Correlation between Liver Stiffness by Two-Dimensional Shear Wave Elastography and Waist Circumference in Japanese Local Citizens with Abdominal Obesity

Abstract

Background: Various factors other than fibrosis could affect liver stiffness (LS), measured by two-dimensional shear wave elastography (2D-SWE). We aimed to clarify the factors affecting LS in local citizens. Methods: We performed a cross-sectional study among local citizens of a health checkup program. Abdominal obesity was defined as waist circumference ≥85 cm for men and ≥90 cm for women. We evaluated the correlation between LS by 2D-SWE (Aplio 500) and waist circumference with linear regression analyses. We selected the following items as variables in the multivariate analysis: waist circumference, sex, hypertension, diabetes, diagnostic components of metabolic syndrome, γ−glutamyl transpeptidase, total bilirubin, NAFLD fibrosis score, and an indicator of a fatty liver, evaluated ultrasonographically. Results: Overall, 345 individuals were included; 318 (181 men and 137 women; age, 63.4 years; waist circumference, 84.0 cm; LS, 5.79 kPa) were analyzed, 128 of whom had abdominal obesity and significantly higher LS than non-abdominally obese individuals. In the multivariate analysis, waist circumference was positively, independently, and significantly correlated with LS only in abdominally obese individuals. Conclusions: Liver stiffness by 2D-SWE could increase with increases in waist circumference in local citizens with abdominal obesity. Physicians should pay attention when assessing the LS of abdominally obese individuals.

Ultrasound-Based Hepatic Elastography in Non-Alcoholic Fatty Liver Disease: Focus on Patients with Type 2 Diabetes

“…MS is associated with high liver stiffness [ 115 ]. Moreover, a cross-sectional, one-center Japanese study in people with abdominal obesity (Japanese diagnostic criteria for MS include waist circumference values of ≥85 cm for men and ≥90 cm for women) showed that waist circumference was significantly and independently correlated with liver stiffness measured by 2D-SWE [ 116 ]. The advantages of 2D-SWE have become evident in individuals with NAFLD and severe obesity, where its findings showed a higher success rate in comparison with TE, one of the most validated tools available [ 117 ].…”

“…F ≥ 3 represents advanced fibrosis, while the F4 fibrosis stage usually suggests cirrhosis [ 142 ]. Supplementary difficulties arise from some studies not reporting LSM cut-offs that define different fibrosis stages [ 57 , 72 , 91 ], while others use different stage appellations that are difficult to correlate with the current standard definitions [ 81 , 83 , 89 , 116 ]. The age-adapted cut-offs should also be taken into account to improve the method’s performance.…”