BACKGROUND: Several studies in healthy populations have investigated normal liver stiffness on transient elastography, but none has excluded subjects with fatty liver. AIMS: To define normal liver stiffness and its determinants in 923 healthy voluntary blood donors with and without fatty liver. METHODS: Seven hundred and forty six subjects were analyzed with transient elastography according to the absence (602) or presence of fatty liver (144) at ultrasonography. The cut-off for significant fibrosis was a liver stiffness of 7.9kPa. RESULTS: Normal subjects had significantly lower liver stiffness (median 4.4kPa) than fatty liver subjects (median 5.3, p<0.001). In normal livers male gender was significantly associated with increased liver stiffness at multiple linear regression analysis. Nine (1.4%) blood donors with normal liver and 9 with fatty liver (6.2%) had >7.9kPa. Subjects with verified liver stiffness >7.9kPa, were further investigated with liver biopsy or non-invasive fibrosis markers: only 1 patient with fatty liver had >F1 fibrosis. CONCLUSIONS: Liver stiffness in normal liver is lower than in fatty liver, and gender is the only influencing variable. Transient elastography has a very low false positive rate for significant fibrosis and may have a role in screening populations at risk for liver disease.
BACKGROUND: Several studies in healthy populations have investigated normal liver stiffness on transient elastography, but none has excluded subjects with fatty liver. AIMS: To define normal liver stiffness and its determinants in 923 healthy voluntary blood donors with and without fatty liver. METHODS: Seven hundred and forty six subjects were analyzed with transient elastography according to the absence (602) or presence of fatty liver (144) at ultrasonography. The cut-off for significant fibrosis was a liver stiffness of 7.9kPa. RESULTS: Normal subjects had significantly lower liver stiffness (median 4.4kPa) than fatty liver subjects (median 5.3, p<0.001). In normal livers male gender was significantly associated with increased liver stiffness at multiple linear regression analysis. Nine (1.4%) blood donors with normal liver and 9 with fatty liver (6.2%) had >7.9kPa. Subjects with verified liver stiffness >7.9kPa, were further investigated with liver biopsy or non-invasive fibrosis markers: only 1 patient with fatty liver had >F1 fibrosis. CONCLUSIONS:Liver stiffness in normal liver is lower than in fatty liver, and gender is the only influencing variable. Transient elastography has a very low false positive rate for significant fibrosis and may have a role in screening populations at risk for liver disease.
Authors: Cristina Felicani; Chiara De Molo; Horia Stefanescu; Fabio Conti; Elena Mazzotta; Veronica Gabusi; Elena Nardi; Antonio Maria Morselli-Labate; Pietro Andreone; Carla Serra Journal: J Ultrasound Date: 2018-05-22
Authors: Karen M Christiansen; Belinda K Mössner; Janne F Hansen; Erik F Jarnbjer; Court Pedersen; Peer B Christensen Journal: PLoS One Date: 2014-11-04 Impact factor: 3.240
Authors: John Ong; Junzhe Zhao; Galit Katarivas Levy; James Macdonald; Alexander W Justin; Athina E Markaki Journal: Sci Rep Date: 2020-07-24 Impact factor: 4.379