Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease. Quantitative ultrasound facilitates clinical grading of hepatic steatosis (the early stage of NAFLD). However, the utility of quantitative ultrasound as a first-line method for community screening of hepatic steatosis remains unclear. Therefore, this study aimed to investigate the utility of quantitative ultrasound to screen for hepatic steatosis and for metabolic evaluation at the community level. In total, 278 participants enrolled from a community satisfied the study criteria. Each subject underwent anthropometric and biochemical examinations, and abdominal ultrasound imaging was performed to measure the controlled attenuation (CAP), integrated backscatter (IB), and information Shannon entropy (ISE). The assessment outcomes were compared with the fatty liver index (FLI), hepatic steatosis index (HSI), metabolic syndrome (MetS), and insulin resistance to evaluate the screening performance through the area under the receiver operating characteristic curve (AUROC) and Delong's test. Ultrasound ISE, CAP, and IB were effective in screening hepatic steatosis, MetS, and insulin resistance. In screening for hepatic steatosis, the AUROCs of ISE, CAP, and IB were 0.85, 0.83, and 0.80 (the cutoff FLI = 60), respectively, and 0.84, 0.75, 0.77 (the cutoff HSI = 36), respectively, and those for the evaluation of MetS and insulin resistance were 0.79, 0.75, 0.79, respectively, and 0.83, 0.76, 0.78, respectively. Delong's test revealed that ISE outperformed CAP and IB for the detection of hepatic steatosis and insulin resistance (P < .05). Based on the present results, ultrasound ISE is a potential imaging biomarker during first-line community screening of hepatic steatosis and insulin resistance.

中文翻译：

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定量超声在肝脂肪变性社区筛查中的应用

非酒精性脂肪性肝病 (NAFLD) 是最常见的慢性肝病。定量超声有助于肝脂肪变性（NAFLD 的早期阶段）的临床分级。然而，定量超声作为肝脂肪变性社区筛查的一线方法的效用仍不清楚。因此，本研究旨在调查定量超声在社区层面筛查肝脂肪变性和代谢评估的效用。总共有 278 名来自社区的参与者符合研究标准。每个受试者都接受了人体测量和生化检查，并进行了腹部超声成像以测量受控衰减 (CAP)、综合反向散射 (IB) 和信息香农熵 (ISE)。将评估结果与脂肪肝指数（FLI）、肝脂肪变性指数（HSI）、代谢综合征（MetS）和胰岛素抵抗进行比较，通过受试者工作特征曲线下面积（AUROC）和德龙检验评估筛查性能. 超声 ISE、CAP 和 IB 可有效筛查肝脂肪变性、MetS 和胰岛素抵抗。在肝脏脂肪变性筛查中，ISE、CAP 和 IB 的 AUROC 分别为 0.85、0.83 和 0.80（截止 FLI = 60）和 0.84、0.75、0.77（截止 HSI = 36），以及那些MetS和胰岛素抵抗的评价分别为0.79、0.75、0.79，分别为0.83、0.76、0.78。Delong 的测试显示 ISE 在检测肝脂肪变性和胰岛素抵抗方面优于 CAP 和 IB (P < .05)。