비알콜성 지방간 초음파 영상에 GLCM과 인공신경망을 적용한 비알콜성 지방간 질환 분류

김지율,예수영 한국방사선학회 2023 한국방사선학회 논문지 Vol.17 No.5

Non-alcoholic fatty liver disease is an independent risk factor for the development of cardiovascular disease, diabetes, hypertension, and kidney disease, and the clinical importance of non-alcoholic fatty liver disease has recently been increasing. In this study, we aim to extract feature values ​​by applying GLCM, a texture analysis method, to ultrasound images of patients with non-alcoholic fatty liver disease. By applying an artificial neural network model using extracted feature values, we would like to classify the degree of fat deposition in non-alcoholic fatty liver into normal liver, mild fatty liver, moderate fatty liver, and severe fatty liver. As a result of applying the GLCM algorithm, the parameters Autocorrelation, Sum of squares, Sum average, and sum variance showed a tendency for the average value of the feature values ​​to increase as it progressed from mild fatty liver to moderate fatty liver to severe fatty liver. The four parameters of Autocorrelation, Sum of squares, Sum average, and sum variance extracted by applying the GLCM algorithm to ultrasound images of non-alcoholic fatty liver disease were applied as inputs to the artificial neural network model. The classification accuracy was evaluated by applying the GLCM algorithm to the ultrasound images of non-alcoholic fatty liver disease and applying the extracted images to an artificial neural network, showing a high accuracy of 92.5%. Through these results, we would like to present the results of this study as basic data when conducting a texture analysis GLCM study on ultrasound images of patients with non-alcoholic fatty liver disease.

비비만인에서 발견되는 비알콜성 지방간의 대사적 의미

이광은 ( Kwang Eun Lee ),김유미 ( Yoo Mee Kim ),강은석 ( Eun Seok Kang ),김혜진 ( Hae Jin Kim ),정혜원 ( Hae Won Chung ),이시훈 ( Sh Hoon Lee ),김형진 ( Hyeung Jin Kim ),김대중 ( Dae Jung Kim ),김수경 ( Soo Kyung Kim ),안철우 ( Ch 대한내과학회 2002 대한내과학회지 Vol.63 No.5

Background : It is well known that non-alcoholic fatty liver disease is associated with metabolic syndrome such as obesity, type II diabetes mellitus, dyslipidemia. Non-alcoholic fatty liver disease is frequently found in non-obese adults, but the meaning of it is unknown. So we studied the association of non-alcoholic fatty liver disease in non-obese adults and metabolic abnormalities. Methods : We examined 779 Korean adults above 30 years old (274 men, 505 women) participating in medical check-up in Health Promotion Center. Hepatitis B and C serologies were negative, and average weekly alcohol intake was .2 drinks. A standard interview, physical examination and biochemical study was conducted. An experienced operator carried out ultrasound liver studies. Results : 370 subjects had non-alcoholic fatty liver disease (47.3%). The frequency in men was higher than that in women (57.3 vs 42.2%, p<0.05). The frequency in non-obese (BMI<25 kg/m2, n=431) group was lower than that in obese (BMI.25 kg/m2, n=348) group (65.5 vs 32.3%, p<0.05). Compared with obese group, waist circumference, waist hip ratio, body fat, impaired fasting serum glucose, total cholesterol, HDL-cholesterol, total cholesterol to HDL-cholesterol ratio, fasting insulin, proinsulin, HOMA-IR and HOMA-beta were significantly different in non-obese, non-alcoholic fatty liver group. After multiple regression analysis, waist circumference was associated with non-alcoholic fatty liver disease in non-obese individuals. Odd ratios of insulin resistance in non-obese, non-alcoholic fatty liver group were 5.8 (CI: 3.1.10.9). Conclusion : The frequency of non-alcoholic fatty liver disease was very high in non-obese adults and well associated with central obesity and insulin resistance.(Korean J Med 63:488-495, 2002) Key Words : Non - alcoholic fatty liver disease, Body mass index, Metabolic syndrome, Central obesity

