title: Meal ingestion markedly increases liver stiffness suggesting the need for liver stiffness determination in fasting conditions.
abstract: BACKGROUND
  The introduction of noninvasive liver stiffness (LS) determination has heralded a new stage in the diagnosis and treatment of liver fibrosis.
  
  
  OBJECTIVE
  We evaluated the effect of food intake on LS in patients with different degrees of liver disease.
  
  
  METHODS
  We evaluated 24 patients (F≤1, n=11 and F> 1, n=13). LS (Fibroscan®) and portal blood flow (PBF) (Doppler ultrasound) were studied before and 30min after ingestion of a standard liquid meal.
  
  
  RESULTS
  Food intake increased PBF (51±10%, p<0.001). Splanchnic hyperemia was accompanied by a significant rise in LS (from 7.8±3.3 to 10.3±4.1kPa, p<0.001). These increases were similar in patients with minimal fibrosis(F≤1) and in those with more advanced fibrosis or cirrhosis (F>1). Hemodynamic and LS values returned to baseline pre-meal levels within 2hours.
  
  
  CONCLUSIONS
  LS increases markedly after ingestion of a standard meal, irrespective of the degree of fibrosis. Our results strongly suggest that LS should be measured in fasting conditions.
authors.affiliation: Servicio de Ecografía, Fundación Favaloro , Buenos Aires, Argentina.
authors.forename: Daniel
authors.initials: D
authors.lastname: Alvarez
authors.affiliation: Servicio de Hepatología, Programa de Trasplante Hepático, Hospital Alemán, Buenos Aires, Argentina.
authors.forename: Federico
authors.initials: F
authors.lastname: Orozco
authors.affiliation: Servicio de Hepatología, Programa de Trasplante Hepático, Hospital Alemán, Buenos Aires, Argentina.
authors.forename: José María
authors.initials: JM
authors.lastname: Mella
authors.affiliation: Servicio de Hepatología, Programa de Trasplante Hepático, Hospital Alemán, Buenos Aires, Argentina.
authors.forename: Maria
authors.initials: M
authors.lastname: Anders
authors.affiliation: Servicio de Hepatología, Programa de Trasplante Hepático, Hospital Alemán, Buenos Aires, Argentina.
authors.forename: Florencia
authors.initials: F
authors.lastname: Antinucci
authors.affiliation: Servicio de Hepatología, Programa de Trasplante Hepático, Hospital Alemán, Buenos Aires, Argentina. Electronic address: rmastai@hospitalaleman.com.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Mastai
mesh_terms: D000328:Adult; D000368:Aged; D000066491:Clinical Decision-Making; D004435:Eating / Q000502:physiology*; D004548:Elasticity; D005215:Fasting / Q000502:physiology*; D005260:Female; D006439:Hemodynamics; D019698:Hepatitis C, Chronic / Q000150:complications / Q000000981:diagnostic imaging; D006801:Humans; D006940:Hyperemia / Q000209:etiology; D017078:Laser-Doppler Flowmetry; D008099:Liver / Q000503:physiopathology*; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology; D008297:Male; D062407:Meals; D008875:Middle Aged; D011446:Prospective Studies; D013152:Splanchnic Circulation; D018608:Ultrasonography, Doppler
keywords: Condición de ayuno; Elastografía de transición; Fasting conditions; Fibroscan(®); Fibrosis; Hepatitis C; Ingesta de alimento; Meal ingestion; Transient elastography