title: Utility of controlled attenuation parameter measurement for assessing liver steatosis in Japanese patients with chronic liver diseases.
abstract: OBJECTIVE
  Steatosis is a common histological feature of chronic liver disease, especially alcoholic and non-alcoholic fatty liver disease, as well as chronic hepatitis C. A recent study showed that evaluating the controlled attenuation parameter (CAP) with transient elastography was an efficient way of non-invasively determining the severity of hepatic steatosis. The objective of this study was to prospectively evaluate the utility of CAP for diagnosing steatosis in patients with chronic liver disease.
  
  
  METHODS
  One hundred and fifty-five consecutive patients with suspected chronic liver disease underwent steatosis diagnosis using CAP, blood sample analyses, computed tomography for assessing the liver/spleen ratio and liver biopsy. Steatosis was graded according to the percentage of fat-containing hepatocytes: S0, less than 5%; S1, 5-33%; S2, 34-66%; and S3: more than 66%.
  
  
  RESULTS
  The CAP was significantly correlated with steatosis grade, and there were significant differences between the CAP value of the S0 patients and those of the patients with other grades of steatosis. S0 and S1-3 hepatic steatosis were considered to represent mild and significant steatosis, respectively. The CAP values of the patients with mild and significant steatosis were significantly different (P < 0.0001). The area under the receiver-operator curve (AUROC) value of the CAP for diagnosing significant steatosis was 0.878 (95% confidence interval, 0.818-0.939), and the optimal CAP cut-off value for detecting significant steatosis was 232.5 db/m. In multivariate analysis, the CAP (P = 0.0002) and the liver to spleen ratio (P = 0.004) were found to be significantly associated with significant steatosis.
  
  
  CONCLUSIONS
  The CAP is a promising tool for rapidly and non-invasively diagnosing steatosis.
authors.affiliation: Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Masaki
authors.forename: Shintaro
authors.initials: S
authors.lastname: Takaki
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Hyogo
authors.forename: Tomoki
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Fukuhara
authors.forename: Noriaki
authors.initials: N
authors.lastname: Naeshiro
authors.forename: Yoji
authors.initials: Y
authors.lastname: Honda
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakahara
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ohno
authors.forename: Daisuke
authors.initials: D
authors.lastname: Miyaki
authors.forename: Eisuke
authors.initials: E
authors.lastname: Murakami
authors.forename: Yuko
authors.initials: Y
authors.lastname: Nagaoki
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Kawaoka
authors.forename: Masataka
authors.initials: M
authors.lastname: Tsuge
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Hiraga
authors.forename: Akira
authors.initials: A
authors.lastname: Hiramatsu
authors.forename: Michio
authors.initials: M
authors.lastname: Imamura
authors.forename: Yoshiiku
authors.initials: Y
authors.lastname: Kawakami
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aikata
authors.forename: Hidenori
authors.initials: H
authors.lastname: Ochi
authors.forename: Shoichi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Koji
authors.initials: K
authors.lastname: Arihiro
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
keywords: FibroScan; controlled attenuation parameter; liver steatosis; non-invasively diagnose