성인 여성에서 비알코올성 지방간의 중증도에 따른 대사증후군 관련성

공은희 고신대학교 의과대학 2009 고신대학교 의과대학 학술지 Vol.24 No.2

Background: The aim of this study was to elucidate the relationship between the grade of non-alcoholic fatty liver diseases diagnosed by ultrasonography and the metabolic syndrome defined by the Third Report of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) guideline. Methods: A total of 198 women who visited a health promotion center from January, 2007 to December, 2008 were selected for this study. The ultrasound scan of the liver was performed to determine the presence and the severity of non-alcoholic fatty liver disease. The relationship between non-alcoholic fatty liver and risk categories of metabolic syndrome using NCEP-ATP III guideline were analysed. Results: The prevalence of metabolic syndrome was 19.2% in women with non-alcoholic fatty livers. When odds ratios(95% CI) for metabolic syndrome in groups with moderate and severe non-alcoholic fatty livers were compared to that of group with mild non-alcoholic fatty livers, there was an increased risk of metabolic syndrome with an odds ratio of 2.24(1.31∼4.41). Conclusion: Non-alcoholic fatty liver disease was closely related to the metabolic syndrome in healthy women and the severity classification of non-alcoholic fatty liver by ultrasound scan could be useful to predict of the severity of insulin resistance and the risk of metabolic syndrome

Sex Difference in the Association between Serum Homocysteine Level and Non-Alcoholic Fatty Liver Disease

Bo-Youn Won,Kyung-Chae Park,Soo-Hyun Lee,Sung-Hwan Yun,Moon-Jong Kim,Kye-Seon Park,Young-Sang Kim,Ji-Hee Haam,Hyung-Yuk Kim,Hye-Jung Kim,Ki-Hyun Park 대한가정의학회 2016 Korean Journal of Family Medicine Vol.37 No.4

Background: The relationship between serum homocysteine levels and non-alcoholic fatty liver disease is poorly understood. This study aims to investigate the sex-specific relationship between serum homocysteine level and non-alcoholic fatty liver disease in the Korean population. Methods: This cross-sectional study included 150 men and 132 women who participated in medical examination programs in Korea from January 2014 to December 2014. Patients were screened for fatty liver by abdominal ultrasound and patient blood samples were collected to measure homocysteine levels. Patients that consumed more than 20 grams of alcohol per day were excluded from this study. Results: The homocysteine level (11.56 vs. 8.05 nmol/L) and the proportion of non-alcoholic fatty liver disease (60.7% vs. 19.7%) were significantly higher in men than in women. In men, elevated serum homocysteine levels were associated with a greater prevalence of non-alcoholic fatty liver disease (quartile 1, 43.6%; quartile 4, 80.6%; P=0.01); however, in females, there was no significant association between serum homocysteine levels and the prevalence of non-alcoholic fatty liver disease. In the logistic regression model adjusted for age and potential confounding parameters, the odds ratio for men was significantly higher in the uppermost quartile (model 3, quartile 4: odds ratio, 6.78; 95% confidential interval, 1.67 to 27.56); however, serum homocysteine levels in women were not associated with non-alcoholic fatty liver disease in the crude model or in models adjusted for confounders. Conclusion: Serum homocysteine levels were associated with the prevalence of non-alcoholic fatty liver disease in men.

The Impact of Weight Changes on Nonalcoholic Fatty Liver Disease in Adult Men with Normal Weight

Ji-Young Cho,Tae-Heum Chung,Kyoung-Mo Lim,Hee-Jin Park,Jung-Mi Jang 대한가정의학회 2014 Korean Journal of Family Medicine Vol.35 No.5

Background: Although it is known that losing weight has an effect on the treatment of non-alcoholic fatty liver disease, the studies that show how losing weight affects the non-alcoholic fatty liver disease for the normal weight male adults are limited so far. In this study, we set body mass index as criteria and investigated how the weight changes for 4 years makes an impact on the risk of non-alcoholic fatty liver disease for the male adults who have the normal body mass index.Methods: From January to December of 2004, among the normal weight male adults who had general check-up at the Health Promotion Center of Ulsan University Hospital, 180 people (average age, 47.4 ± 4.61 years) who were diagnosed with fatty liver through abdominal ultrasonography were included in this study and were observed according to the variety of data and ultrasonography after 4 years (2008). People who had a history of drinking more than 140 g of alcohol per week or who had a past medical history were excluded from the analysis. The weight change of subjects was calculated using the formula ‘weight change = weight of 2008 (kg) - weight of 2004 (kg)’ and classified into three groups, loss group (≤-3.0 kg), stable group (-2.9 to 2.9 kg), and gain group (≥3.0 kg). The odds for disappearance of non-alcoholic fatty liver disease in those three different groups were compared.Results: Among 180 subjects, compared with stable group (67.2%, 121 subjects), loss group (11.7%, 21 subjects) showed 18.37-fold increase in the odds of disappearance of non-alcoholic fatty liver disease (95% confidence interval [CI], 4.34 to 77.80) and gain group (21.1%, 38 subjects) showed 0.28-fold decrease in the odds of disappearance of non-alcoholic fatty liver disease (95% CI, 0.10 to 0.83).Conclusion: Even for the normal weight people, losing weight has an effect on the improvement of non-alcoholic fatty liver disease.

