Cherry angioma has acceptable diagnostic value for nonalcoholic fatty liver disease: Diagnosis of fatty liver by cherry angioma

Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) is becoming a significant problem especially through substantial increase in the incidence of obesity worldwide. Currently it is the most common cause of abnormal serum aminotransferase levels both in low- and middle-income countries and in high-income countries and despite its high prevalence, well-defined screening recommendations are currently lacking.Objectives: The purpose of this study was to calculate statistical values of cherry angioma in the diagnosis of NAFLD. We were looking for evidence to be able to recommend cherry angioma as a screening tool for NAFLD that needs further investigations including ultrasonography.Patients and Methods: We studied individuals who visited the private clinic between July 2011 and December 2012 for health examinations. Physician evaluated each individual by different laboratory tests for systemic, viral and hereditary diseases and excluded those with any of these disease. After completion of physical examination, registration of the cherry angioma diagnosis and lab tests, 340 individuals referred to a radiologist for the diagnosis of NAFLD by abdominal ultrasonography.Results: Among 340 study subjects, 150 (44%) were males and 190 (55%) were females. Mean of age and BMI were 47.9 years and 26.9 kg/m2, respectively. Of referred individuals, we diagnosed 238 persons as fatty liver disease through abdominal ultrasonography. We assigned them as NAFLD group. The other 102 individuals were identified with normal livers and were assigned as non-NAFLD group. There was no difference in age and height but for weight and BMI between individuals of NAFLD and non-NAFLD groups. Individuals in NAFLD group were more obese than those in non-NAFLD group. Overall, sensitivity, specificity, PPV, NPV and accuracy were, 76.9, 80.4, 95.8, 37.5, and 77.4, respectively. All values were higher among women than men. The highest sensitivity was observed in individuals with age >40 years, and the highest specificity was observed in individuals with age ≤40 years.Conclusions: In conclusion, NAFLED can be sufficiently predicted by cherry angioma on physical examination.