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Fatty Liver in HIV & HCV
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Reported by jules Levin
EACS Nov 13 2009 Cologne Germany
the Grundy definition of SM is a constellation of metabolic disorders in part related to defects in insulin sensitivity that lead to an increased risk for the development of Atherosclerosis, DM2, PCOS, liver steastosis
This allows me to introduce a new paradigm in the metabolic arena that is the idea to consider metabolism at an organ level. That is the liver. .
NAFLD prevalence in general population based surveys varies from 14% to 31% [9], depending on which diagnostic criteria are used
The gold standard for NAFLD diagnosis is histological assessment of fatty liver through biopsy Non-invasive imaging evaluations to diagnose steatosis include ultrasound, computed tomography (CT) and magnetic resonance (MR) imaging. In research setiting MRI spettroscopy appear to be the more sensitive tool being able to detect a 5% steatosis of the liver. In clinical setting the liver transplant experience analysisng iving liver donors it has been shown that a liver/spleen attenuation ratio <1.1 can predict >30% of hepatic steatosis. This measure seems to be more objective than ultrasound evaluation
Histological features includes macrovesicular steatosis, non-alcoholic steatohepatitis (NASH), fibrosis and cirrhosis. Persons whose liver histology demonstrates simple steatosis may have a benign clinical course, while those with NASH may progress to end-stage liver disease or develop hepatocellular carcinoma.
We grouped HCV and HIV liver steatosis
No study exists to compare VAFLD with nafld
In order to evaluate the relationship between the number of components of MS and IR we applied a linear model in which HOMA is the response variable and the number of componento of MS is the esplanatory variable.
Comparison between NAFLD and VAFLD was carried out by specifying a single linear model in which the parameters of VAFLD were expressed as increment with respect to the value of the corresponding paramethers for NAFLD. Since intecept were not statistically different we selected a model with common intercept.
You may recongnasie that the slope of the two courves are different from NAFLD in HCV and HCV_HIV patients
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