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Fatty Liver Disease Diagnosis

Fatty Liver Disease: Diagnosis


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1. NAFLD spectrum test

The NAFLD spectrum is the standard by which the severity of the fatty liver disease is judged. It depends on the amount of fat accumulation in the liver tissue. Simple fatty liver is the initial abnormality seen in the NAFLD spectrum. The fat accumulated is simple triglyceride that is deposited in the fat cells of the liver. The next degree of severity is NASH or non-alcoholic steatohepatitis. The last and most severe degree of abnormality is liver cirrhosis. In this way, one can diagnose the severity of fat accumulation in FLD by the NAFLD spectrum.

2. ALD and AST level test

Persistent elevated levels of transaminases, namely ALD and ADT, are a clear diagnostic evidence of fatty liver disease. These liver enzymes show marked increase in the blood levels due to inflammation of the liver or hepatitis. The most classic biochemical abnormality is that the levels of ALT are greater than AST in fatty liver disease. This can be used to differentiate hepatitis due to alcoholic cirrhosis where the case is vice versa, that is AST is higher than ALT.

3. Ultrasound liver scan

With specific and sophisticated ultrasound equipments available, this is one of the most preferred methods of diagnosis in fatty liver disease. An ultrasound scan can find out minute changes in the liver tissue and classify the severity of the fatty liver disease. Moreover, it is non-invasive and therefore cannot harm the patient in any way. It can also be visually seen by the patient, which makes it even more comforting and assuring to the individual undergoing the ultrasound scan. The reports are all saved automatically and come out as a clear print out with all the details.

4. GGTP test

GGT or gamma-glutamyl transpeptidase is an enzyme present in the liver that is responsible for the transport of amino acids and peptides into cells. It also plays an important role in glutathione metabolism. Elevated levels of GGT are found in persons suffering from fatty liver due to both alcoholic and non-alcoholic factors. The rise in GGT levels give a clear indication that all is not well with the liver metabolism and treatment should begin taking into regard all the factors. GGT metabolizes extracellular glutathione. However, increased serum GGT levels can give a strong indication of alcoholic fatty liver disease and proper rehabilitation can prevent further deterioration of the liver. One needs to evaluate the GGT levels properly along with other tests such as the BMI index to come to an accurate conclusion about alcohol involvement in the fatty liver disease.

5. CT Scan

A computerized tomography scan or a CT scan is an important diagnostic aid for fatty liver disease. Being non-invasive, it requires the patient to be placed under the CT equipment and the desired area is scanned for abnormalities. Since everything is computerized, the results are usually accurate and all the results are recorded simultaneously. In the CT scan of the liver, FLD is easily diagnosed with marked change in the size and texture of the liver. Deposition of fat is clearly marked and monitored to aid in diagnosis.

6. MRI scan

Magnetic resonance imaging is yet another noninvasive method of diagnosis that is very useful in fatty liver disease. Magnetic radiations are made use of to detect minute abnormalities in the scanned tissues. It is an expensive procedure but is very helpful in coming to an accurate diagnosis, when two or three conditions exhibit similar signs and symptoms.

7. Liver FNAC

Fine needle aspiration cytology (FNAC) is an important tool for diagnosing liver diseases. A fine needle is pricked into the liver and a few cells are aspirated from the target tissue. These cells are then evaluated for abnormalities. Liver FNAC is an invasive procedure and it should be done when other non-invasive procedures do not help in the diagnosis of FLD. Liver FNAC is an accurate method of diagnosis in FLD, since the fat cells can be detected under microscopic examination from the aspirated liver tissue from the fine needle. One needs to be an expert to prick the needle accurately into the liver tissues and not the surrounding organs.

8. Liver biopsy

Liver biopsy involves excising a small section of liver tissue and then examining it under microscopic environment to diagnose the presence of fatty liver disease in an individual. While the treatment regime may remain the same even after conclusion from liver biopsy, this is sometimes required to qualify the patient for a certain drug regime that may affect the liver.

9. Fibro test

Fibro test is a test that is used widely for the correct assessment of alcoholic and non-alcoholic fatty liver disease. It is a patented test developed in the US and involves the use of six test results from various blood serum tests to come to a final diagnosis. A score is then generated to assess the severity of liver damage in the affected patients. It is also known as FibroSure test. The six parameters that are measured are GGT, ALT, total bilirubin, Apolipoprotein, haptoglobin, and alpha-2-macroglobulin. The levels are compared with the standard markers and then assessed and correlated with other diagnostic tests to come to a proper diagnosis. The Fibro Test is an expensive test that is done only when essential.

10. Steato test

Steato test is similar to fibro test but involves only five of the components of fibro test. These readings are then clubbed with the body mass index, glucose levels and ALT test to come to an accurate diagnosis. The age and gender of the patient are other important factors that are taken into consideration. This is especially useful in the diagnosis of steatohepatitis. This test too is expensive. Since it is non-invasive, it is preferred to liver biopsy in fatty liver disease. Gradings of S0, S1, S2, and S3 are given according to the severity of steatosis.

11. Insulin resistance test

Most of the affected individuals in fatty liver disease show an increase in insulin resistance. This can be used as a marker to differentiate FLD from other liver abnormalities. Insulin resistance test involves a series of tests such as increased levels of glucose, LDL, and triglycerides, and decreased levels of HDL. All these tests should be performed in the laboratory to conclude insulin resistance. The common way to detect insulin resistance is to use the homeostatic model assessment or HOMA that involves the measuring of insulin and glucose levels and then calculate the beta cell function along with insulin sensitivity.

12. Insulin resistance test

Most of the affected individuals in fatty liver disease show an increase in insulin resistance. This can be used as a marker to differentiate FLD from other liver abnormalities. Insulin resistance test involves a series of tests such as increased levels of glucose, LDL, and triglycerides, and decreased levels of HDL. All these tests should be performed in the laboratory to conclude insulin resistance. The common way to detect insulin resistance is to use the homeostatic model assessment or HOMA that involves the measuring of insulin and glucose levels and then calculate the beta cell function along with insulin sensitivity.

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