Xinyu Yang1,2, Xinxia Chang1,2, Shengdi Wu3, Xiaoyang Sun1,2, Xiaopeng Zhu1,2, Liu Wang1,2, Yushan Xu4, Xiuzhong Yao5, Shengxiang Rao5, Xiqi Hu6, Mingfeng Xia7,8, Hua Bian9,10,11, Hongmei Yan12,13, Xin Gao1,2. 1. Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China. 2. Fudan Institute for Metabolic Disease, Fudan University, Shanghai, China. 3. Department of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai, China. 4. Department of Endocrinology and Metabolism, The First Affiliated Hospital of Kunming Medical University, Kunming, China. 5. Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China. 6. Department of Pathology, Shanghai Medical College, Fudan University, Shanghai, China. 7. Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China. xia.mingfeng@zs-hospital.sh.cn. 8. Fudan Institute for Metabolic Disease, Fudan University, Shanghai, China. xia.mingfeng@zs-hospital.sh.cn. 9. Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China. zhongshan_bh@126.com. 10. Fudan Institute for Metabolic Disease, Fudan University, Shanghai, China. zhongshan_bh@126.com. 11. Department of Endocrinology and Metabolism, Wusong Branch of Zhongshan Hospital, Fudan University, Shanghai, China. zhongshan_bh@126.com. 12. Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China. yan.hongmei@zs-hospital.sh.cn. 13. Fudan Institute for Metabolic Disease, Fudan University, Shanghai, China. yan.hongmei@zs-hospital.sh.cn.
Abstract
BACKGROUND: The performance of liver stiffness measurements (LSMs) obtained using FibroScan can be affected by several factors, and cut-off values are different for fibrosis caused by various aetiologies. The study aims to evaluate the diagnostic accuracy of LSM in nonalcoholic fatty liver disease (NAFLD) patients with abnormal glucose metabolism and investigate whether the LSM value would be affected by metabolic indicators. METHODS: The study involved 91 NAFLD patients with abnormal glucose metabolism who underwent liver biopsy. The diagnostic accuracy of LSM value was evaluated by the receiver operator characteristic (ROC) curves, with the biopsy results taken as the gold standard. Multivariate linear regression and subgroup analysis were performed to determine the correlated indicators. RESULTS: The areas under the ROC curves (AUROCs) of LSM values for detecting fibrosis stage ≥1, 2, 3 and 4 were 0.793 (95% confidence interval [CI]: 0.695-0.871), 0.764 (95% CI: 0.663-0.846), 0.837 (95% CI: 0.744-0.906) and 0.902 (95% CI: 0.822-0.955), with cut-off values of 6.3, 7.6, 8.3 and 13.8 kPa, respectively. Multivariate linear regression demonstrated that haemoglobin A1c (HbA1c, β = 0.205, P = 0.026) and alanine aminotransferase (ALT, β = 0.192, P = 0.047) were independently associated with the LSM value after adjustment for fibrosis stage, ballooning and inflammation grade from liver biopsy. Subgroup analysis demonstrated that LSM values were slightly higher in patients with HbA1c ≥7% than in those with HbA1c < 7% and in patients with body mass index (BMI) ≥30 kg/m2 than in those with BMI < 30 kg/m2. CONCLUSIONS: FibroScan was valuable for the evaluation of liver fibrosis in NAFLD patients with abnormal glucose metabolism. FibroScan is recommended to evaluate severe fibrosis, especially to exclude advanced fibrosis. Glucose metabolism state may affect LSM values.
BACKGROUND: The performance of liver stiffness measurements (LSMs) obtained using FibroScan can be affected by several factors, and cut-off values are different for fibrosis caused by various aetiologies. The study aims to evaluate the diagnostic accuracy of LSM in nonalcoholic fatty liver disease (NAFLD) patients with abnormal glucose metabolism and investigate whether the LSM value would be affected by metabolic indicators. METHODS: The study involved 91 NAFLD patients with abnormal glucose metabolism who underwent liver biopsy. The diagnostic accuracy of LSM value was evaluated by the receiver operator characteristic (ROC) curves, with the biopsy results taken as the gold standard. Multivariate linear regression and subgroup analysis were performed to determine the correlated indicators. RESULTS: The areas under the ROC curves (AUROCs) of LSM values for detecting fibrosis stage ≥1, 2, 3 and 4 were 0.793 (95% confidence interval [CI]: 0.695-0.871), 0.764 (95% CI: 0.663-0.846), 0.837 (95% CI: 0.744-0.906) and 0.902 (95% CI: 0.822-0.955), with cut-off values of 6.3, 7.6, 8.3 and 13.8 kPa, respectively. Multivariate linear regression demonstrated that haemoglobin A1c (HbA1c, β = 0.205, P = 0.026) and alanine aminotransferase (ALT, β = 0.192, P = 0.047) were independently associated with the LSM value after adjustment for fibrosis stage, ballooning and inflammation grade from liver biopsy. Subgroup analysis demonstrated that LSM values were slightly higher in patients with HbA1c ≥7% than in those with HbA1c < 7% and in patients with body mass index (BMI) ≥30 kg/m2 than in those with BMI < 30 kg/m2. CONCLUSIONS: FibroScan was valuable for the evaluation of liver fibrosis in NAFLD patients with abnormal glucose metabolism. FibroScan is recommended to evaluate severe fibrosis, especially to exclude advanced fibrosis. Glucose metabolism state may affect LSM values.
Authors: Paul Angulo; David E Kleiner; Sanne Dam-Larsen; Leon A Adams; Einar S Bjornsson; Phunchai Charatcharoenwitthaya; Peter R Mills; Jill C Keach; Heather D Lafferty; Alisha Stahler; Svanhildur Haflidadottir; Flemming Bendtsen Journal: Gastroenterology Date: 2015-04-29 Impact factor: 22.682
Authors: Christopher D Williams; Joel Stengel; Michael I Asike; Dawn M Torres; Janet Shaw; Maricela Contreras; Cristy L Landt; Stephen A Harrison Journal: Gastroenterology Date: 2010-09-19 Impact factor: 22.682