Assessment of transient elastography in Japanese patients with non‐alcoholic fatty liver disease

Seki, Kazuhiko; Shima, Toshihide; Oya, Hirohisa; Mitsumoto, Yasuhide; Mizuno, Masayuki; Okanoue, Takeshi

doi:10.1111/hepr.12829

Cited by 17 publications

(11 citation statements)

References 36 publications

(42 reference statements)

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“…Since then, many reports have been published and recently, Seki et al . reported that the cut‐off value of LSM by VCTE for predicting liver fibrosis stage ≥3 is 10.0 kPa in Japanese NAFLD patients . Furthermore, we previously reported the 4‐year disease progression in NAFLD patients as evaluated using LSM data obtained using VCTE …”

Section: Discussionmentioning

confidence: 54%

Assessment of 10‐year changes in liver stiffness using vibration‐controlled transient elastography in non‐alcoholic fatty liver disease

Nogami

Yoneda

Kobayashi

et al. 2019

Hepatology Research

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Aim Although liver biopsy is the gold standard for the diagnosis and staging of non‐alcoholic fatty liver disease (NAFLD), repeated assessment of patients’ liver tissue conditions are impractical. We assessed the 10‐year changes in liver stiffness measurements (LSM) utilizing vibration‐controlled transient elastography in NAFLD patients. Methods From January 2006 to September 2007, LSM was carried out for 97 biopsy‐proven NAFLD patients. Of these, 34 patients underwent 10‐year LSM reassessments (14 of them with paired biopsies). Results We evaluated the changes in the fibrosis stage as estimated using LSM (FS‐LSM). Over a 10‐year period, 32.4% had FS‐LSM progression, 50% had static disease, and 17.6% had FS‐LSM improvement. From among the initially diagnosed non‐alcoholic steatohepatitis patients, 18% had progressed to considerable stage 4 (cirrhosis) 10 years later. In this cohort, none of the patients who had been initially diagnosed as FS‐LSM stage 0 had progressed to cirrhosis 10 years later. The changes in LSM were correlated with the change in the histological fibrosis stage, the NAFLD activity score, and the change in the sum of the steatosis, activity, and fibrosis score. Improving more than 1 body mass index (kg/m2) and having a higher initial aspartate aminotransferase, alanine aminotransferase (ALT), or ALT responder (>30% improvement or reduction to less than 40 IU/L) were factors contributing to LSM improvements (≥2 kPa). Conclusions Vibration‐controlled transient elastography is likely to become a more clinically important tool for the long‐term monitoring of NAFLD patients.

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Section: Discussionmentioning

confidence: 54%

Assessment of 10‐year changes in liver stiffness using vibration‐controlled transient elastography in non‐alcoholic fatty liver disease

Nogami

Yoneda

Kobayashi

et al. 2019

Hepatology Research

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“…Fourth, the diagnostic accuracy of T4C7S CLEIA should be compared with the LSM using elastography 30 . Our previous studies revealed that the AUROCs of the T4C7S RIA and LSM of vibration‐controlled transient elastography (FibroScan®) for predicting the advanced liver fibrosis were comparable 13,31 . Fifth, a significant increase in the serum level of T4C7S was observed with increasing severity of lobular inflammation and hepatocyte ballooning in this study.…”

Section: Discussionmentioning

confidence: 60%

A novel rapid immunoassay of serum type IV collagen 7S for the diagnosis of fibrosis stage of nonalcoholic fatty liver diseases

