Korean J Hepatol.  2009 Dec;15(4):464-473. 10.3350/kjhep.2009.15.4.464.

Factors associated with liver stiffness in chronic liver disease

• Lee DM
• Moon EJ
• Hwang JA
• Lee MS
• Cheong JY
• Cho SW
• Kim YB
• Kim DJ
• Hwang SG
• Yang JM

• KMID: 1384054
• DOI: http://doi.org/10.3350/kjhep.2009.15.4.464

Abstract

BACKGROUND/AIMS
Transient elastography is a new noninvasive tool for measuring liver stiffness that accurately predicts significant fibrosis and cirrhosis. However, several studies have indicated that liver stiffness can be significantly influenced by major changes in aminotransferase in patients with chronic viral hepatitis. The aim of this study was to determine the factors influencing liver stiffness in patients with chronic liver disease. METHODS: We studied 158 patients with chronic liver disease who underwent transient elastography and liver biopsy sampling. Histologic findings on fibrosis and necroinflammatory activity in the biopsy specimens were evaluated according to the Korean Society of Pathologists Scoring System. Routine biochemical tests were performed according to standard methods. RESULTS: Liver stiffness was strongly correlated with liver fibrosis stage (Spearman coefficient=0.636, P<0.001), lobular activity (Spearman coefficient=0.359, P<0.001), and portoperiportal activity grade (Spearman coefficient=0.448, P<0.001). Liver stiffness was significantly associated with serum levels of total bilirubin (P=0.025), direct bilirubin (P=0.049), gamma-glutamyl transpeptidase (P=0.014), platelet count (P=0.004), albumin (P<0.001), and international normalized ratio (P<0.001). Multivariate analysis showed that fibrosis stage (B 3.50, P=0.009) and lobular activity grade (B 3.25, P=0.047) were independently associated with liver stiffness. CONCLUSIONS: Liver stiffness as measured by transient elastography is associated with the grade of necroinflammatory activity and the stage of fibrosis, irrespective of serum ALT levels.

Keyword

Liver stiffness; Fibrosis stage; Necroinflammatory activity; Biochemical test, Viral hepatitis

MeSH Terms

Adult
Aged
Bilirubin/blood
Biopsy
Chronic Disease
Elasticity
*Elasticity Imaging Techniques
Female
Hepatitis B, Chronic/*complications
Hepatitis C, Chronic/*complications
Humans
International Normalized Ratio
Liver Cirrhosis/etiology/pathology/*ultrasonography
Male
Middle Aged
Platelet Count
Risk Factors
Severity of Illness Index
gamma-Glutamyltransferase/blood