Controlled attenuation parameter is correlated with actual hepatic fat content in patients with non‐alcoholic fatty liver disease with none‐to‐mild obesity and liver fibrosis

Fujimori, Naoyuki; Tanaka, Naoki; Shibata, Soichiro; Sakai, Kenji; Yamazaki, Tomoo; Sekiguchi, Tomohiro; Kitabatake, Hiroyuki; Ichikawa, Yūki; Komatsu, Michiharu; Umemura, Takeji; Matsumoto, Akihiro; Tanaka, Eiji

doi:10.1111/hepr.12649

Cited by 37 publications

(29 citation statements)

References 27 publications

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“…Due to the fact that 70% of study patients were female and 30% of liver disease were chronic hepatitis B and the mean BMI of subjects was 25.6 ± 4.5 kg/m 2 , the generalizability of the results study should be cautious. The accuracy of CAP measurement for steatosis determination is low in the patients with obesity and advanced fibrosis [20]. Furthermore, we did not have a control group with normal water taking to exclude the influence of liquid volume as in the study of Mederacke I, et al [11].…”

Section: Discussionmentioning

confidence: 99%

The inverse effect of meal intake on controlled attenuation parameter and liver stiffness as assessed by transient elastography

et al. 2017

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BackgroundControlled attenuation parameter (CAP) and liver stiffness (LS) measured by transient elastography (TE, Fibroscan®) have been used for steatosis and fibrosis assessment. We evaluated the effect of meal intake on CAP and LS values.MethodsForty patients who had had a liver biopsy within the previous month were recruited. The biopsy was graded for fibrosis (F) and steatosis (S) stagings. TE was performed after overnight fasting (baseline values) and 15, 30, 45, 60, 90, and 120 min following the intake of a standard commercial formula meal, and every 30 min until LS and CAP values returned to baseline. The effect of meal intake on CAP and LS values was analyzed with a multilevel mixed model approach. ResultsThe mean age was 53.1 ± 11.2 years old. The mean (SD) BMI was 25.6 ± 4.5 kg/m2. F0, F1, F2, F3 and F4 fibrosis stages were found in 17 (42.5%), 9 (22.5%), 4 (10.0%), 8 (20.0%) and 2 (5.0%), respectively. S0, S1, S2 and S3 steatosis stages were seen in 22 (55.0%), 11 (27.5%), 4 (10.0%) and 3 (7.5%), respectively. The mean (SD) CAP and median (IQR) LS values at baseline were 249.7 ± 58.1 dB/m and 11.9 (6–18.1) kPa. A significant decrease in CAP values was observed in all patients 15 to 120 min after meals, with the CAP peak value at 60 min and the mean post-meal delta reduction of 18.1 dB/min. CAP values declined after meals at early fibrosis stages and across all stages of steatosis. A significant increase in LS values after meal intake was observed within 15 to 120 min, with the LS peak value at 15 min and the mean post-meal delta increase of 2.4 kPa. Post-meal CAP and LS values returned to baseline within 150 min following meals.ConclusionFollowing a meal, patients’ CAP values declined with the peak value at 60 min, contrasting with the rising of LS values with the peak value at 15 min. The post-meal CAP and LS values returned to baseline by 150 min. A fasting period of more than 150 min after a meal is recommended for patients undergoing TE.

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Section: Discussionmentioning

confidence: 99%

The inverse effect of meal intake on controlled attenuation parameter and liver stiffness as assessed by transient elastography

et al. 2017

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“…It is difficult to measure LS in patients with ascites or obesity. In particular, in NAFLD patients with a BMI 28, LS has wide dispersion [22]. In addition, LS is known to be affected by inflammation, jaundice, and congestion, as well as liver fibrosis [23].…”

Section: Discussionmentioning

confidence: 99%

Association between Liver Stiffness and Gastro-Esophageal Varices in Chronic Liver Diseases

Kishino¹,

Nakamura²,

ashimoto³

et al. 2018

obm hg

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Objective: Elastography is a non-invasive method used to estimate the extent of liver fibrosis, measured as liver stiffness (LS). We examined the relationship between gastro-esophageal varices and LS and the value of LS for prediction of esophageal varices and varices bleeding.Methods: From 2014 to 2016, we conducted a retrospective study of 138 patients with chronic liver diseases, including non-alcoholic fatty liver disease (NAFLD), alcoholic liver disease, primary biliary cholangitis, and viral hepatitis. LS was measured by transient elastography, with the median values being considered the final result. Results:In 63 cirrhosis cases, LS was highest in alcoholic cirrhosis. In the 89 cases who underwent endoscopy, a significant correlation between LS and the presence or absence of esophageal varices was confirmed (present, 38.2 ± 22.6 kPa; absent, 14.3 ± 11.2 kPa; P < 0.0001), while there were no significant differences between the two groups in terms of the form and red color sign of varicose veins. LS was significantly higher in patients with a history of bleeding compared to those without (bleeding, 42.1 ± 26.7 kPa; no bleeding, 23.0 ± 19.0 kPa; P = 0.0047). In addition, LS of multiple bleeding varices tended to be higher than that of a single bleeding varicose vein, although this difference was not statistically significant. Conclusion:The LS index is useful for diagnosing gastro-esophageal varices and as an indicator of the risk of bleeding or intractability. However, the cut-off values differed among the various liver diseases, so it is important to determine cut-off values for each separate etiology.

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“…Other glucose‐lowering agents had already been administered in three patients. Non‐alcoholic steatohepatitis was suspected based on the criteria of: (i) the presence of hepatorenal contrast and increased hepatic echogenicity on abdominal ultrasonography; (ii) ethanol consumption of <20 g/day; (iii) the absence of other causes of liver dysfunction, such as viral hepatitis, drug‐induced liver injury, autoimmune liver diseases, primary sclerosing cholangitis, Wilson disease, hereditary hemochromatosis, and citrin deficiency; and (iv) histologically confirmed using biopsied specimens. Body weight (BW) and height were measured before liver biopsy in a fasting state.…”

Section: Methodsmentioning

confidence: 99%

“…The presence of obesity was defined as a body mass index (BMI) >25 kg/m 2 according to criteria released by the Japan Society for the Study of Obesity. Clinical information was also recorded, with the presence of hypertension and hyperlipidemia being evaluated as described previously …”

Section: Methodsmentioning

confidence: 99%

Miglitol attenuates non‐alcoholic steatohepatitis in diabetic patients

Komatsu

Tanaka

Fujimori

et al. 2018

Hepatology Research

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Controlled attenuation parameter is correlated with actual hepatic fat content in patients with non‐alcoholic fatty liver disease with none‐to‐mild obesity and liver fibrosis

Abstract: CAP may be a promising tool for quantifying hepatic fat content in NAFLD patients with none-to-mild obesity and liver fibrosis. Further improvement of CAP performance is needed for the NAFLD patients with BMI of more than 28 kg/m(2) or significant hepatic fibrosis.

Cited by 37 publications

References 27 publications

The inverse effect of meal intake on controlled attenuation parameter and liver stiffness as assessed by transient elastography

The inverse effect of meal intake on controlled attenuation parameter and liver stiffness as assessed by transient elastography

Association between Liver Stiffness and Gastro-Esophageal Varices in Chronic Liver Diseases

Miglitol attenuates non‐alcoholic steatohepatitis in diabetic patients

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