{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T18:28:17Z","timestamp":1793125697614,"version":"4.5.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,1,31]],"date-time":"2022-01-31T00:00:00Z","timestamp":1643587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background\/Objectives<\/jats:title><jats:p>Renaming non-alcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated fatty liver disease (MAFLD) suggests a shift of emphasis to the accompanying metabolic disturbance. Controlled attenuation parameter (CAP) measured by FibroScan has been shown to be correlated with hepatic steatosis. We aim to validate its usefulness as a novel surrogate marker for evaluating metabolic derangement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects\/Methods<\/jats:title><jats:p>Volunteers were recruited from medical staff at our hospital to undergo CAP measurements. Anthropometrics, CAP, and laboratory assessments for metabolic profiles and insulin resistance were collected. CAP &amp;lt; 238 dB\/m denoted no hepatic steatosis, 238 \u2264 CAP \u2264 259 dB\/m denoted mild, 260 \u2264 CAP \u2264 291 dB\/m denoted moderate, and CAP &amp;gt; 291 dB\/m denoted severe hepatic steatosis according to previous reports.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data of 824 participants were included for analysis. The age was 53.2 \u00b1 15.4 years, body mass index (BMI) was 23.6 \u00b1 3.1 kg\/m<jats:sup>2<\/jats:sup>, 24.4% were male subjects, and 22.0% met the criteria for metabolic syndrome (MetS). Taking the group with CAP &amp;lt; 238 dB\/m as control, subjects with mild, moderate, and severe hepatic steatosis had increased odds of MetS by 3.51-, 3.32-, and 5.12-fold, respectively, after adjusting for multiple confounders (<jats:italic>p<\/jats:italic> = 0.020). Metabolic profiles, insulin resistance, and presence of MetS were similar between normal-weight subjects with CAP \u2265 238 dB\/m and overweight subjects with CAP &amp;lt; 238 dB\/m. Even in subjects with no MetS components, those with CAP \u2265 238 dB\/m had higher BMI, waist circumferences, uric acid, triglyceride, white blood cell count, and insulin resistance, whereas lower adiponectin and estimated glomerular filtration rate. Waist circumference [OR 1.11 (1.04, 1.18), <jats:italic>p<\/jats:italic> = 0.001] and homeostatic model assessment of insulin resistance (HOMA-IR) [OR 2.39 (1.18, 4.83), <jats:italic>p<\/jats:italic> = 0.016] were predictive of hepatic steatosis according to CAP \u2265 238 dB\/m.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CAP is a convenient, sensitive, and non-invasive indicator for metabolic derangement. Prospective studies are needed to further validate its usefulness as a surrogate marker for the transition of metabolic status over time.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2021.739875","type":"journal-article","created":{"date-parts":[[2022,1,31]],"date-time":"2022-01-31T05:28:48Z","timestamp":1643606928000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":28,"title":["Validation of Controlled Attenuation Parameter Measured by FibroScan as a Novel Surrogate Marker for the Evaluation of Metabolic Derangement"],"prefix":"10.3389","volume":"12","author":[{"given":"Zhimin","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaka","family":"Ng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanping","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanbing","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,1,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1038\/nrgastro.2017.109","article-title":"Global Burden of NAFLD and NASH: Trends, Predictions, Risk Factors and Prevention","volume":"15","author":"Younossi","year":"2018","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1999","DOI":"10.1053\/j.gastro.2019.s11.312","article-title":"International Consensus Panel. MAFLD: A Consensus-Driven Proposed Nomenclature for Metabolic Associated Fatty Liver Disease","volume":"158","author":"Eslam","year":"2020","journal-title":"Gastroenterology"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.03.039","article-title":"A New Definition for Metabolic Dysfunction-Associated Fatty Liver Disease: An International Expert Consensus Statement","volume":"73","author":"Eslam","year":"2020","journal-title":"J Hepatol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2010.07.005","article-title":"Controlled Attenuation Parameter (CAP): A Novel VCTE\u2122 Guided Ultrasonic Attenuation Measurement for the Evaluation of Hepatic Steatosis: Preliminary Study and Validation in a Cohort of Patients With Chronic Liver Disease From Various Causes","volume":"36","author":"Sasso","year":"2010","journal-title":"Ultrasound