Ivana Mikolasevic1,2,3, Goran Hauser1,3,4, Maja Mijic2, Viktor Domislovic5, Delfa Radic-Kristo6,7, Zeljko Krznaric5,7, Melanija Razov-Radas8, Tajana Pavic7,9, Marija Matasin7, Tajana Filipec Kanizaj2,7. 1. Department of Gastroenterology, University Hospital Center Rijeka, Rijeka, Croatia. 2. Department of Gastroenterology, University Hospital Merkur, Zagreb, Croatia. 3. Faculty of Medicine, Rijeka, Croatia. 4. Faculty of Health Studies, Rijeka, Croatia. 5. Department for Gastroenterology and Hepatology, University Hospital Center Zagreb, Zagreb, Croatia. 6. Department of Hematology, University Hospital Merkur, Zagreb, Croatia. 7. Faculty of Medicine, Zagreb, Croatia. 8. Division of Gastroenterology, Department of Internal Medicine, Zadar General Hospital, Zadar, Croatia. 9. Department of Internal Medicine, Division of Gastroenterology and Hepatology, University Hospital Center "Sestre Milosrdnice", Zagreb, Croatia.
Abstract
Aim: The primary objective of this study was to evaluate the prevalence of increased controlled attenuation parameter (CAP) and liver stiffness measurements (LSM) as surrogate markers of liver steatosis and fibrosis in liver transplant recipient (LTR). Secondary objectives were to determine the predictors of increased CAP and LSM in population of LTR. Methods: In this prospective, cross-sectional study, we have evaluated 175 LTRs' mean age as 61 (53-65) with a functioning graft for more than one year who came for regular outpatient examinations to the Department of Gastroenterology, University Hospital (UH) Merkur, Zagreb, Croatia. Results: Of 175 analyzed LTRs, 34.28% had obesity, 64.00% had hypertension, 38.28% had diabetes, and 58.85% had hyperlipidemia. The prevalence of liver steatosis was 68.57%, while the prevalence of severe liver steatosis was 46.85%. On multivariate analysis, independent factors associated with liver steatosis were male gender, total cholesterol as positive predictor, and HDL as negative predictor, and independent factors positively associated with severe liver steatosis were higher body mass index (BMI) and higher triglyceride levels. The prevalence of moderate liver fibrosis was 54.85%, while the prevalence of advanced liver fibrosis was 24%. On multivariate analysis, independent factors positively associated with moderate fibrosis were gamma-glutamyl transferase (GGT) and CAP, while the independent factor positively associated with advanced fibrosis was GGT. Conclusion: Our study showed high prevalence of increased CAP and LSM measurements as surrogate markers of liver steatosis and fibrosis. Metabolic syndrome components were highly present and were associated with CAP and LSM values as well as in the pretransplant setting. Due to high prevalence of metabolic comorbidities and nonalcoholic fatty liver disease in LTRs and the lack of the abnormal liver test in a significant number of these patients, TE with CAP may be a reasonable initial assessment for LTRs with one or more components of the metabolic syndrome.
Aim: The primary objective of this study was to evaluate the prevalence of increased controlled attenuation parameter (CAP) and liver stiffness measurements (LSM) as surrogate markers of liver steatosis and fibrosis in liver transplant recipient (LTR). Secondary objectives were to determine the predictors of increased CAP and LSM in population of LTR. Methods: In this prospective, cross-sectional study, we have evaluated 175 LTRs' mean age as 61 (53-65) with a functioning graft for more than one year who came for regular outpatient examinations to the Department of Gastroenterology, University Hospital (UH) Merkur, Zagreb, Croatia. Results: Of 175 analyzed LTRs, 34.28% had obesity, 64.00% had hypertension, 38.28% had diabetes, and 58.85% had hyperlipidemia. The prevalence of liver steatosis was 68.57%, while the prevalence of severe liver steatosis was 46.85%. On multivariate analysis, independent factors associated with liver steatosis were male gender, total cholesterol as positive predictor, and HDL as negative predictor, and independent factors positively associated with severe liver steatosis were higher body mass index (BMI) and higher triglyceride levels. The prevalence of moderate liver fibrosis was 54.85%, while the prevalence of advanced liver fibrosis was 24%. On multivariate analysis, independent factors positively associated with moderate fibrosis were gamma-glutamyl transferase (GGT) and CAP, while the independent factor positively associated with advanced fibrosis was GGT. Conclusion: Our study showed high prevalence of increased CAP and LSM measurements as surrogate markers of liver steatosis and fibrosis. Metabolic syndrome components were highly present and were associated with CAP and LSM values as well as in the pretransplant setting. Due to high prevalence of metabolic comorbidities and nonalcoholic fatty liver disease in LTRs and the lack of the abnormal liver test in a significant number of these patients, TE with CAP may be a reasonable initial assessment for LTRs with one or more components of the metabolic syndrome.
Authors: Stefano Gitto; Nicola de Maria; Fabrizio di Benedetto; Giuseppe Tarantino; Valentina Serra; Lorenzo Maroni; Matteo Cescon; Antonio D Pinna; Filippo Schepis; Pietro Andreone; Erica Villa Journal: Eur J Gastroenterol Hepatol Date: 2018-07 Impact factor: 2.566
Authors: Robert J Wong; Maria Aguilar; Ramsey Cheung; Ryan B Perumpail; Stephen A Harrison; Zobair M Younossi; Aijaz Ahmed Journal: Gastroenterology Date: 2014-11-25 Impact factor: 22.682
Authors: Alshaima Alhinai; Afsheen Qayyum-Khan; Xun Zhang; Patrick Samaha; Peter Metrakos; Marc Deschenes; Philip Wong; Peter Ghali; Tian-Yan Chen; Giada Sebastiani Journal: World J Hepatol Date: 2021-12-27