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The Application of Liver Stiffness Measurement in Residents Without Overt Liver Diseases Through a Community-Based Screening Program

View Article: PubMed Central - PubMed

ABSTRACT

The application of liver stiffness measurement (LSM) by transient elastography (TE) in general population remains to clarify. This cohort study aimed to examine the usefulness of TE and to identify factors associated with significant liver fibrosis in community-based population.

We conducted a hepatitis screening program in 2 remote villages of Southern Taiwan. All residents participated voluntarily and received questionnaire evaluation, blood tests, abdominal sonography, and LSM by TE. Residents with any one of following criteria including hepatitis B virus infection, hepatitis C virus infection, more than moderate alcohol drinking, and failure to obtain valid or reliable LSM were excluded.

There were 831 residents participated in program. The valid and reliable LSM were obtained in 98.3% and 96.3% of residents, respectively. Finally, a total of 559 residents including 283 residents with nonalcoholic steatotic fatty liver disease (NAFLD) were enrolled for analysis. The mean liver stiffness was 4.9 ± 1.9 kPa. The liver stiffness increased in residents with diabetes mellitus (DM), higher body mass index (BMI), hypertension, abnormal waist–hip circumference ration (WHR), higher waist circumference (WC), and presence of fatty liver. Higher body weight, higher BMI, higher WC, abnormal WHR, abnormal aspartate aminotransferase (AST), abnormal alanine aminotransferase (ALT), and DM were the factors associated with significant fibrosis (liver stiffness ≥7 kPa) in either all participants or NAFLD residents. As determined by multivariate analysis, abnormal AST values and DM were the 2 independent factors in all participants (abnormal AST: OR 3.648, 95% CI 1.134–11.740, P = 0.03; DM: OR 2.882, 95% CI 1.282–6.478, P = 0.01) and in residents with NAFLD (abnormal AST: OR 4.197, 95% CI 1.154–15.262, P = 0.03; DM: OR 3.254, 95% CI 1.258–8.413, P = 0.02).

LSM by TE is a useful screening tool in community. In residents, who were absence of chronic hepatitis virus infection or consumed less than moderate alcohol drinking, exhibited DM or abnormal AST values may consider a substantial group with significant fibrosis in community.

No MeSH data available.


Related in: MedlinePlus

Liver stiffness measurement (LSM) values according to 6 factors. (A) Body mass index, (B) diabetes mellitus, (C) hypertension, (D) fatty liver, (E) waist–hip circumference ratio in males (≥0.9) or females (≥0.85), (F) waist circumference in males (>90 cm) or females (>80 cm).
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Figure 3: Liver stiffness measurement (LSM) values according to 6 factors. (A) Body mass index, (B) diabetes mellitus, (C) hypertension, (D) fatty liver, (E) waist–hip circumference ratio in males (≥0.9) or females (≥0.85), (F) waist circumference in males (>90 cm) or females (>80 cm).

Mentions: We compared the liver stiffness between or among residents with different characteristics. Liver stiffness increased significantly as the increment of BMI from 4.6 ± 1.5 kPa of normal BMI (<24 kg/m2), 4.7 ± 1.5 kPa of overweight (BMI between 24 and 27 kg/m2), and 5.8 ± 2.9 kPa of obesity (BMI > 27 kg/m2) (P < 0.001). Those residents with DM also presented significantly higher LSM than those without DM (6.1 ± 3.1 vs 4.7 ± 1.7 kPa, P = 0.001). Hypertension, WHR, and WC also had impact on LSM in either males or females (Figure 3). Interestingly, fatty liver change shown on sonography (NAFLD) increased liver stiffness significantly (P = 0.01). No interaction between residents with smoking versus nonsmoking (4.8 ± 1.8 vs 5.3 ± 2.8 kPa, P = 0.26) and with or without dyslipidemia (4.9 ± 1.9 vs 4.9 ± 2.3 kPa, P = 0.81) was observed for the association with liver stiffness.


