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Background and Aim: Ultrasound (US) is recommended for hepatic steatosis screening. The purpose of this study was to determine the usefulness of US hepatic-renal echo-intensity (HR) difference in the quantitative assessment of hepatic steatosis. Methods: Consecutive patients undergoing liver biopsy were prospectively enrolled. Using US histogram technique, the mean gray level of hepatic parenchyma and right renal parenchyma at selected regions of interest were evaluated on the same day of biopsy. With steatosis assessed by histology as the reference, the diagnostic performances of HR difference in predicting the degree of steatosis was analyzed. The optimal cut-off level, diagnostic validity and post-test probability were assessed. Results: A total of 175 patients were enrolled (M/F, 103/72; mean age, 48.6 ± 11.7). There were 64 (36.5 %), 42 (24 %), 29 (16.6 %), 12 (6.9 %) and 28 (16 %) patients with steatosis of <5, 5-9, 10-19, 20-29 and ≥30 %, respectively. Multivariate analysis showed HR difference correlated with the severity of steatosis ( R = 0.425, p < 0.001) with positive correlation between HR difference and the severity of steatosis ( r = 0.60, p < 0.001). The diagnostic performances were 0.927, 0.890, 0.816 and 0.760 for steatosis ≥30, ≥20, ≥10 and ≥5 %, respectively. The cut-off is 7 for diagnosing steatosis ≥30 %, with a negative predictive value of 97.6 %. The cut-off is 4 in predicting steatosis ≥5 %, with a positive predictive value of 79 %. The prevalence of steatosis influenced the post-test probability. Conclusions: Quantitative assessment of HR difference with US histogram technique is useful in excluding moderate to severe hepatic steatosis. [ABSTRACT FROM AUTHOR]

Background: Biliary atresia-induced cholestasis increases hepatic oxidative stress with eventual progression to cirrhosis and liver failure. Omega-3 fatty acids play a possible role in the regulation of oxidative stress and the improvement of cholestasis. Aim: The goal of the present study is to investigate the role of dietary supplementation of fish omega-3 fatty acids in the reduction of hepatocellular damage by using a rat common bile duct ligation model. Methods: Sprague-Dawley rats received either sham or bile duct ligation (BDL) and were divided into four study groups: Sham+saline (Sham+sal) group, Sham+Fish oil (Sham+FO) group, BDL+saline (BDL+sal) group, and BDL+Fish oil (BDL+FO) group. Rats from each group were assigned to receive, besides regular chow, once daily with either normal saline or fish omega-3 fatty acids (0.4 % of its own body weight) via gavage for 10 days. Samples of blood, liver tissue homogenates, and histological studies from different groups were analyzed at the end of the study. Results: Rats from BDL+FO had significantly impaired liver function as compared to other study groups ( p < 0.05 is of significant difference). Ishak scores and the TGF-b1 contents were significantly higher in rats that received BDL+FO, p < 0.05. Contrary to TGF-b1 liver content, rats from the BDL+FO group had the lowest glutathione levels among the study groups, p < 0.05. Conclusions: Fish omega-3 fatty acids supplementation, albeit increased tissue content of DHA, tended to increase liver fibrosis in BDL rats, decrease liver glutathione level, and compromise hepatic function; fish oil supplementation to subjects with biliary atresia might be of potential hazard and should be used with caution. [ABSTRACT FROM AUTHOR]