{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T03:34:19Z","timestamp":1793072059599,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T00:00:00Z","timestamp":1639958400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","award":["NNF20OC0063883"],"award-info":[{"award-number":["NNF20OC0063883"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009804","name":"Svenska Diabetesstiftelsen","doi-asserted-by":"publisher","award":["DIA 2020\u2010518"],"award-info":[{"award-number":["DIA 2020\u2010518"]}],"id":[{"id":"10.13039\/501100009804","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","award":["Astra Zeneca Agreement for Research"],"award-info":[{"award-number":["Astra Zeneca Agreement for Research"]}],"id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003793","name":"Hj\u00e4rt-Lungfonden","doi-asserted-by":"publisher","award":["20200191"],"award-info":[{"award-number":["20200191"]}],"id":[{"id":"10.13039\/501100003793","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["VR 2021\u2010005208"],"award-info":[{"award-number":["VR 2021\u2010005208"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004063","name":"Knut och Alice Wallenbergs Stiftelse","doi-asserted-by":"publisher","award":["KAW 2017.0203"],"award-info":[{"award-number":["KAW 2017.0203"]}],"id":[{"id":"10.13039\/501100004063","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>The ultrasound\u2010based controlled attenuation parameter (CAP) is a non\u2010invasive tool widely validated for assessing liver steatosis across different etiologies. However, few studies, with liver biopsy available, have investigated its performance in individuals with morbid obesity. Herein, we aimed to evaluate the diagnostic accuracy of CAP in participants with morbid obesity from the MAFALDA study before bariatric surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 120 individuals with valid examinations within three months from bariatric surgery were included. Clinical, laboratory, FibroScan<jats:sup>\u00ae<\/jats:sup> (XL probe), and liver biopsy data were collected using standardized procedures. The overall accuracy of CAP for detecting liver steatosis was estimated by the area under the receiver\u2010operating characteristics curve (AUROC). Optimal cut\u2010offs were chosen at points with the highest Youden index.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The AUROCs of CAP for detecting S\u00a0\u2265\u00a0S1, S\u00a0\u2265\u00a0S2, and S\u00a0=\u00a0S3 were 0.91 (95% CI 0.86\u20130.97), 0.83 (95% CI 0.76\u20130.90), and 0.86 (95% CI 0.79\u20130.94), respectively. The best CAP cut\u2010offs for S\u00a0\u2265\u00a0S1, S\u00a0\u2265\u00a0S2, and S\u00a0=\u00a0S3 were 300\u00a0dB\/m (95% CI 275\u2013316), 328\u00a0dB\/m (95% CI 296\u2013345), and 344\u00a0dB\/m (95% CI 343\u2013352), respectively. CAP values were independently influenced by steatosis grade (estimate 20.60, 95% CI 12.70\u201328.40, <jats:italic>P<\/jats:italic>\u00a0=\u00a01.05\u00a0\u00d7\u00a010<jats:sup>\u22126<\/jats:sup>). The AUROC of FibroScan\u2010AST (FAST) score for detecting progressive non\u2010alcoholic steatohepatitis was 0.76 (95% CI 0.66\u20130.86).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In individuals with morbid obesity, CAP measured by XL probe is an accurate non\u2010invasive tool for grading liver steatosis. Measurement of liver fat content by CAP may help identify those eligible for bariatric procedures and estimate the effect of bariatric surgery on hepatic steatosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Lay Summary<\/jats:title><jats:p>The ultrasound\u2010based controlled attenuation parameter (CAP) by using the XL probe has an excellent performance for grading liver steatosis among individuals with morbid obesity.<\/jats:p><jats:p>CAP may represent an accurate tool for the non\u2010invasive assessment of liver steatosis among individuals with morbid obesity before and after bariatric surgery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.15127","type":"journal-article","created":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T15:14:24Z","timestamp":1639149264000},"page":"374-383","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Accuracy of controlled attenuation parameter for assessing liver steatosis in individuals with morbid obesity before bariatric surgery"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1720-4355","authenticated-orcid":false,"given":"Federica","family":"Tavaglione","sequence":"first","affiliation":[{"name":"Clinical Medicine and Hepatology Unit Department of Internal Medicine and Geriatrics Campus Bio\u2010Medico University Rome Italy"},{"name":"Department of Molecular and Clinical Medicine Institute of Medicine Sahlgrenska Academy Wallenberg Laboratory University of Gothenburg Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0220-0500","authenticated-orcid":false,"given":"Antonio","family":"De Vincentis","sequence":"additional","affiliation":[{"name":"Internal Medicine Unit Department of Internal Medicine and Geriatrics Campus Bio\u2010Medico University Rome Italy"},{"name":"Clinical Lecturer of Internal Medicine Saint Camillus International University of Health and Medical Sciences Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Bruni","sequence":"additional","affiliation":[{"name":"Bariatric Surgery Unit Campus Bio\u2010Medico University Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ida Francesca","family":"Gallo","sequence":"additional","affiliation":[{"name":"Bariatric Surgery Unit Campus Bio\u2010Medico University Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3164-1500","authenticated-orcid":false,"given":"Simone","family":"Carotti","sequence":"additional","affiliation":[{"name":"Research Unit of Microscopic and Ultrastructural Anatomy Department of Medicine Campus Bio\u2010Medico University Rome Italy"},{"name":"Predictive Molecular Diagnostic Unit Department of Pathology Campus Bio\u2010Medico University Hospital Rome 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