Liver stiffness and portal blood flow modifications induced by a liquid meal consumption: pathogenetic mechanisms and clinical relevance

Barone, M.; Iannone, Andrea; Brunetti, Natale Daniele; Sebastiani, Francesco; Cecere, O; Berardi, Elsa; Antonica, Gianfranco; Leo, Alfredo Di

doi:10.3109/00365521.2014.1003396

Cited by 18 publications

(11 citation statements)

References 20 publications

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“…32,33,34 The increase of liver stiffness after food intake is related to an increase of portal blood flow. 35,36 Concerning spleen stiffness, Han et al have shown its decrease after reducing portal hypertension in patients who underwent transjugular intrahepatic portosystemic shunt (TIPS). 37 Thus, it seems that tissue stiffness is changing with fluid pressure and with the content of fluid in the studied organs.…”

Section: Discussionmentioning

confidence: 99%

Is Kidney Stiffness Measured Using Elastography Influenced Mainly by Vascular Factors in Patients with Diabetic Kidney Disease?

et al. 2018

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Studies published so far using ultrasound-based elastography in the kidneys, lack to prove a clear relationship between kidney shear wave speed (KSWS) and renal disease progression. Taking into account that the kidney is a highly vascularized organ, the present study aims to find a relationship between KSWS and vascular factors (blood pressure [BP], arterial stiffness). Our study included 38 diabetic kidney disease patients (mean age 56.52 ± 16.12 years, 19 female, 19 male). KSWS, an indicator of renal stiffness, was measured using point Shear Wave Elastography (pSWE; Siemens Acuson S2000). In every patient, we recorded BP, and we measured aortic augmentation index (AAI) and brachial pulse wave velocity (PWV), using oscillometry. We found statistically significant indirect correlations of KSWS with indicators of arterial stiffness, such as PWV ( r = -.41, p = .036), and AAI ( r = -.37, p = .031). We found also an indirect correlation of KSWS with diastolic BP ( r = -.65, p = .02) and systolic BP ( r = -.54, p = .008). We found no correlation of KSWS with estimated glomerular filtration rate (eGFR), urinary albumin/creatinine ratio, stage of diabetic retinopathy, or glycated hemoglobin. Our study shows that high BP and the progression of arteriosclerosis (high PWV and AAI), leads to a decrease of renal stiffness. Thus, it seems that KSWS is influenced by renal blood flow, rather than other factors, such as albuminuria or chronic kidney disease stage.

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Section: Discussionmentioning

confidence: 99%

Is Kidney Stiffness Measured Using Elastography Influenced Mainly by Vascular Factors in Patients with Diabetic Kidney Disease?

et al. 2018

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“…[13] However, another study suggested a linear relationship between liver stiffness and portal flow in non-cirrhotic patients. [26]…”

Section: Discussionmentioning

confidence: 99%

High risk of misinterpreting liver and spleen stiffness using 2D shear-wave and transient elastography after a moderate or high calorie meal

et al. 2017

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Food intake increases liver stiffness, but it is believed that liver stiffness returns to baseline two hours after a meal. The aim of this study was to investigate the impact of different sized meals on liver stiffness. Liver and spleen stiffness was measured with transient elastography (TE) and real-time 2-dimensional shear wave elastography (2D-SWE). Patients ingested a 625 kcal and a 1250 kcal liquid meal on two consecutive days. We measured liver and spleen elasticity, Controlled attenuation parameter (CAP) and portal flow at baseline and after 20, 40, 60, 120 and 180 minutes. Sixty patients participated, 83% with alcoholic liver disease. Twenty-eight patients had METAVIR fibrosis score F0-3 and 32 patients had cirrhosis. Liver stiffness, spleen stiffness and CAP increased after both meals for all stages of fibrosis. False positive 2D-SWE liver stiffness measurements caused 36% and 52% of patients with F0-3 fibrosis to be misclassified with higher stages of fibrosis after the moderate and high caloric meal. Likewise, 10% and 13% of compensated cirrhosis patients were misclassified with clinically significant portal hypertension after the two meals. We observed similar misclassification rates with TE. After three hours, liver stiffness remained elevated more than 20% from baseline in up to 50% of patients. In conclusion: Liver stiffness, spleen stiffness and CAP increase after a meal across all stages of fibrosis and across elastography techniques. Up to half of patients may be misclassified with higher stages of fibrosis, if they are assessed after less than three hours fasting period.

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“…Measurements of the liver stiffness were performed on the right lobe of the liver, on a site localized by previous ultrasound evaluation, through the intercostal spaces with patient in supine position. Ten valid measurements were performed on each patient and only exams with a success rate of at least 60% and an interquartile interval <30% were considered reliable [ 33 ]. We excluded from the study conditions that technically prevented the execution of liver elastography (severe obesity, narrowness of intercostal spaces).…”

Section: Methodsmentioning

confidence: 99%

Chronic Viral Hepatitis in a Cohort of Inflammatory Bowel Disease Patients from Southern Italy: A Case-Control Study

et al. 2020

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We performed an epidemiologic study to assess the prevalence of chronic viral hepatitis in inflammatory bowel disease (IBD) and to detect their possible relationships. Methods: It was a single centre cohort cross-sectional study, during October 2016 and October 2017. Consecutive IBD adult patients and a control group of non-IBD subjects were recruited. All patients underwent laboratory investigations to detect chronic hepatitis B (HBV) and C (HCV) infection. Parameters of liver function, elastography and IBD features were collected. Univariate analysis was performed by Student’s t or chi-square test. Multivariate analysis was performed by binomial logistic regression and odds ratios (ORs) were calculated. We enrolled 807 IBD patients and 189 controls. Thirty-five (4.3%) had chronic viral hepatitis: 28 HCV (3.4%, versus 5.3% in controls, p = 0.24) and 7 HBV (0.9% versus 0.5% in controls, p = 0.64). More men were observed in the IBD–hepatitis group (71.2% versus 58.2%, p < 0.001). Patients with IBD and chronic viral hepatitis had a higher mean age and showed a higher frequency of diabetes, hypertension and wider waist circumference. They suffered more frequently from ulcerative colitis. Liver stiffness was greater in subjects with IBD and chronic viral hepatitis (7.0 ± 4.4 versus 5.0 ± 1.2 KPa; p < 0.001). At multivariate analysis, only old age directly correlated with viral hepatitis risk (OR = 1.05, 95%CI 1.02–1.08, p < 0.001). In conclusion, the prevalence of HBV/HCV in IBD is low in our region. Age may be the only independent factor of viral hepatitis–IBD association. Finally, this study firstly measured liver stiffness in a large scale, showing higher values in subjects with both diseases.

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Liver stiffness and portal blood flow modifications induced by a liquid meal consumption: pathogenetic mechanisms and clinical relevance

Abstract: A low calories/low-volume meal is capable of significantly increasing LS regardless of the grade of stiffness, determining a reclassification rate of 17%. In presence of minimal or moderate stiffness, the increase of LS is significantly correlated with the augment of PBF.

Cited by 18 publications

References 20 publications

Is Kidney Stiffness Measured Using Elastography Influenced Mainly by Vascular Factors in Patients with Diabetic Kidney Disease?

Is Kidney Stiffness Measured Using Elastography Influenced Mainly by Vascular Factors in Patients with Diabetic Kidney Disease?

High risk of misinterpreting liver and spleen stiffness using 2D shear-wave and transient elastography after a moderate or high calorie meal

Chronic Viral Hepatitis in a Cohort of Inflammatory Bowel Disease Patients from Southern Italy: A Case-Control Study

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