Prevalence of Nonalcoholic Fatty Liver Disease (NAFLD) and Nonalcoholic Steatohepatitis (NASH) Utilizing Ultrasound and Percutaneous Liver Biopsy
Condition: Fatty Liver
MeSH terms: Liver Diseases; Fatty Liver; Non-alcoholic Fatty Liver Disease
Study type: Observational

Summary: 
      Prospective determination of the prevalence of non-alcoholic fatty liver disease (NAFLD) and
      non-alcoholic steatohepatitis (NASH)in a primary care setting using ultrasound and
      percutaneous liver biopsy.
    

Detailed description: 
      Patients between the ages of 18 and 70 years who are eligible for care at Brooke Army Medical
      Center are considered for enrollment. After obtaining informed consent, a baseline
      questionnaire is given to patients who present to the Primary Care Clinic for routine clinic
      visits or during colon cancer screening classes within the Gastroenterology Clinic. The
      questionnaire includes information about the patient's past medical history to include: known
      history of chronic liver disease, current medications, current and past alcohol ingestion,
      dietary habits that included consumption of fructose containing beverages and frequency of
      fast food visits. Patients are excluded if they are found to have a history of chronic liver
      disease, HIV, on medications that are associated with a fatty liver, or consumption of more
      than 20 grams of alcohol per day. Right upper quadrant ultrasound will then be performed to
      determine if there is evidence of fatty liver disease. All patients with a positive
      ultrasound for hepatic steatosis are then offered a liver biopsy after obtaining fasting
      blood work that included a complete blood count, coagulation studies, liver function tests,
      fasting lipid panel, glucose and insulin. Patients with a negative ultrasound for fatty liver
      are not referred for liver biopsy and are considered as completed study patients. Serum is
      also stored for adipokine and cytokine analysis. A study investigator using a 14g Bard
      Monopty biopsy gun will perform the liver biopsy. A single expert hepatopathologist will
      review all liver biopsies and utilize the Brunt system (9) for grading and staging of
      steatohepatitis if present.
    

Intervention name(s): possible liver biopsy and serum collection
Intervention type(s): Procedure
Intervention description(s): All patients with a positive ultrasound for hepatic steatosis offered a liver biopsy after obtaining fasting blood work that included a complete blood count, coagulation studies, liver function tests, fasting lipid panel, glucose and insulin. Patients with a negative ultrasound for fatty liver are not referred for liver biopsy and are considered as completed study patients. Serum is also stored for adipokine and cytokine analysis. A study investigator using a 14g Bard Monopty biopsy gun performs the liver biopsy.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Patients 18 to 70 years of age who have access to care through the Primary Care Clinics or
        the Gastroenterology Clinic at Brooke Army Medical Center
      
Biospecimen description: 
      liver biopsies and serum blood samples may be obtained
    
Keywords: Fatty liver disease