAP value and negatively correlated with E value;it is suggested that the increase of liver enzymes,the decrease of TG level and ALB level indirectly reflect the decrease of hepatocyte inflammation and liver synthesis function,suggesting the progress of the disease from steatosis to liver fibrosis and cirrhosis.