Individual patient data meta-analysis on controlled attenuation parameter for the XL probe in obese patients

Petroff, David; Blank, Valentin; Shalimar, S.; Newsome, Philip; Voican, Cosmin Sebastian; Thiele, Maja; Lédinghen, Victor de; Baumeler, Stephan; Chan, Wah‐Kheong; Perlemuter, Gabriel; Cardoso, Ana Carolina; Aggarwal, Sandeep; Sasso, M.; Eddowes, Peter; Allison, Michael; Tsochatzis, Emmanuel; Anstee, Quentin M.; Sheridan, David C.; Cobbold, Jeremy; Sylvie, Naveau; Lupșor-Platon, Monica; Mueller, Sebastian; Krag, Aleksander; Irlès‐Depé, Marie; Semela, David; Wong, Grace Lai–Hung; Wong, Vincent Wai‐Sun; Villela-Nogueira, Cristiane Alves; Harshit, Garg; Chazouillères, Olivier; Karlas, Thomas

doi:10.1016/s0168-8278(20)31356-8

Cited by 8 publications

(11 citation statements)

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“…However, a limitation of our study is that we did not perform a liver biopsy, which is considered the gold standard for diagnosing MASLD. Nevertheless, previous studies have shown good comparability between transient elastography and liver biopsy for MASLD diagnosis [32][33][34][35]. Another consideration is that our scoring system was developed using data from a specific subgroup of individuals with prediabetes and high cardiometabolic risk.…”

Section: Discussionmentioning

confidence: 99%

Clinical Predictive Score for Identifying Metabolic Dysfunction-Associated Steatotic Liver Disease in Individuals with Prediabetes Using Transient Elastography

Mahachai,

Washirasaksiri,

Ariyakunaphan

et al. 2023

JCM

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Scoring systems for metabolic dysfunction-associated steatotic liver disease (MASLD) in individuals with prediabetes have not been extensively explored. This study aimed to investigate the prevalence of MASLD and to develop predictive tools for its detection in high cardiometabolic people with prediabetes. A cross-sectional study was conducted using baseline data from the prediabetes cohort. All participants underwent transient elastography to assess liver stiffness. MASLD was defined using a controlled attenuation parameter value > 275 dB/m and/or a liver stiffness measurement ≥ 7.0 kPa. Cases with secondary causes of hepatic steatosis were excluded. Out of 400 participants, 375 were included. The observed prevalence of MASLD in individuals with prediabetes was 35.7%. The most effective predictive model included FPG ≥ 110 mg/dL; HbA1c ≥ 6.0%; sex-specific cutoffs for HDL; ALT ≥ 30 IU/L; and BMI levels. This model demonstrated good predictive performance with an AUC of 0.80 (95% CI 0.73–0.86). At a cutoff value of 4.5, the sensitivity was 70.7%, the specificity was 72.3%, the PPV was 58.8%, and the NPV was 81.5%. Our predictive model is practical, easy to use, and relies on common parameters. The scoring system should aid clinicians in determining when further investigations of MASLD are warranted among individuals with prediabetes, especially in settings with limited resources.

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Section: Discussionmentioning

confidence: 99%

Clinical Predictive Score for Identifying Metabolic Dysfunction-Associated Steatotic Liver Disease in Individuals with Prediabetes Using Transient Elastography

Mahachai,

Washirasaksiri,

Ariyakunaphan

et al. 2023

JCM

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“…To assess the presence of any degree of steatosis (S ≥ 1), a CAP value of 274 kPa was used as the reference, which was based on the study by Eddowes PJ et al that reported a sensitivity of >90% at this cut-off [21]. We did not test other cut-offs to further distinguish between the grades of steatosis as it was repeatedly shown that the performance of the CAP for this purpose was suboptimal [21,22]. According to a recent consensus document, MASLD is defined as the presence of liver steatosis in conjunction with at least one cardiometabolic risk factor and no other discernible cause [23].…”

Section: Methodsmentioning

confidence: 99%

“…Overall, the suboptimal performance of the ATT measurements may be a consequence of using the CAP as the reference method, which is not entirely optimal for assessing steatosis. CAP has a relatively acceptable performance for detecting any degree of steatosis (S ≥ 1), but it is not reliable enough for further differentiation between individual steatosis stages [21,22]. In this regard, we conclude that it would be necessary to evaluate this new ATT measurement method against another more reliable reference method for assessing liver steatosis, such as liver biopsy or magnetic resonance imaging (MRI).…”

