title: [Clinical factors influencing liver stiffness as measured by transient elastography (Fibroscan) in patients with chronic liver disease].
abstract: OBJECTIVE
  Transient elastography as performed using the Fibroscan is a useful noninvasive method for evaluating hepatic fibrosis. However, recent studies have found that liver stiffness measurement (LSM) values are inappropriately elevated in acute hepatitis or in the acute flare state of chronic hepatitis, suggesting that the LSM value obtained by the Fibroscan is not a reliable marker for fibrosis. We retrospectively evaluated the clinical factors influencing the LSM value obtained using transient elastography as performed using the Fibroscan in patients with chronic liver disease.
  
  
  METHODS
  A total of 298 patients who were followed in Kungpook National University Hospital from November 2007 to May 2008 due to previously established liver cirrhosis or chronic liver disease were investigated using the Fibroscan, laboratory test, ultrasound, and/or abdominal computed tomography.
  
  
  RESULTS
  The 298 patients were aged 47.8+/-12.9 years (mean+/-SD). The cut-off value for a diagnosis of liver cirrhosis was 12.5 kPa (as used in previous studies). Thirty-six patients (15%) and 202 patients (85%) with chronic liver disease without clinical manifestation of cirrhosis had LSMs of >12.5 kPa and <12.5 kPa, respectively. Multivariate analysis revealed that LSM values were unusually increased in patients with chronic liver disease who were older (P=0.007) or who had increased gamma glutamyltranspeptidase (GGT) (P=0.022), decreased albumin (P=0.015), or increased total bilirubin (P=0.009).
  
  
  CONCLUSIONS
  This study reveals that age, GGT, and albumin are clinical factors influencing LSM values. This reinforces the need to interpret LSM values in the context of a defined diagnosis, biochemical data, radiologic examination, and other clinical findings.
authors.affiliation: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Rack Cheon
authors.initials: RC
authors.lastname: Bae
authors.forename: Han Jin
authors.initials: HJ
authors.lastname: Cho
authors.forename: Jong Taek
authors.initials: JT
authors.lastname: Oh
authors.forename: Eung Kap
authors.initials: EK
authors.lastname: Lee
authors.forename: Jun
authors.initials: J
authors.lastname: Heo
authors.forename: Keun Young
authors.initials: KY
authors.lastname: Shin
authors.forename: Soo Young
authors.initials: SY
authors.lastname: Park
authors.forename: Min Kyu
authors.initials: MK
authors.lastname: Jeong
authors.forename: Seong Woo
authors.initials: SW
authors.lastname: Jeon
authors.forename: Chang Min
authors.initials: CM
authors.lastname: Cho
authors.forename: Won Young
authors.initials: WY
authors.lastname: Tak
authors.forename: Young Oh
authors.initials: YO
authors.lastname: Kweon
mesh_terms: D000328:Adult; D000367:Age Factors; D001663:Bilirubin / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D054459:Elasticity Imaging Techniques; D005260:Female; D006505:Hepatitis / Q000175:diagnosis / Q000000981:diagnostic imaging; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000000981:diagnostic imaging; D008107:Liver Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism; D014057:Tomography, X-Ray Computed; D005723:gamma-Glutamyltransferase / Q000378:metabolism
chemical_list: D015415:Biomarkers; D012709:Serum Albumin; D005723:gamma-Glutamyltransferase; D001663:Bilirubin