NAFLD (Non Alcoholic Fatty Liver Disease) is the most prevalent cause of hepatic disease in Western Countries (1).
It includes a wide spectrum of pathological syndromes,
progressively more severe,
ranging from steatosis to inflammation (s.c.
Non Alcoholic Steatohepatitis) to fibrosis and it could lead to cirrhosis with the development of nodules of regeneration and Hepatocellular Carcinoma (HCC).
NAFLD pathogenesis is complex and increased insulin-resistance plays a “key role” in it: it follows a frequent association and overlapping with other diseases such as diabetes and...
Methods and Materials
A prospective single-centre case-control study was performed in our Magnetic Resonance (MRI) Service in collaboration with University Departments of Gastroenterology and Cardiology.
Between October 2014 and February 2016,
33 patients with biopsy proven NAFLD (26 men,
average age 46 years) and 13 healthy controls (7 men,
average age 38 years) were enrolled.
To exclude the presence of diabetes,
metabolic syndrome and hypertension all patients underwent metabolic analysis.
We assessed cardiac function and epicardial fat with transthoracic echocardiography (TTE) and MRI.
MRI was performed,
The analysis of glucose metabolism and anthropometric parameters showed a relevant difference of body mass index (BMI) between NAFLD patients and control group (BMI NAFLD patients: 27 kg/m2 vs 22 kg/m2); a difference in insulin sensibility and resistance indexes was also found (HOMA index NAFLD patients: 2,82 ± 1,7 vs 1,43 ± 0,5; p= 0,034.
OGIS index NAFLD patients: 11,04 ± 1,6 vs13,1 ± 1,1; p= 0,004).
In patients’ group the volume of epicardial fat tissue measured with MRI was increased if compared with the...
Many publications already investigated the quantification of epicardial adipose tissue volume using imaging modalities such as CT and MRI (4; 5).
Our approach allowed us to estimate volume in a fast and reproducible way,
with some sporadic difficulties,
in particular in the delimitation of sovra-diafragmatic fat in patients who had an epicardial adipose tissue of limited thickness.
The evaluation took 8-10 minutes per patient,
we used a sequence (axial SSFP) normally part of cardiac MRI protocols we use in our Institution.
1) Bhatia LS1,
Curzen NP et al.
“Non-alcoholic fatty liver disease: a new and important cardiovascular risk factor?”,
Eur Heart J.
2) Ballestri S,
Lonardo A et al.
“Risk of cardiovascular,
cardiac and arrhythmic complications in patients with non-alcoholic fatty liver disease”,
World J Gastroenterol.
2014 Feb 21;20(7):1724-45.
3) Sacks HS1,
“Human epicardial adipose tissue: a review”,
Am Heart J.
4) Elming MB1,
“Measurements of pericardial adipose tissue using contrast enhanced cardiac multidetector computed tomography--comparison...