The Application of Liver Stiffness Measurement in Residents Without Overt Liver Diseases Through a Community-Based Screening Program
Liver stiffness measurement (LSM) values according to 6 factors. (A) Body mass index, (B) diabetes mellitus, (C) hypertension, (D) fatty liver, (E) waist–hip circumference ratio in males (≥0.9) or females (≥0.85), (F) waist circumference in males (>90 cm) or females (>80 cm).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998410&req=5

Figure 3: Liver stiffness measurement (LSM) values according to 6 factors. (A) Body mass index, (B) diabetes mellitus, (C) hypertension, (D) fatty liver, (E) waist–hip circumference ratio in males (≥0.9) or females (≥0.85), (F) waist circumference in males (>90 cm) or females (>80 cm).
Mentions: We compared the liver stiffness between or among residents with different characteristics. Liver stiffness increased significantly as the increment of BMI from 4.6 ± 1.5 kPa of normal BMI (<24 kg/m2), 4.7 ± 1.5 kPa of overweight (BMI between 24 and 27 kg/m2), and 5.8 ± 2.9 kPa of obesity (BMI > 27 kg/m2) (P < 0.001). Those residents with DM also presented significantly higher LSM than those without DM (6.1 ± 3.1 vs 4.7 ± 1.7 kPa, P = 0.001). Hypertension, WHR, and WC also had impact on LSM in either males or females (Figure 3). Interestingly, fatty liver change shown on sonography (NAFLD) increased liver stiffness significantly (P = 0.01). No interaction between residents with smoking versus nonsmoking (4.8 ± 1.8 vs 5.3 ± 2.8 kPa, P = 0.26) and with or without dyslipidemia (4.9 ± 1.9 vs 4.9 ± 2.3 kPa, P = 0.81) was observed for the association with liver stiffness.

View Article: PubMed Central - PubMed

ABSTRACT

The application of liver stiffness measurement (LSM) by transient elastography (TE) in general population remains to clarify. This cohort study aimed to examine the usefulness of TE and to identify factors associated with significant liver fibrosis in community-based population.

We conducted a hepatitis screening program in 2 remote villages of Southern Taiwan. All residents participated voluntarily and received questionnaire evaluation, blood tests, abdominal sonography, and LSM by TE. Residents with any one of following criteria including hepatitis B virus infection, hepatitis C virus infection, more than moderate alcohol drinking, and failure to obtain valid or reliable LSM were excluded.

There were 831 residents participated in program. The valid and reliable LSM were obtained in 98.3% and 96.3% of residents, respectively. Finally, a total of 559 residents including 283 residents with nonalcoholic steatotic fatty liver disease (NAFLD) were enrolled for analysis. The mean liver stiffness was 4.9&#8202;&plusmn;&#8202;1.9&#8202;kPa. The liver stiffness increased in residents with diabetes mellitus (DM), higher body mass index (BMI), hypertension, abnormal waist&ndash;hip circumference ration (WHR), higher waist circumference (WC), and presence of fatty liver. Higher body weight, higher BMI, higher WC, abnormal WHR, abnormal aspartate aminotransferase (AST), abnormal alanine aminotransferase (ALT), and DM were the factors associated with significant fibrosis (liver stiffness &ge;7&#8202;kPa) in either all participants or NAFLD residents. As determined by multivariate analysis, abnormal AST values and DM were the 2 independent factors in all participants (abnormal AST: OR 3.648, 95% CI 1.134&ndash;11.740, P&#8202;=&#8202;0.03; DM: OR 2.882, 95% CI 1.282&ndash;6.478, P&#8202;=&#8202;0.01) and in residents with NAFLD (abnormal AST: OR 4.197, 95% CI 1.154&ndash;15.262, P&#8202;=&#8202;0.03; DM: OR 3.254, 95% CI 1.258&ndash;8.413, P&#8202;=&#8202;0.02).

LSM by TE is a useful screening tool in community. In residents, who were absence of chronic hepatitis virus infection or consumed less than moderate alcohol drinking, exhibited DM or abnormal AST values may consider a substantial group with significant fibrosis in community.

No MeSH data available.


Related in: MedlinePlus