{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T05:55:45Z","timestamp":1769147745385,"version":"3.49.0"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,9,21]],"date-time":"2017-09-21T00:00:00Z","timestamp":1505952000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2018,5]]},"abstract":"Abstract<\/jats:title>Background & Aims<\/jats:title>Evaluation of the controlled attenuation parameter (CAP<\/jats:styled-content>) is a promising noninvasive method for assessing hepatic steatosis. Despite the increasing reliability of the CAP<\/jats:styled-content> for assessing steatosis in subjects with chronic liver disease, few studies have evaluated the CAP<\/jats:styled-content> in asymptomatic subjects without overt liver disease. Therefore, we aimed to evaluate the usefulness of the CAP<\/jats:styled-content> for a health check\u2010up population.<\/jats:p><\/jats:sec>Methods<\/jats:title>We enrolled subjects who underwent abdominal ultrasonography (US<\/jats:styled-content>), FibroScan (Echosens, France) and blood sampling during medical health check\u2010ups. The CAP<\/jats:styled-content> was measured using FibroScan, and increased CAP<\/jats:styled-content> was defined as CAP<\/jats:styled-content>\u00a0\u2265\u00a0222 dB<\/jats:styled-content>\/m.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 1133 subjects were included; 589 subjects (52.0%) had fatty liver based on US<\/jats:styled-content>, and 604 subjects (53.3%) had increased CAP<\/jats:styled-content>. Increased CAP<\/jats:styled-content> was significantly associated with metabolic abnormalities, including higher body mass index (BMI<\/jats:styled-content>)[odds ratio (OR<\/jats:styled-content>)\u00a0=\u00a01.33;95% confidence interval (CI<\/jats:styled-content>),1.24\u20101.43; P\u00a0<\u00a0<\/jats:italic>.001], higher alanine aminotransferase (ALT<\/jats:styled-content>) (OR<\/jats:styled-content>\u00a0=\u00a01.02; 95% CI<\/jats:styled-content>, 1.01\u20101.04; P<\/jats:italic>\u00a0=\u00a0.003), higher insulin (OR<\/jats:styled-content>\u00a0=\u00a01.04; 95% CI<\/jats:styled-content>, 1.00\u20101.08; P<\/jats:italic>\u00a0=\u00a0.037), higher triglyceride (OR\u00a0=\u00a01.00; 95% CI, 1.00\u20101.01; P<\/jats:italic>\u00a0=\u00a00.042) and older age (OR<\/jats:styled-content>\u00a0=\u00a01.02; 95% CI<\/jats:styled-content>, 1.00\u20101.03; P<\/jats:italic>\u00a0=\u00a0.05). Furthermore, a comparison of clinical parameters among three groups (normal vs no fatty liver by US<\/jats:styled-content> but increased CAP<\/jats:styled-content> vs fatty liver based on US<\/jats:styled-content>) revealed that metabolic parameters, including blood pressure, BMI<\/jats:styled-content>, waist circumference, aspartate aminotransferase (AST<\/jats:styled-content>), ALT<\/jats:styled-content>, triglycerides, fasting glucose, uric acid, insulin, homeostasis model assessment\u2010estimated insulin resistance and liver stiffness measurements, gradually increased across the three groups (all P\u00a0<\u00a0<\/jats:italic>.001).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>In conclusion, increased CAP<\/jats:styled-content> could be an early indicator of fatty liver disease with metabolic abnormalities that manifests even before a sonographic fatty change appears.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.13558","type":"journal-article","created":{"date-parts":[[2017,9,21]],"date-time":"2017-09-21T17:52:42Z","timestamp":1506016362000},"page":"915-923","source":"Crossref","is-referenced-by-count":18,"title":["Clinical implications of controlled attenuation parameter in a health check\u2010up cohort"],"prefix":"10.1111","volume":"38","author":[{"given":"Min\u2010Sun","family":"Kwak","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Healthcare Research Institute Gangnam Healthcare Center Seoul National University Hospital Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8344-7737","authenticated-orcid":false,"given":"Goh Eun","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Healthcare Research Institute Gangnam Healthcare Center Seoul National University Hospital Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jong In","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Healthcare Research Institute Gangnam Healthcare Center Seoul National University Hospital Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0705-2490","authenticated-orcid":false,"given":"Jeong Yoon","family":"Yim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Healthcare Research Institute Gangnam Healthcare Center Seoul National University Hospital Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su Jin","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Healthcare Research Institute Gangnam Healthcare Center Seoul National University Hospital Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Se Young","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Radiology Healthcare Research Institute Gangnam Healthcare Center Seoul National University Hospital Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joo Sung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Healthcare Research Institute Gangnam Healthcare Center Seoul National University Hospital Seoul 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