[Factors associated with liver stiffness in chronic liver disease].
OBJECTIVE
Transient elastography is a new noninvasive tool for measuring liver stiffness that accurately predicts significant fibrosis and cirrhosis. However, several studies have indicated that liver stiffness can be significantly influenced by major changes in aminotransferase in patients with chronic viral hepatitis. The aim of this study was to determine the factors influencing liver stiffness in patients with chronic liver disease.


METHODS
We studied 158 patients with chronic liver disease who underwent transient elastography and liver biopsy sampling. Histologic findings on fibrosis and necroinflammatory activity in the biopsy specimens were evaluated according to the Korean Society of Pathologists Scoring System. Routine biochemical tests were performed according to standard methods.


RESULTS
Liver stiffness was strongly correlated with liver fibrosis stage (Spearman coefficient=0.636, P<0.001), lobular activity (Spearman coefficient=0.359, P<0.001), and portoperiportal activity grade (Spearman coefficient=0.448, P<0.001). Liver stiffness was significantly associated with serum levels of total bilirubin (P=0.025), direct bilirubin (P=0.049), gamma-glutamyl transpeptidase (P=0.014), platelet count (P=0.004), albumin (P<0.001), and international normalized ratio (P<0.001). Multivariate analysis showed that fibrosis stage (B 3.50, P=0.009) and lobular activity grade (B 3.25, P=0.047) were independently associated with liver stiffness.


CONCLUSIONS
Liver stiffness as measured by transient elastography is associated with the grade of necroinflammatory activity and the stage of fibrosis, irrespective of serum ALT levels.
Lee
Da Mi
DM
Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea.
Moon
Eun Joon
EJ
Hwang
Joo An
JA
Lee
Min Suk
MS
Cheong
Jae Youn
JY
Cho
Sung Won
SW
Kim
Yeong Bae
YB
Kim
Dong Joon
DJ
Hwang
Seong Gyu
SG
Yang
Jin Mo
JM
D000328:Adult; D000368:Aged; D001663:Bilirubin / Q000097:blood; D001706:Biopsy; D002908:Chronic Disease; D004548:Elasticity; D054459:Elasticity Imaging Techniques; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D019934:International Normalized Ratio; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D012307:Risk Factors; D012720:Severity of Illness Index; D005723:gamma-Glutamyltransferase / Q000097:blood
D005723:gamma-Glutamyltransferase; D001663:Bilirubin