Shima

Ohtakaki

Kikuchi

et al. 2021

Hepatology Research

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Aim: Type IV collagen 7S (T4C7S) is a valuable biomarker for detecting liver fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). The conventional T4C7S measurement via radioimmunoassay (T4C7S RIA) has shortcomings of radioisotope usage and longer assay periods. We compared T4C7S RIA with a newly developed, fast T4C7S chemiluminescent enzyme immunoassay (T4C7S CLEIA) and examined the diagnostic accuracies of and correlation between the two techniques. Methods: We evaluated 170 biopsy-confirmed patients with NAFLD. T4C7S was measured via both T4C7S RIA and T4C7S CLEIA. The correlation between T4C7S RIA and T4C7S CLEIA was analyzed in 305 total serum samples via exploratory research and 47 validation samples. The diagnostic accuracies of T4C7S CLEIA and T4C7S RIA were compared in the sera of patients with NAFLD and test samples. Results: Sera T4C7S levels of T4C7S CLEIA and T4C7S RIA significantly correlated in patients' samples via exploratory (r ¼ 0.914, P ¼ 0.000) and validation (r ¼ 0.929, P ¼ 0.000) research. At a 10% coefficient, T4C7S CLEIA concentration was 0.26 ng/ml in the serum samples, indicating high accuracy at even low concentrations. T4C7S CLEIA revealed distinct changes between each stage and high sensitivity in detecting the F2 stage, indicating a higher sensitivity in detecting low fibrosis stages than T4C7S RIA in patients with NAFLD. Conclusions: The T4C7S CLEIA correlated well with the T4C7S RIA. Favorably, the T4C7S CLEIA has a higher sensitivity and rapid measurement time and requires a small sample volume; thus, it is a promising and popular biomarker for fibrosis stage diagnosis in NAFLD. Abbreviations: AUROC, the area under the receiver operator characteristic curve; CLEIA, chemiluminescent enzyme immunoassay; CV, coefficient of variation; NAFLD, nonalcoholic fatty liver disease; NAS, NAFLD activity score; NASH, non-alcoholic steatohepatitis; RIA, radioimmunoassay; T4C7S, type IV collagen 7S; T4C7S CLEIA, type IV collagen 7S with chemiluminescent enzyme immunoassay; T4C7S RIA, type IV collagen 7S with radioimmunoassay. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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“…They found that CAP and LSM by FibroScan to assess liver steatosis and fibrosis with AUROC values ranged from 0.70 to 0.89 [ 84 ]; however, VCTE was less accurate in distinguishing a lower fibrosis stage, higher steatosis grades, or the presence of NASH [ 103 ]. In a few Japanese studies, 9.6–10.8 kPa of LSM was an optimal cutoff value for identifying advanced fibrosis in NAFLD [ 104 , 105 , 106 ].…”

Section: Noninvasive Tests For Diagnosis Of Nafld and Staging Fibrmentioning

confidence: 99%

“…VCTE is recommended as the second step, considering its simplicity, portability, and non-invasiveness. In a few Japanese studies, 9.6–10.8 kPa of LSM was an optimal cutoff value for identifying advanced fibrosis in NAFLD [ 104 , 105 , 106 ]. A two-step referral pathway system from Canada suggested that the cutoff value of VCTE was 8.0 kPa after triaging by FIB-4 index [ 111 ].…”

Section: Two-step Algorithm In Nafld Diagnosismentioning

confidence: 99%

Epidemiology, Pathogenesis, and Diagnostic Strategy of Diabetic Liver Disease in Japan

Sumida

Shima

Mitsumoto

et al. 2020

IJMS

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Type 2 diabetes (T2D) is closely associated with nonalcoholic fatty liver disease (NAFLD). Nonalcoholic steatohepatitis (NASH), a severe form of NAFLD, can lead to cirrhosis, hepatocellular carcinoma (HCC), and hepatic decompensation. Patients with T2D have twice the risk of HCC incidence compared with those without T2D. Because the hepatic fibrosis grade is the main determinant of mortality in patients with NAFLD, identifying patients with advanced fibrosis using non-invasive tests (NITs) or imaging modalities is crucial. Globally, the fibrosis-4 index (FIB-4 index), NAFLD fibrosis score, and enhanced liver fibrosis test have been established to evaluate hepatic fibrosis. Two-step algorithms using FIB-4 index as first triaging tool are globally accepted. It remains unknown which kinds of NITs or elastography are best as the second step tool. In Japan, type IV collagen 7s or the CA-fibrosis index (comprising type IV collagen 7s and aspartate aminotransferase (AST)) is believed to precisely predict advanced fibrosis in NAFLD. Patients with NAFLD who have high non-invasive test results should be screened for HCC or esophageal varices. Risk factors of rapid fibrosis progression in NAFLD includes age, severe obesity, presence of T2D, menopause in women, and a patatin-like phospholipase domain containing the 3 GG genotype. Patients with NAFLD who have these risk factors should be intensively treated with lifestyle modification or pharmacotherapies for preventing liver-related mortality.

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Assessment of transient elastography in Japanese patients with non‐alcoholic fatty liver disease

Abstract: In NAFLD patients, TE has excellent utility for the assessment of liver fibrosis, particularly for advanced stage cases. The cut-off value of LSM by TE for predicting liver fibrosis stage ≥3 is 10.0 kPa in Japanese NAFLD patients.

Cited by 17 publications

References 36 publications

Assessment of 10‐year changes in liver stiffness using vibration‐controlled transient elastography in non‐alcoholic fatty liver disease

Assessment of 10‐year changes in liver stiffness using vibration‐controlled transient elastography in non‐alcoholic fatty liver disease

A novel rapid immunoassay of serum type IV collagen 7S for the diagnosis of fibrosis stage of nonalcoholic fatty liver diseases

Epidemiology, Pathogenesis, and Diagnostic Strategy of Diabetic Liver Disease in Japan

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