Med Biol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.01.042","article-title":"Accuracy of FibroScan Controlled Attenuation Parameter and Liver Stiffness Measurement in Assessing Steatosis and Fibrosis in Patients With Nonalcoholic Fatty Liver Disease","volume":"156","author":"Eddowes","year":"2019","journal-title":"Gastroenterology"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.5009\/gnl14202","article-title":"Usefulness of the Controlled Attenuation Parameter for Detecting Liver Steatosis in Health Checkup Examinees","volume":"9","author":"Kim","year":"2015","journal-title":"Gut Liver"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2013.12.018","article-title":"Controlled Attenuation Parameter (CAP) for the Diagnosis of Steatosis: A Prospective Study of 5323 Examinations","volume":"60","author":"de L\u00e9dinghen","year":"2014","journal-title":"J Hepatol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8111775","article-title":"Noninvasive and Convenient Screening of Metabolic Syndrome Using the Controlled Attenuation Parameter Technology: An Evaluation Based on Self-Paid Health Examination Participants","volume":"8","author":"Lin","year":"2019","journal-title":"J Clin Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.metabol.2016.10.003","article-title":"Obesity Is More Closely Related With Hepatic Steatosis and Fibrosis Measured by Transient Elastography Than Metabolic Health Status","volume":"66","author":"Huh","year":"2017","journal-title":"Metabolism"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2016.05.014","article-title":"Factors Associated With Significant Liver Steatosis and Fibrosis as Assessed by Transient Elastography in Patients With One or More Components of the Metabolic Syndrome","volume":"30","author":"Mikolasevic","year":"2016","journal-title":"J Diabetes Complicat"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29367","article-title":"The Diagnosis and Management of Nonalcoholic Fatty Liver Disease: Practice Guidance From the American Association for the Study of Liver Diseases","volume":"67","author":"Chalasani","year":"2018","journal-title":"Hepatology"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-0288","article-title":"The Product of Triglycerides and Glucose, a Simple Measure of Insulin Sensitivity. Comparison With the Euglycemic-Hyperinsulinemic Clamp","volume":"95","author":"Guerrero-Romero","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-17-0883","article-title":"METS-IR, a Novel Score to Evaluate Insulin Sensitivity, is Predictive of Visceral Adiposity and Incident Type 2 Diabetes","volume":"178","author":"Bello-Chavolla","year":"2018","journal-title":"Eur J Endocrinol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23312","article-title":"Diagnosis of Fibrosis and Cirrhosis Using Liver Stiffness Measurement in Nonalcoholic Fatty Liver Disease","volume":"51","author":"Wong","year":"2010","journal-title":"Hepatology"},{"key":"B15","doi-asserted-by":"publisher","first-page":"4","DOI":"10.3760\/cma.j.issn.1674-5809.2018.01.003","article-title":"Guidelines for the Prevention and Control of Type 2 Diabetes in China (2017 Edition)","volume":"10","year":"2018","journal-title":"Chin J Diabetes Mellitus"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.12.012","article-title":"NAFLD: A Multisystem Disease","volume":"62","author":"Byrne","year":"2015","journal-title":"J Hepatol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26717","article-title":"Extrahepatic Complications of Nonalcoholic Fatty Liver Disease","volume":"59","author":"Armstrong","year":"2014","journal-title":"Hepatology"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3109\/07853890.2010.518623","article-title":"Meta-Analysis: Natural History of non-Alcoholic Fatty Liver Disease (NAFLD) and Diagnostic Accuracy of non-Invasive Tests for Liver Disease Severity","volume":"43","author":"Musso","year":"2011","journal-title":"Ann Med"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e1001680","DOI":"10.1371\/journal.pmed.1001680","article-title":"Association of non-Alcoholic Fatty Liver Disease With Chronic Kidney Disease: A Systematic Review and Meta-Analysis","volume":"11","author":"Musso","year":"2014","journal-title":"PloS Med"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2011.12.039","article-title":"Independent Association Between Nonalcoholic Fatty Liver Disease and Cardiovascular Disease in the US Population","volume":"10","author":"Stepanova","year":"2012","journal-title":"Clin Gastroenterol Hepatol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-2980.2011.00571.x","article-title":"Natural Course of Nonalcoholic