title: Liver stiffness and portal blood flow modifications induced by a liquid meal consumption: pathogenetic mechanisms and clinical relevance.
abstract: OBJECTIVE
  The correlation between liver stiffness (LS) variations and portal blood flow (PBF) modifications induced by a standardized liquid meal consumption and the clinical relevance of this matter are two aspects not yet fully elucidated. Herein, we evaluated the variations of LS and PBF after a standardized liquid meal intake in patients with chronic liver disease.
  
  
  METHODS
  PBF and LS were determined after an overnight fasting period in 54 patients. They were divided in three groups according to baseline LS (absent, moderate, and severe). They consumed 200 ml of water and a standardized liquid meal (300 Kcal/200 ml) after 60 min. PBF and LS were measured at 30 min after water and liquid meal consumption.
  
  
  RESULTS
  In all groups, LS and PBF values significantly increased only after meal consumption. A significant correlation between baseline LS values and post-meal increase of LS was observed. Moreover, higher basal stiffness values were associated to a larger increase of LS variation after meal consumption. The effect of the meal on LS remained statistically significant after multiple regression analysis. A significant correlation between increase of LS and PBF was found in patients with absent and moderate baseline LS. Nine patients (17%) switched from a lower to a higher level of LS after meal consumption.
  
  
  CONCLUSIONS
  A low calories/low-volume meal is capable of significantly increasing LS regardless of the grade of stiffness, determining a reclassification rate of 17%. In presence of minimal or moderate stiffness, the increase of LS is significantly correlated with the augment of PBF.
authors.affiliation: Department of Medical and Surgical Science, Gastroenterology Unit, University of Foggia , Foggia , Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Barone
authors.forename: Andrea
authors.initials: A
authors.lastname: Iannone
authors.forename: Natale Daniele
authors.initials: ND
authors.lastname: Brunetti
authors.forename: Francesco
authors.initials: F
authors.lastname: Sebastiani
authors.forename: Onofrio
authors.initials: O
authors.lastname: Cecere
authors.forename: Elsa
authors.initials: E
authors.lastname: Berardi
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Antonica
authors.forename: Alfredo
authors.initials: A
authors.lastname: Di Leo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004326:Drinking; D004435:Eating; D004548:Elasticity; D054459:Elasticity Imaging Techniques; D005215:Fasting; D005260:Female; D006801:Humans; D016014:Linear Models; D008107:Liver Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011169:Portal Vein / Q000000981:diagnostic imaging*; D019518:Postprandial Period; D012039:Regional Blood Flow; D055815:Young Adult
keywords: chronic liver disease; cirrhosis; liver fibrosis; transient elastography