title: Controlled attenuation parameter for the detection of hepatic steatosis in patients with chronic hepatitis B.
abstract: BACKGROUND
  Controlled attenuation parameter (CAP) is a non-invasive method for diagnosing liver steatosis based on vibration-controlled transient elastography. The primary objective of this study was to assess CAP performance and determine the cut-off values for the diagnosis of hepatic steatosis in patients with chronic hepatitis B (CHB) using liver biopsy as a gold standard. The second objective was to apply the cut-off values found in the first cohort to a larger cohort to compare the performance of CAP and ultrasonography.
  
  
  METHODS
  Overall, 189 patients with CHB who underwent liver biopsy and CAP detection and 1707 patients with CHB and CAP who underwent abdominal ultrasonography were prospectively enrolled. The performance of CAP for evaluating hepatic steatosis compared with liver biopsy was calculated using the area under the receiver operating characteristic curve (AUROC).
  
  
  RESULTS
  In the 189 patients who underwent liver biopsy, the cut-offs for the CAP with steatosis S ≥ 1, S ≥ 2 and S ≥ 3 were 222 dB/m, 247 dB/m and 274 dB/m, respectively, and the AUROC were 0.88 (95% confidence interval [CI] = 0.82-0.95), 0.92 (95% CI = 0.87-0.97) and 0.94 (95% CI = 0.90-0.99), respectively. After applying the cut-offs above to the 1707 patients, it was found that CAP had a good concordance with abdominal ultrasonography with steatosis grade > S2. On multivariate analysis, body mass index (p < 0.001), triglyceride level (p < 0.001) and fasting glucose level (p = 0.001) were independent risk factors of CAP.
  
  
  CONCLUSIONS
  CAP had high diagnostic performance for evaluating hepatic steatosis in patients with CHB and had a good concordance with abdominal ultrasonography.
authors.affiliation: a Center of Infectious Diseases, West China Hospital, Sichuan University , Chengdu , PR China ;|b Division of Infectious Diseases, State Key Laboratory of Biotherapy , Sichuan University , Chengdu , PR China.
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.affiliation: a Center of Infectious Diseases, West China Hospital, Sichuan University , Chengdu , PR China ;|b Division of Infectious Diseases, State Key Laboratory of Biotherapy , Sichuan University , Chengdu , PR China.
authors.forename: Dongbo
authors.initials: D
authors.lastname: Wu
authors.affiliation: a Center of Infectious Diseases, West China Hospital, Sichuan University , Chengdu , PR China ;|b Division of Infectious Diseases, State Key Laboratory of Biotherapy , Sichuan University , Chengdu , PR China.
authors.forename: Menglan
authors.initials: M
authors.lastname: Wang
authors.affiliation: a Center of Infectious Diseases, West China Hospital, Sichuan University , Chengdu , PR China ;|b Division of Infectious Diseases, State Key Laboratory of Biotherapy , Sichuan University , Chengdu , PR China.
authors.forename: Enqiang
authors.initials: E
authors.lastname: Chen
authors.affiliation: a Center of Infectious Diseases, West China Hospital, Sichuan University , Chengdu , PR China ;|b Division of Infectious Diseases, State Key Laboratory of Biotherapy , Sichuan University , Chengdu , PR China.
authors.forename: Lang
authors.initials: L
authors.lastname: Bai
authors.affiliation: a Center of Infectious Diseases, West China Hospital, Sichuan University , Chengdu , PR China ;|b Division of Infectious Diseases, State Key Laboratory of Biotherapy , Sichuan University , Chengdu , PR China.
authors.forename: Cong
authors.initials: C
authors.lastname: Liu
authors.affiliation: a Center of Infectious Diseases, West China Hospital, Sichuan University , Chengdu , PR China ;|b Division of Infectious Diseases, State Key Laboratory of Biotherapy , Sichuan University , Chengdu , PR China.
authors.forename: Juan
authors.initials: J
authors.lastname: Liao
authors.affiliation: a Center of Infectious Diseases, West China Hospital, Sichuan University , Chengdu , PR China ;|b Division of Infectious Diseases, State Key Laboratory of Biotherapy , Sichuan University , Chengdu , PR China.
authors.forename: Hong
authors.initials: H
authors.lastname: Tang
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005234:Fatty Liver / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D014463:Ultrasonography; D055815:Young Adult
keywords: CAP; abdominal ultrasonography; hepatic steatosis; laboratory examination