Fatty Liver Disease in Southern China: A Prospective Cohort Study","volume":"13","author":"Zhou","year":"2012","journal-title":"J Dig Dis"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d6891","article-title":"Non-Alcoholic Fatty Liver Disease and Mortality Among US Adults: Prospective Cohort Study","volume":"343","author":"Lazo","year":"2011","journal-title":"BMJ"},{"key":"B23","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1038\/nature13478","article-title":"The Role of Hepatic Lipids in Hepatic Insulin Resistance and Type 2 Diabetes","volume":"510","author":"Perry","year":"2014","journal-title":"Nature"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-3093","article-title":"Clinical Review: Nonalcoholic Fatty Liver Disease: A Novel Cardiometabolic Risk Factor for Type 2 Diabetes and its Complications","volume":"98","author":"Targher","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2015.12.012","article-title":"The Multiple-Hit Pathogenesis of Non-Alcoholic Fatty Liver Disease (NAFLD)","volume":"65","author":"Buzzetti","year":"2016","journal-title":"Metabolism"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2015-309265","article-title":"Screening Diabetic Patients for Non-Alcoholic Fatty Liver Disease With Controlled Attenuation Parameter and Liver Stiffness Measurements: A Prospective Cohort Study","volume":"65","author":"Kwok","year":"2016","journal-title":"Gut"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29489","article-title":"NASH Clinical Research Network. Performance Characteristics of Vibration-Controlled Transient Elastography for Evaluation of Nonalcoholic Fatty Liver Disease","volume":"67","author":"Vuppalanchi","year":"2018","journal-title":"Hepatology"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.029617","article-title":"Cardiovascular and Metabolic Heterogeneity of Obesity: Clinical Challenges and Implications for Management","volume":"137","author":"Neeland","year":"2018","journal-title":"Circulation"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1159\/000471488","article-title":"The Metabolic Phenotype in Obesity: Fat Mass, Body Fat Distribution, and Adipose Tissue Function","volume":"10","author":"Goossens","year":"2017","journal-title":"Obes Facts"},{"key":"B30","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1016\/j.cmet.2017.07.008","article-title":"Causes, Characteristics, and Consequences of Metabolically Unhealthy Normal Weight in Humans","volume":"26","author":"Stefan","year":"2017","journal-title":"Cell Metab"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.02.055","article-title":"Metabolically Healthy Obesity, Transition to Metabolic Syndrome, and Cardiovascular Risk","volume":"71","author":"Mongraw-Chaffin","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(18)30137-2","article-title":"Transition From Metabolic Healthy to Unhealthy Phenotypes and Association With Cardiovascular Disease Risk Across BMI Categories in 90257 Women (the Nurses\u2019 Health Study): 30 Year Follow-Up From a Prospective Cohort Study","volume":"6","author":"Eckel","year":"2018","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1111\/jgh.13857","article-title":"Asia-Pacific Working Party on Non-Alcoholic Fatty Liver Disease Guidelines 2017-Part 1: Definition, Risk Factors and Assessment","volume":"33","author":"Wong","year":"2018","journal-title":"J Gastroenterol Hepatol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.08.011","article-title":"Beneficial Effects of Lifestyle Intervention in non-Obese Patients With Non-Alcoholic Fatty Liver Disease","volume":"69","author":"Wong","year":"2018","journal-title":"J Hepatol"},{"key":"B35","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.phrs.2017.03.008","article-title":"Sex- and Gender-Related Prevalence, Cardiovascular Risk and Therapeutic Approach in Metabolic Syndrome: A Review of the Literature","volume":"120","author":"Pucci","year":"2017","journal-title":"Pharmacol Res"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-019-0643-8","article-title":"Sex Differences in Cardiometabolic Disorders","volume":"25","author":"Gerdts","year":"2019","journal-title":"Nat Med"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2021.739875\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,31]],"date-time":"2022-01-31T05:28:51Z","timestamp":1643606931000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2021.739875\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,31]]},"references-count":36,"alternative-id":["10.3389\/fendo.2021.739875"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2021.739875","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,31]]},"article-number":"739875"}}