Study of reliability and validation of ultrasound screening for fatty liver and fat in the abdominal wall compared with computed tomography: the longitudinal study of adult health - ELSA - Brazil

• Grant number: 10/16696-6
• Support Opportunities: Regular Research Grants
• Start date: May 01, 2011
• End date: April 30, 2012
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Alessandra Carvalho Goulart
• Grantee: Alessandra Carvalho Goulart
• Host Institution: Hospital Universitário (HU). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Associated researchers: Airlane Pereira Alencar ; Carlos Felipe Moraes da Silva ; Cláudio Campi de Castro ; Danilo Peron Meireles ; Ilka Regina Souza de Oliveira ; Isabela Judith Martins Bensenor ; Paulo Andrade Lotufo

Abstract

Subclinical atherosclerosis can be assessed through a number of exams, among them, ultrasonography (USG) for the screening of liver steatosis as a cardiovascular risk factor. There are few studies that compare diagnostic methods, quantify the intra-and inter-observer variability, using more objective measures to diagnose and quantify the degree of fatty infiltration, intrahepatic. We therefore propose an ancillary study to evaluate the accuracy of the protocol of ultrasonography for the evaluation of abdominal wall and liver, emphasizing the anteroposterior diameter (APD) of the right lobe of the liver for screening fatty liver disease in its various degrees, among the participants of the Longitudinal Study of Adult Health (Elsa)-Brasil. Methodology: STEP 1: reliability of reading / measurement of the images acquired from a random sample of 500 participants exams from the ELSA-Brazil. STEP 2: reliability of image acquisition, with emphasis on measurements of APD and fatty layers of the abdominal wall, to assess the agreement and the quality of images acquired for the USG. STEP 3: validation of the USG-ELSA protocol for conventional ultrasonography and computed tomography of the liver and abdominal wall in the same subsample of 176 individuals. For STEPS 2 and 3, individuals will be assigned to 4 groups according to the probability of clinical and laboratory hepatic steatosis on the following criteria: (1) elevation of AST, ALT and GGT up to 2x the normal, (2) triglycerides e 400 mg / dL, (3) body mass index e 30kg/m2 (4) waist circumference e 88 cm for women and e 102 cm for men. It will be calculated reliability and agreement indices, as well as, ROC curve to define cutoff points for DAP. (AU)