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, DOI https://doi.org/10.1007/s12072-018-9843-4.
Full text not available from this repository.Abstract
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 |
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Funders: | UNSPECIFIED |
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 |
URI: | http://eprints.um.edu.my/id/eprint/21708 |
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