The Risk of Abdominal Obesity according to the Degree of Non- Alcoholic Fatty Liver Disease in Korean Men

박성근,류재홍,최중명,서민우,박정민 대한의학회 2016 Journal of Korean medical science Vol.31 No.3

Although non-alcoholic fatty liver disease has been reported as a cardiometabolic risk factor, the effect of non-alcoholic fatty liver is yet to be clarified on abdominal obesity. Therefore, this study was conducted to investigate the longitudinal relationship of nonalcoholic fatty liver on the development of abdominal obesity. The study participants were composed of 11,212 Korean men without abdominal obesity. They were followed up from 2005 to 2010 to be monitored for the development of abdominal obesity according to their degree of non-alcoholic fatty liver disease (normal, mild, and moderate to severe). Cox-proportional hazard model was used to calculate the hazard ratios for abdominal obesity according to the degree of non-alcoholic fatty liver disease. While the average incidence was 15.5%, the incidence of abdominal obesity increased according to the degree of non-alcoholic fatty liver (normal: 11.6%, mild: 25.2%, moderate to severe: 41.0%, P < 0.001). Multivariable-adjusted hazard ratios for abdominal obesity independently increased proportionally to the degree of NAFLD (mild [1.07; 0.94-1.23], moderate to severe [1.58; 1.11-2.26], P for trend < 0.001). The risk of abdominal obesity increased proportionally to the degree of non-alcoholic fatty liver disease. This finding guarantees further studies to reveal the incidental relationship of abdominal obesity with non-alcoholic fatty liver disease.

AHP 기법을 이용한 비알콜성 지방간에 인진호탕(茵蔯蒿湯) 선택과정 분석

김기태 ( Kitae Kim ),고흥 ( Heung Ko ),신선미 ( Seonmi Shin ) 대한한의진단학회 2015 大韓韓醫診斷學會誌 Vol.19 No.3

Abstract Objectives: Lately, non alcoholic fatty liver patients are increasing rapidly and the average age of patients are getting younger. Non alcoholic fatty liver often represents asymptomatic and korean pattern diagnosis is difficult to implement without symptoms. This study aimed to analyze interrelationship between non alcoholic fatty liver disease and Injinho-tang. Methods The AHP is a systematic procedure for analyzing the elements of any problem hierarchically. Based on survey of expertise, as series of pairwise comparison judgements is performed to evaluate the various elements in the hierarchy. We are expected to use the AHP analysis that would apply to oriental doctor`s diagnostic process analysis. Results and conclusion Non-alcoholic fatty liver disease induced complex causes of the metabolic syndrome. Injinho-tang has been widely used disease that causes jaundice and liver biliary disease. According to AHP analysis, LFT is the most important facor in choosing Injinho-tang on non alcoholic fatty liver disease. BMI and body composition by bioelectrical impedance analysis are the next important factors. Personal hot temper also gives a big impact on choicing Injinho-tang on non alcoholic fatty liver disease.

