Facilitated By

San Antonio Medical Foundation

The Prevalence Of Nonalcoholic Fatty Liver Disease (NAFLD) In Adults

Brooke Army Medical Center

Brooke Army Medical Center (BAMC) at Fort Sam Houston, Texas, is proud to provide safe, quality care to our military service members, their families, veterans and civilian emergency patients as the most robust and productive healthcare organization within the Military Health System (MHS).

Principal Investigator(s)
Email for information
Funded by
Geneva
Research Start Date
Status
Active

Nonalcoholic fatty liver disease (NAFLD) is a global health concern with a suspected increasing prevalence due to the rise in obesity and diabetes mellitus. The vast majority of patients will have isolated steatosis or steatosis with mild inflammation that is very unlikely to progress in severity. However, about 25% of patients with NAFLD have non-alcoholic steatohepatitis (NASH), the more aggressive form of the disease that is associated with fibrosis progression and potential risk for cirrhosis and end-stage liver disease complications. Additionally, multiple studies have demonstrated an association between NAFLD and the presence of coronary artery disease by either coronary CT angiography (CCTA) or coronary artery calcium (CAC) score. These analyses are retrospective in nature and based on the computed tomography (CT) definition of fatty liver based on hounsfield unit (HU) attenuation in the spleen compared with the liver parenchyma. CCTA coronary artery disease (CAD) burden has been best described in symptomatic patients wherein there is minimal data for CAC score in asymptomatic patients. Multiple analyses have suggested that NAFLD is an independent and strong predictor of significant CAD independent of cardiovascular risk factors, including a significant burden of high risk CCTA findings in one analysis of symptomatic patients in the emergency department. Current prospective prevalence studies for NAFLD and NASH are lacking and no prospective prevalence studies have been performed to correlate both calcified and non-calcified CAD burden in NAFLD patients In addition, it is suboptimal to require a liver biopsy to diagnose NASH. Recent imaging advances have made it possible to assess liver fibrosis but have yet to be fully studied in NAFLD. The purpose of this study is to assess the current prevalence of NAFLD and NASH in adult patients and to correlate to new imaging modalities available at BAMC and to circulating biomarker panels. As a secondary endpoint, prevalence and severity of CAD by multidetector coronary CT angiography will be defined and patient outcomes will be monitored prospectively.

Clinical Care
Infectious Disease
The appearance of name-brand products in this article does not constitute endorsement by Brooke Army Medical Center, the U.S. Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Army, the Department of Defense, or the U.S. Government of the information, products, or services contained therein.