Section: Supplementary Materialsmentioning

confidence: 96%

Compensated Advanced Chronic Liver Disease and Steatosis in Patients with Type 2 Diabetes as Assessed through Shear Wave Measurements and Attenuation Measurements

Barisic-Jaman,

Milosevic,

Skurla

et al. 2024

Biomedicines

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Patients with type 2 diabetes (T2D) are at risk of developing metabolic dysfunction-associated steatotic liver disease (MASLD). We investigated the prevalence of compensated advanced chronic liver disease (cACLD) and steatosis in patients with T2D using the new non-invasive diagnostic methods of shear wave measurements (SWMs) and attenuation (ATT) measurements in comparison with those of vibration-controlled transient elastography (VCTE) and the controlled attenuation parameter (CAP), which served as the reference methods. Among 214 T2D patients, steatosis at any grade and cACLD were revealed in 134 (62.6%) and 19 (8.9%) patients, respectively. SWMs showed a high correlation with VCTE (Spearman’s ρ = 0.641), whereas SWMs produced lower (mean of −0.7 kPa) liver stiffness measurements (LSMs) overall. At a LSM of >11.0 kPa (Youden), SWMs had an AUROC of 0.951 that was used to diagnose cACLD (defined as a LSM of >15 kPa through VCTE) with 84.2% sensitivity and 96.4% specificity. The performance of ATT measurements in diagnosing liver steatosis at any grade (defined as the CAP of ≥274 dB/m) was suboptimal (AUROC of 0.744 at the ATT measurement cut-off of >0.63 dB/cm/MHz (Youden) with 59% sensitivity and 81.2% specificity). In conclusion, the prevalence of liver steatosis and previously unrecognized cACLD in patients with T2D is high and SWMs appear to be a reliable diagnostic method for this purpose, whereas further investigation is needed to optimize the diagnostic performance of ATT measurements.

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“…Controlled attenuation parameter (CAP) is a tool for diagnosing steatosis only available with FibroScan. However, a recent individual-patient data meta-analysis found poor diagnostic accuracies for CAP to detect steatosis, with AUROCs well below 0.80 [33]. In the subpopulation of bariatric surgery patients, diagnostic accuracies were marginally better, but remained <0.80, with sensitivities and specificities below 80% and wide confidence intervals for the optimal cut-off points.…”

Section: Ultrasound Elastography and Controlled Attenuation Parametermentioning

confidence: 97%

The Role of Diagnostic Biomarkers, Omics Strategies, and Single-Cell Sequencing for Nonalcoholic Fatty Liver Disease in Severely Obese Patients

Wernberg

Ravnskjær

Lauridsen

et al. 2021

JCM

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Liver disease due to metabolic dysfunction constitute a worldwide growing health issue. Severe obesity is a particularly strong risk factor for non-alcoholic fatty liver disease, which affects up to 93% of these patients. Current diagnostic markers focus on the detection of advanced fibrosis as the major predictor of liver-related morbidity and mortality. The most accurate diagnostic tools use elastography to measure liver stiffness, with diagnostic accuracies similar in normal-weight and severely obese patients. The effectiveness of elastography tools are however hampered by limitations to equipment and measurement quality in patients with very large abdominal circumference and subcutaneous fat. Blood-based biomarkers are therefore attractive, but those available to date have only moderate diagnostic accuracy. Ongoing technological advances in omics technologies such as genomics, transcriptomics, and proteomics hold great promise for discovery of biomarkers and increased pathophysiological understanding of non-alcoholic liver disease and steatohepatitis. Very recent developments have allowed for single-cell sequencing and cell-type resolution of gene expression and function. In the near future, we will therefore likely see a multitude of breakthrough biomarkers, developed from a deepened understanding of the biological function of individual cell types in the healthy and injured liver.

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Individual patient data meta-analysis on controlled attenuation parameter for the XL probe in obese patients

Cited by 8 publications

References 0 publications

Clinical Predictive Score for Identifying Metabolic Dysfunction-Associated Steatotic Liver Disease in Individuals with Prediabetes Using Transient Elastography

Clinical Predictive Score for Identifying Metabolic Dysfunction-Associated Steatotic Liver Disease in Individuals with Prediabetes Using Transient Elastography

Compensated Advanced Chronic Liver Disease and Steatosis in Patients with Type 2 Diabetes as Assessed through Shear Wave Measurements and Attenuation Measurements

The Role of Diagnostic Biomarkers, Omics Strategies, and Single-Cell Sequencing for Nonalcoholic Fatty Liver Disease in Severely Obese Patients

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