Repeated liver stiffness measurement compared with paired liver biopsy in patients with non-alcoholic fatty liver disease

Kamarajah, Sivesh Kathir and Chan, Wah Kheong and Nik Mustapha, Nik Raihan and Mahadeva, Sanjiv (2018) Repeated liver stiffness measurement compared with paired liver biopsy in patients with non-alcoholic fatty liver disease. Hepatology International, 12 (1). pp. 44-55. ISSN 1936-0533

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Introduction: The value of repeated liver stiffness measurement (LSM) in non-alcoholic fatty liver disease (NAFLD) has not been shown before. Methods: A longitudinal study of biopsy-proven NAFLD patients was conducted at the Asian tertiary hospital from November 2012 to January 2017. Patients with paired liver biopsies and LSM were followed prospectively for liver-related and non-liver related complications, and survival. Results: The data for 113 biopsy-proven NAFLD patients (mean age 51.3 ± 10.6 years, male 50%) were analyzed. At baseline, advanced fibrosis based on histology and LSM was observed in 22 and 46%, respectively. Paired liver biopsy and LSM at 1-year interval was available in 71 and 80% of patients, respectively. High-risk cases (defined as patients with advanced fibrosis at baseline who had no fibrosis improvement, and patients who developed advanced fibrosis on repeat assessment) were seen in 23 and 53% of patients, based on paired liver biopsy and LSM, respectively. Type 2 diabetes mellitus was independently associated with high-risk cases. The median follow-up was 37 months with a total follow-up of 328 person-years. High-risk cases based on paired liver biopsy had significantly higher rates of liver-related complications (p = 0.002) but no difference in other outcomes. High-risk patients based on paired LSM had a significantly higher rate of liver-related complications (p = 0.046), cardiovascular events (p = 0.025) and composite outcomes (p = 0.006). Conclusion: Repeat LSM can predict liver-related complications, similar to paired liver biopsy, and may be useful in identifying patients who may be at an increased risk of cardiovascular events. Further studies in a larger cohort and with a longer follow-up should be carried out to confirm these observations.

Item Type: Article
Uncontrolled Keywords: Cirrhosis; Fibroscan; Liver biopsy; Liver fibrosis; NAFLD
Subjects: R Medicine
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 31 Jul 2019 01:43
Last Modified: 31 Jul 2019 01:43

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