title: Rapid decline of liver stiffness following alcohol withdrawal in heavy drinkers.
abstract: BACKGROUND
  Measurement of liver stiffness (LS) using real-time elastography appears as a promising tool to evaluate the severity of chronic liver diseases. Previous studies in patients with alcoholic liver disease have suggested that fibrosis was the only histological parameter to influence LS. To challenge this hypothesis, we have prospectively tested the short-term impact of alcohol withdrawal on LS value.
  
  
  METHODS
  Patients hospitalized for alcohol withdrawal in our Liver and Addiction Unit between 2007 and 2010 had an LS determination at entry (D0) and 7 days after alcohol withdrawal (D7). LS value was given as the median of 10 measurements performed with a FibroScan(®) device. For a given patient, variation of LS was considered as significant when the comparison of the 10 measurements at D0 and at D7 yielded a p-value under 0.05 (Wilcoxon test).
  
  
  RESULTS
  One hundred and thirty-seven patients were included in the study (median alcohol consumption: 150 g/d; hepatitis C: n = 21 [15.6%]). Considering all patients, median LS value decreased from 7.2 to 6.1 kPa between D0 and D7 (p = 0.00001, paired Wilcoxon test). LS decreased significantly in 62 patients (45.3%), and there was a reduction in the estimated stage of fibrosis in 32 (23.3%). LS increased significantly in 16 patients (11.7%). Subgroup analyses revealed that the decrease in LS was still significant in patients with or without hepatitis C infection, and aspartate transaminase level below or above 100 UI/l.
  
  
  CONCLUSIONS
  LS decreases significantly in nearly half of heavy drinkers after only 7 days of abstinence. This result strongly suggests that nonfibrotic lesions (such as the presence of alcoholic hepatitis) may influence LS. From a practical point of view, it also shows that variation of alcohol consumption must be taken into account for the interpretation of LS value.
authors.affiliation: Unité d'Hépatologie et d'Addictologie, Hôpital Cochin, Assitance Publique - Hôpitaux de Paris, France. jean-baptiste.trabut@cch.aphp.fr
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Trabut
authors.forename: Véronique
authors.initials: V
authors.lastname: Thépot
authors.forename: Bertrand
authors.initials: B
authors.lastname: Nalpas
authors.forename: Béatrice
authors.initials: B
authors.lastname: Lavielle
authors.forename: Simona
authors.initials: S
authors.lastname: Cosconea
authors.forename: Marion
authors.initials: M
authors.lastname: Corouge
authors.forename: Anaïs
authors.initials: A
authors.lastname: Vallet-Pichard
authors.forename: Hélène
authors.initials: H
authors.lastname: Fontaine
authors.forename: Vincent
authors.initials: V
authors.lastname: Mallet
authors.forename: Philippe
authors.initials: P
authors.lastname: Sogni
authors.forename: Stanislas
authors.initials: S
authors.lastname: Pol
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000473:pathology* / Q000534:rehabilitation; D001219:Aspartate Aminotransferases / Q000097:blood; D015331:Cohort Studies; D018450:Disease Progression; D054459:Elasticity Imaging Techniques; D005260:Female; D006526:Hepatitis C / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000473:pathology; D008108:Liver Diseases, Alcoholic / Q000473:pathology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013375:Substance Withdrawal Syndrome / Q000473:pathology*
chemical_list: D001219:Aspartate Aminotransferases