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Objective To assess the grading diagnostic value of controlled attenuation parameter (CAP) on hepatic steatosis in patients with nonalcoholic fatty liver disease (NAFLD). Methods Patients with biopsy-proven NAFLD, admitted in the Fifth Medical Center of Chinese PLA General Hospital from January 2015 to December 2020, were enrolled in present study.The CAP value was detected with transient elastography (TE) within 3 days before liver biopsy. The serological noninvasive models[hepatic steatosis index (HSI) and triglyceride-glucose index (TyG)] were calculated based on their own formula. The relativity between these 3 noninvasive approaches and hepatic steatosis grades were analyzed with Spearman method, the independent influencing factors of CAP value were analyzed using linear multiple regression analysis, the diagnostic efficiency was evaluated with receiver operating characteristics (ROC). Results A total of 405 patients [258 males (63.7%)] with NAFLD were enrolled,and divided into four groups according to hepatic steatosis grades: no steatosis (grade S0, n=17), mild steatosis (grade S1, n=75),moderate steatosis (grade S2, n=163) and severe steatosis (grade S3, n=150). As steatosis grade increasing, CAP value and ALT level increased correspondingly with statistically significant difference (P<0.05). Spearman analysis showed that CAP value, HSI and TyG index were positively correlated with hepatic steatosis grades with correlation coefficient of 0.713, 0.296 and 0.141, respectively (P<0.05).Multiple linear regression analysis showed that hepatic steatosis grade was the independent influential factor for CAP. ROC analysis showed that the diagnostic efficiency of CAP for different hepatic steatosis grades were significantly higher than that of HSI or TyG index,and the areas under ROC curves for CAP diagnosis of S1-S3 grades were 0.876, 0.878 and 0.885 with the corresponding cut-off values of 286, 303 and 314 dB/m, respectively. Conclusion With CAP value the hepatic steatosis grades could be accurately judged in patients with NAFLD, which might help to establish or adjust the optimal treatment strategy, thus having a good clinical application value.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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