P1C-2 Liver Stiffness Measurement Using Transient Elastography in Patients with Non-Alcoholic Fatty Liver (NAFLD) and Non-Alcoholic Steatohepatitis (NASH)
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Abstract:
Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of injury in many countries around the world. NAFLD covers a wide spectrum, ranging from simple steatosis, which is generally non progressive, to nonalcoholic steatohepatitis. There are no established noninvasive methods of evaluation for patients with NASH and until recently, liver biopsy was the unique method to quantify liver fibrosis. Liver stiffness measurement (LSM) has been proposed as non invasive tool to assess liver fibrosis in patients with hepatic chronic disease. This poster presents 3 clinical studies which demonstrate the usefulness of LSM to assess liver fibrosis in patients with histological features of NAFLD and which compared the efficiency of LSM and of two blood markers.Keywords:
Transient elastography
Steatohepatitis
Steatosis
Chronic liver disease
Transient elastography
Steatosis
Liver disease
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Transient elastography
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Transient elastography
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Transient elastography
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Age groups
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OBJECTIVES:To investigate the effect of meal intake on liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) in patients with biopsy-proven nonalcoholic fatty liver disease undergoing vibration-controlled transient elastography.METHODS:LSM and CAP were assessed at baseline and
Transient elastography
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Tapper, Elliot B MD; Sengupta, Neil MD; Hunink, Myriam M G MD, PhD; Afdhal, Nezam H MD; Lai, Michelle MD, MPH
Transient elastography
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Transient elastography
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Purpose: The purpose of this study was to assess by Transient Elastography (TE) the severity and dynamics of liver fibrosis in NASH patients.
Transient elastography
Steatohepatitis
Transient (computer programming)
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Nonalcoholic fatty liver disease (NAFLD) is the most frequent liver disease in North America. Patients with inflammatory bowel disease (IBD) are at risk for NAFLD due to chronic inflammation, hepatotoxic drugs, and alteration of gut microbiota. However, prospective data in unselected patients by means of validated and accurate diagnostic methods are lacking. We prospectively investigated prevalence and predictors of NAFLD and liver fibrosis by transient elastography (TE) with associated controlled attenuation parameter (CAP) in unselected IBD patients free of liver disease as part of a routine screening program. Any grade (involving >10% of hepatocytes), moderate (>30%) and severe (>60%) steatosis were defined as CAP ≥238, CAP ≥260 and CAP ≥292 dB/m, respectively. Significant liver fibrosis and cirrhosis (stage 2 and 4 out of 4, respectively) were defined as TE measurement ≥8 and ≥13 kPa. Active IBD was defined as partial Mayo score ≥3 and Harvey Bradshaw Index ≥5 for ulcerative colitis and Crohn’s disease, respectively. Predictors of any grade NAFLD and significant liver fibrosis were determined by logistic regression analysis. 317 patients (mean age 42.9, 48.8% male) were included; 65.9% had Crohn’s disease, and 28% had active disease at time of recruitment. Prevalence of any grade, moderate and severe steatosis was as follows: 39.7%, 32.6% and 19.8%, respectively. The prevalence of significant liver fibrosis and cirrhosis was 9.5% and 1.9%, respectively. Main predictors of NAFLD were older age, being overweight (BMI >25) and methotrexate use (Table1). The main predictors of significant liver fibrosis were prior IBD-related surgery, being overweight, dyslipidemic and on methotrexate. NAFLD diagnosed by TE with CAP is a major comorbidity in unselected IBD patients without known liver disease. These patients may also have significant liver fibrosis and cirrhosis, likely suggesting the coexistence of non-alcoholic steatohepatitis. Non-invasive screening strategies can help early diagnosis and initiation of interventions in this population, including weight loss, treatment of dyslipidemia and potentially drug regimen modification. Table 1. Multivariate analysis of predictors of NAFLD and fibrosis Table 1. Multivariate analysis of predictors of NAFLD and fibrosis None
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