Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with nonalcoholic fatty liver disease (NAFLD).
BACKGROUND
Liver fibrosis is the main predictor of the progression of nonalcoholic fatty liver disease. Transient elastography (FibroScan), which measures liver stiffness, is a novel, noninvasive method to assess liver fibrosis.


OBJECTIVE
We investigated the usefulness of liver stiffness measurement in the evaluation of liver fibrosis in nonalcoholic fatty liver disease patients.


METHODS
A total of 97 nonalcoholic fatty liver disease patients.


METHODS
Transient elastography was performed for liver stiffness measurement in 97 nonalcoholic fatty liver disease patients. And the relationship between histological parameters and liver stiffness measurement was studied by multivariate analysis. Moreover, we investigated the relationship between liver stiffness measurement and the serum levels of hyaluronic acid and type IV collagen 7s domain.


RESULTS
The liver stiffness was well correlated with the stage of liver fibrosis (Kruskal-Wallis test p < 0.0001). The areas under the receiver-operating characteristic curves were 0.927 for > or = F1, 0.865 for > or = F2, 0.904 for > or = F3, 0.991 for > or = F4. Only fibrosis stage was correlated significantly with liver stiffness measurement by multiple regression analysis. Liver stiffness was also strongly correlated with the serum levels of type IV collagen 7s domain (r = 0.525, p < 0.0001) and hyaluronic acid (r = 0.457, p < 0.0001).


CONCLUSIONS
Our results show a significant correlation between liver stiffness measurement and fibrosis stage in nonalcoholic fatty liver disease patients, as confirmed by the results of liver biopsy, which remains the gold standard for evaluation of the severity of liver fibrosis in patients with nonalcoholic steatohepatitis.
Yoneda
M
M
Division of Gastroenterology, Yokohama City University, Graduate School of Medicine, 3-9 Fuku-ura, Yokohama, Japan.
Yoneda
M
M
Mawatari
H
H
Fujita
K
K
Endo
H
H
Iida
H
H
Nozaki
Y
Y
Yonemitsu
K
K
Higurashi
T
T
Takahashi
H
H
Kobayashi
N
N
Kirikoshi
H
H
Abe
Y
Y
Inamori
M
M
Kubota
K
K
Saito
S
S
Tamano
M
M
Hiraishi
H
H
Maeyama
S
S
Yamaguchi
N
N
Togo
S
S
Nakajima
A
A
D001706:Biopsy; D024143:Collagen Type VII / Q000097:blood; D018450:Disease Progression; D004548:Elasticity; D054459:Elasticity Imaging Techniques / Q000379:methods; D005234:Fatty Liver / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008099:Liver / Q000473:pathology / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed
D024143:Collagen Type VII