title: Clinical predictors of silent but substantial liver fibrosis in primary Sjogren's syndrome.
abstract: OBJECTIVE
  To investigate the prevalence and the predictors of silent but substantial liver fibrosis in patients with primary Sjogren's syndrome (pSS).
  
  
  METHODS
  We enrolled 101 pSS patients with normal liver function and structures, and without significant liver diseases or other conditions affecting liver fibrosis. The European league against rheumatism (EULAR) SS patients reported index (ESSPRI) and the EULAR SS disease activity index (ESSDAI) were analyzed. Liver stiffness (LS) was measured using transient elastography and 7.4 kPa was determined as the cutoff value for significant liver fibrosis.
  
  
  RESULTS
  The median age of patients (91women) was 53 years and the median LS value was 4.7 kPa. The median ESSPRI and ESSDAI showed no correlation with LS values. Twelve patients (11.9%) had significant liver fibrosis. In multivariate logistic regression, white blood cells count ≤4000.0/mm(3) (Odds ratio [OR] 9.821), serum albumin ≤3.8 mg/dL (OR 16.770) and aspartate aminotransferase (AST) ≥ 27.0 IU/L (OR 20.858) independently predicted silent but substantial liver fibrosis in pSS patients.
  
  
  CONCLUSIONS
  The prevalence of silent but substantial liver fibrosis was 11.9% in pSS and its predictors were leukopenia, decreased serum albumin and increased AST levels.
authors.affiliation: a Division of Rheumatology, Department of Internal Medicine , Yonsei University College of Medicine , Seoul , South Korea .
authors.forename: Sang-Won
authors.initials: SW
authors.lastname: Lee
authors.affiliation: b Department of Internal Medicine , Yonsei University College of Medicine , Seoul , South Korea , and.|c Liver Cirrhosis Clinical Research Center , Seoul , South Korea.
authors.forename: Beom Kyung
authors.initials: BK
authors.lastname: Kim
authors.affiliation: b Department of Internal Medicine , Yonsei University College of Medicine , Seoul , South Korea , and.|c Liver Cirrhosis Clinical Research Center , Seoul , South Korea.
authors.forename: Jun Yong
authors.initials: JY
authors.lastname: Park
authors.affiliation: b Department of Internal Medicine , Yonsei University College of Medicine , Seoul , South Korea , and.|c Liver Cirrhosis Clinical Research Center , Seoul , South Korea.
authors.forename: Do Young
authors.initials: do Y
authors.lastname: Kim
authors.affiliation: b Department of Internal Medicine , Yonsei University College of Medicine , Seoul , South Korea , and.|c Liver Cirrhosis Clinical Research Center , Seoul , South Korea.
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Ahn
authors.affiliation: a Division of Rheumatology, Department of Internal Medicine , Yonsei University College of Medicine , Seoul , South Korea .
authors.forename: Jungsik
authors.initials: J
authors.lastname: Song
authors.affiliation: a Division of Rheumatology, Department of Internal Medicine , Yonsei University College of Medicine , Seoul , South Korea .
authors.forename: Yong-Beom
authors.initials: YB
authors.lastname: Park
authors.affiliation: a Division of Rheumatology, Department of Internal Medicine , Yonsei University College of Medicine , Seoul , South Korea .
authors.forename: Soo-Kon
authors.initials: SK
authors.lastname: Lee
authors.affiliation: b Department of Internal Medicine , Yonsei University College of Medicine , Seoul , South Korea , and.|c Liver Cirrhosis Clinical Research Center , Seoul , South Korea.
authors.forename: Kwang-Hyub
authors.initials: KH
authors.lastname: Han
authors.affiliation: b Department of Internal Medicine , Yonsei University College of Medicine , Seoul , South Korea , and.|c Liver Cirrhosis Clinical Research Center , Seoul , South Korea.
authors.forename: Seung Up
authors.initials: SU
authors.lastname: Kim
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases / Q000453:epidemiology; D054459:Elasticity Imaging Techniques / Q000379:methods; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging*; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D008111:Liver Function Tests / Q000379:methods; D008297:Male; D008875:Middle Aged; D062072:Patient Acuity; D011237:Predictive Value of Tests; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012859:Sjogren's Syndrome / Q000150:complications / Q000175:diagnosis; D014463:Ultrasonography / Q000379:methods
keywords: Liver fibrosis; Sjögren's syndrome; Transient elastography