Liver Stiffness and Nutrition

Liver stiffness (LS) typically increases after meal intake within 30 min by ~20%. LS usually normalizes after 2–3 h. The reasons for LS elevation in response to food are not completely clarified but encompass liver perfusion (portal and arterial) and most likely elevated hepatic vascular resistance such as metabolic hepatocyte swelling. First preliminary studies on portal vein injection of glucose and alcohol demonstrate an almost immediate elevation of portal vein pressure and LS. While these mechanisms may also apply to alcohol consumption, the significant decrease of LS by ~20% in response to alcohol withdrawal requires 1–2 weeks and is primarily associated with the resolution of liver injury (hepatocyte ballooning and inflammation). Levels of AST reflect best the alcohol-mediated increase of LS. CAP also increases in response to both hypercaloric intake and alcohol although paradox responses have been observed in the very short range within 30 min. After alcohol withdrawal, CAP decreases consistently by 30 dB/m within a week. Taken together, both LS and CAP respond to nutritional intake. While this needs to be considered for LS and CAP assessment, the underlying molecular mechanism are still not completely understood.