title: Transient elastography in healthy subjects and factors influencing liver stiffness in non-alcoholic fatty liver disease: An Italian community-based population study.
abstract: BACKGROUND
  Few studies have been performed to explore parameters that influence liver stiffness measurement (LSM) using transient elastography in general population.
  
  
  OBJECTIVE
  To explore factors influencing LSM in healthy and in subjects with non-alcoholic fatty liver disease (NAFLD).
  
  
  METHODS
  LSM was performed in a well-characterized cohort of subjects aged between 30 and 63 years. After exclusion of any causes of liver disease, the healthy cohort was defined and was compared with participants with NAFLD. The 95th percentile value of LSM in healthy was used as a cutoff suggesting relevant fibrosis.
  
  
  RESULTS
  Among 780 subjects evaluated, 331 were defined as healthy. The median value was 4.4kPa (3.7-5.2) and the 95th percentile was 6.8kPa. LSM was not influenced by gender, age, anthropometrics and biochemical parameters. Only insulin resistance was independently associated with increasing of LSM. In the cohort of 157 subjects with NAFLD, LSM was higher than in healthy (5.6±1.9 vs 4.6±1.3kPa; p<0.001). On multivariate analysis, the degree of steatosis was independently associated with increasing of LSM in NAFLD cohort (β=0.271; 95% CI=0.026-0.095; p<0.001). Participants with diabetes and/or severe steatosis had the highest probabilities of relevant fibrosis.
  
  
  CONCLUSIONS
  LSM varies between 3.7 and 5.2kPa in healthy Caucasians and is influenced only by insulin resistance. In NAFLD, severe steatosis and diabetes are factors influencing LSM.
authors: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors: Fabio
authors: F
authors: Conti
authors: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors: Ranka
authors: R
authors: Vukotic
authors: Department of Internal Medicine, Hospital of Faenza, AUSL Romagna, Faenza (RA), Italy.
authors: Francesco Giuseppe
authors: FG
authors: Foschi
authors: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors: Marco
authors: M
authors: Domenicali
authors: Department of Internal Medicine, Hospital of Faenza, AUSL Romagna, Faenza (RA), Italy.
authors: Pierluigi
authors: P
authors: Giacomoni
authors: Department of Internal Medicine, Hospital of Faenza, AUSL Romagna, Faenza (RA), Italy.
authors: Sara
authors: S
authors: Savini
authors: Department of Internal Medicine, Hospital of Faenza, AUSL Romagna, Faenza (RA), Italy.
authors: Arianna
authors: A
authors: Lanzi
authors: Department of Internal Medicine, Hospital of Faenza, AUSL Romagna, Faenza (RA), Italy.
authors: Anna Chiara
authors: AC
authors: Dall'Aglio
authors: Department of Internal Medicine, Hospital of Faenza, AUSL Romagna, Faenza (RA), Italy.
authors: Gaia
authors: G
authors: Saini
authors: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors: Marianna
authors: M
authors: Matroroberto
authors: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors: Mauro
authors: M
authors: Bernardi
authors: Department of Internal Medicine, Hospital of Faenza, AUSL Romagna, Faenza (RA), Italy.
authors: Giuseppe Francesco
authors: GF
authors: Stefanini
authors: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. Electronic address: pietro.andreone@unibo.it.
authors: Pietro
authors: P
authors: Andreone
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D007558:Italy; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications* / Q000000981:diagnostic imaging*
keywords: Fibroscan; Insulin resistance; NAFLD; Normal value