Controlled Attenuation Parameter reflects steatosis in compensated advanced chronic liver disease.

Piccinni, Rosangela; G. Rodrigues, Susana; Montani, Matteo; Murgia, Giuseppe; Delgado, Maria G.; Casu, Stefania; Stirnimann, Guido; Semmo, Nasser; De Gottardi, Andrea; Dufour, Jean-François; Berzigotti, Annalisa (2020). Controlled Attenuation Parameter reflects steatosis in compensated advanced chronic liver disease. Liver international, 40(5), pp. 1151-1158. Wiley 10.1111/liv.14325

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BACKGROUND & AIMS Controlled Attenuation Parameter (CAP) for steatosis assessment has not been validated in compensated advanced chronic liver disease cACLD. We primarily aimed at assessing the accuracy of CAP for the diagnosis and quantification of steatosis in cACLD. Secondary aim: to assess the validity of non-invasive criteria for cACLD according to liver stiffness measurement (LSM). METHODS This is a single center retrospective study including patients with cACLD defined as LSM ≥10 kPa, CAP measurement and liver biopsy (reference standard for steatosis and fibrosis) observed in 06/2015-06/2017. Steatosis was graded as S0 (<5%), S1 (5-32%), S2 (33-66%) and S3 (>66%). The diagnostic performance of CAP for any grade of steatosis and for high-grade steatosis (≥S2) was studied. RESULTS Among 461 consecutive patients, 111 with LSM-based diagnosis of cACLD were included (63% male, median age 55 yrs, median BMI 28.1 Kg/m2 , etiology: 32% NAFLD/NASH, 32% alcohol or viral +metabolic syndrome, 15% viral, 6% autoimmune, 4% alcohol, 11% others). Median LSM and CAP were 16.1 kPa and 277 dB/m, respectively. On liver biopsy, steatosis was found in 88/111 patients (79%); 44 patients (43 with metabolic syndrome) had high-grade steatosis. CAP was accurate in identifying any grade of steatosis (AUROC 0.847;95%CI 0.767-0.926,p<0.0001), and ≥S2 steatosis (0.860;95%CI0.788-0.932,p<0.0001). CAP performed similarly in patients with CAP-IQR≥ or <40 dB/m. CONCLUSIONS Steatosis is frequent in patients with cACLD and metabolic syndrome. CAP diagnostic accuracy for any steatosis and high-grade steatosis is good in this population. A CAP-IQR ≥40 dB/m does not impair CAP diagnostic accuracy in cACLD.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology
04 Faculty of Medicine > Service Sector > Institute of Pathology > Clinical Pathology
04 Faculty of Medicine > Service Sector > Institute of Pathology
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie

UniBE Contributor:

Gomes Rodrigues, Susana; Montani, Matteo; Murgia, Giuseppe; Delgado, Maria Gabriela; Casu, Stefania; Stirnimann, Guido; Semmo, Nasser; De Gottardi, Andrea; Dufour, Jean-François and Berzigotti, Annalisa

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

1478-3231

Publisher:

Wiley

Language:

English

Submitter:

Thi Thao Anh Pham

Date Deposited:

14 Jan 2020 07:44

Last Modified:

02 May 2020 01:31

Publisher DOI:

10.1111/liv.14325

PubMed ID:

31823449

Uncontrolled Keywords:

Liver cirrhosis NASH liver biopsy liver stiffness steatosis

BORIS DOI:

10.7892/boris.137066

URI:

https://boris.unibe.ch/id/eprint/137066

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