한방 비만 치료 후 간기능 개선을 보인 비알코올성 지방간 환자 1례 보고

허자경 ( Ja Kyung Heo ),황덕상 ( Deok Sang Hwang ),이창훈 ( Chang Hoon Lee ),이경섭 ( Kyung Sub Lee ) 한방비만학회 2007 한방비만학회지 Vol.7 No.2

The purpose of this study was to investigate the clinical effect of oriental medical obesity therapy on obese patient with non-alcoholic fatty liver disease. We supposed to treat patient 21 years old that had non-alcoholic fatty liver with oriental medical obesity therapy. Methods The patient was treated from the 19th of July to the 22th of August for obesity treatment. And the patient had intensive care through admission treatment from the 19th of July to the 30th of July. Herbal medicine, low calorie and low cholesterol diet, electrolipolysis, auricular acupuncture, aerobic exercise was done during the treatment period. Results His body weight decreased from 107.10㎏ to 98.85㎏. The BMI decreased from 36.2㎏/㎡ to 34.5㎏/㎡. Abdominal visceral fat tissue decreased from 190.80㎠ to 145.05㎠. AST was decreased from 113 to 45. ALT was decreased from 145 to 40. r-GT was decreased from 123 to 51. Oriental obesity therapy could be effective to treat obese patient with non-alcoholic fatty liver disease. Conclusions The obese patient with non-alcoholic fatty liver disease had improved liver function after oriental obesity treatment.

Fatty Liver & Diabetes Statistics in Korea: Nationwide Data 2009 to 2017

한유진,한경도,이용호,김수경,홍상모,박정환,박철영 대한당뇨병학회 2023 Diabetes and Metabolism Journal Vol.47 No.3

Background: This study investigated the changes of fatty liver disease prevalence in general Korean population.Methods: This study analyzed data from the Korean National Health Insurance Service from 2009 to 2017 that included individuals aged 20 years or older who had undergone a medical health examination. Fatty liver disease was assessed using the fatty liver index (FLI). The disease severity was defined by FLI cutoff, ≥30 as moderate, and ≥60 as severe fatty liver disease.Results: The prevalence of Korean adults aged 20 years or over with fatty liver disease (FLI ≥60) increased from 13.3% in 2009 to 15.5% in 2017 (P for trend <0.001). The increase in fatty liver disease prevalence was prominent in men (from 20.5% to 24.2%) and the young age (20 to 39 years) group (from 12.8% to 16.4%) (P for interaction <0.001). The prevalence of fatty liver disease was the highest in type 2 diabetes mellitus (T2DM, 29.6%) population compared to that of prediabetes or normoglycemia (10.0% and 21.8%) in 2017. The prevalence of fatty liver disease had statistically increased in individuals with T2DM and prediabetes (P for trend <0.001). Its prevalence increased more steeply in the young-aged population with T2DM, from 42.2% in 2009 to 60.1% in 2017. When applying a lower FLI cutoff (≥30) similar results were observed.Conclusion: The prevalence of fatty liver disease in the Korean population has increased. Individuals who are young, male, and have T2DM are vulnerable to fatty liver disease.

Endoplasmic reticulum stress and autophagy dysregulation in alcoholic and non-alcoholic liver diseases

김윤석,Sang Geon Kim 대한간학회 2020 Clinical and Molecular Hepatology(대한간학회지) Vol.26 No.4

Alcoholic and non-alcoholic liver diseases begin from an imbalance in lipid metabolism in hepatocytes as the earliest response. Both liver diseases share common disease features and stages (i.e., steatosis, hepatitis, cirrhosis, and hepatocellular carcinoma). However, the two diseases have differential pathogenesis and clinical symptoms. Studies have elucidated the molecular basis underlying similarities and differences in the pathogenesis of the diseases; the factors contributing to the progression of liver diseases include depletion of sulfhydryl pools, enhanced levels of reactive oxygen and nitrogen intermediates, increased sensitivity of hepatocytes to toxic cytokines, mitochondrial dysfunction, and insulin resistance. Endoplasmic reticulum (ER) stress, which is caused by the accumulation of misfolded proteins and calcium depletion, contributes to the pathogenesis, often causing catastrophic cell death. Several studies have demonstrated a mechanism by which ER stress triggers liver disease progression. Autophagy is an evolutionarily conserved process that regulates organelle turnover and cellular energy balance through decomposing damaged organelles including mitochondria, misfolded proteins, and lipid droplets. Autophagy dysregulation also exacerbates liver diseases. Thus, autophagy-related molecules can be potential therapeutic targets for liver diseases. Since ER stress and autophagy are closely linked to each other, an understanding of the molecules, gene clusters, and networks engaged in these processes would be of help to find new remedies for alcoholic and non-alcoholic liver diseases. In this review, we summarize the recent findings and perspectives in the context of the molecular pathogenesis of the liver diseases.