Multicenter prospective study to validate a new transient elastography device for staging liver fibrosis in patients with chronic hepatitis B

Duan, Wanru; Wang, Xiao Zhong; Lin, An Shen; Shang, Jia; Yang, Nan; Gao, Zhi; Tang, Hong; Fu, Qing Chun; Xie, Qing; Mao, Qing; Niu, Jun; Han, Tao; Li, Jun; Han, Ying; Cao, Jian; Kong, Yuan; Shi, Xin; Lv, Fu Dong; Wang, Tai Ling; Ma, Hong; You, Hong; Ou, X J; Jia, Ji Dong

doi:10.1111/1751-2980.12924

Cited by 14 publications

(16 citation statements)

References 28 publications

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“…Moreover, the FT can automatically adjust the dynamic probes according to the thickness of the subcutaneous fat to increase the rate of reliable measurements and shorten detection time (16,19). It was found that FT had considerable diagnostic efficacy in fibrosis staging in patients with chronic viral hepatitis (26). Also, it had a good correlation with liver histopathology in the staging of liver steatosis and fibrosis (17,19).…”

Section: Discussionmentioning

confidence: 99%

Accuracy of FibroTouch in assessing liver steatosis and fibrosis in patients with metabolic-associated fatty liver disease combined with type 2 diabetes mellitus

Liu

Zhang

et al. 2021

Ann Palliat Med

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Background: Metabolic-associated fatty liver disease (MAFLD) is highly prevalent in type 2 diabetes mellitus (T2DM) patients and can rapidly progress to steatohepatitis, liver fibrosis, and hepatocellular carcinoma (HCC). Accurate evaluation and proper management of MAFLD can help prevent adverse liver outcomes. Here we evaluated the precision of the FibroTouch (FT) in the staging of liver steatosis and fibrosis in patients with MAFLD combined with T2DM using two indicators: controlled attenuation parameter (CAP) and liver stiffness measurement (LSM).Methods: Eighty-five adult MAFLD combined with T2DM patients were selected at our center from July 2016 to July 2019 and underwent liver puncture biopsy for histopathology and the FT assay simultaneously.Two blinded pathologists independently reviewed the samples. The severity of fatty liver was classified using two scoring systems: the nonalcoholic fatty liver disease activity score (NAS) and the fibrosis score. Scores were then assessed following the Pathology Working Group of the NASH Clinical Research Network of the National Institutes of Health. Similarly, the severity of nonalcoholic steatohepatitis (NASH) was classified using the European Steatosis Activity Fibrosis (SAF) system. The FT assay was applied to obtain the LSM and the CAP. FT accuracy in diagnosing steatosis and fibrosis was determined by the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUROC).Results: Using biopsy analysis as the gold standard, the AUROCs and cutoff values of CAP in diagnosing liver steatosis were as follows: 0.84 (95% CI: 0.67-1.01) and 278 dB/m for S ≥ S1, 0.88 (95% CI: 0.81-0.95) and 305 dB/m for S ≥ S2, 0.89 (95% CI: 0.82-0.95) and 307 dB/m for S ≥ S3. The AUROCs and cutoff values of LSM in diagnosing liver fibrosis were as follows: 0.76 (95% CI: 0.66-0.86) for F ≥ F2, 0.81 (95% CI: 0.71-0.91) and 13.8 kPa for F ≥ F3, 0.92 (95% CI: 0.85-1.00) and 20.1 kPa for F ≥ F4. Conclusions:In patients of MAFLD with T2DM, CAP and LSM obtained by FT are highly accurate in assess liver steatosis and fibrosis, respectively, with AUROC values ranging from 0.76 to 0.92.

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Section: Discussionmentioning

confidence: 99%

Accuracy of FibroTouch in assessing liver steatosis and fibrosis in patients with metabolic-associated fatty liver disease combined with type 2 diabetes mellitus

Liu

Zhang

et al. 2021

Ann Palliat Med

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“…FibroTouch (FT5000), which was as valid as FibroScan, was used to evaluate liver steatosis and fibrosis in the present study 16 , 17 . The liver stiffness measurement (LSM) value in FibroTouch showed a high coincidence rate with hepatic fibrosis staging according to the liver biopsy, which is the gold standard for diagnosis of cirrhosis and staging of fibrosis or steatosis 18 , 19 . Transient elastography was carried out by a certified physician who was blinded to the patients’ clinical data, and manipulated according to the operations manual.…”

Section: Methodsmentioning

confidence: 99%

“…The CAP and LSM were considered reliable only if 10 successful measurements were obtained, with an interquartile range/median of <30% and a success rate of ≥60%. The cut‐off points of CAP and LSM were set at 240 dB/m and 9.5 kPa, respectively, according to Chinese thresholds 19 , 20 . Therefore, individuals with CAP ≥240 dB/m and LSM ≥9.5 kPa were assigned to steatosis and fibrosis, respectively.…”

Section: Methodsmentioning

confidence: 99%

Liver fibrosis is independently associated with diabetic peripheral neuropathy in type 2 diabetes mellitus

Huang

Liu

et al. 2021

J of Diabetes Invest

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Aims/Introduction Non‐alcoholic fatty liver disease and type 2 diabetes mellitus are closely related, and often occur simultaneously in patients. Type 2 diabetes increases the risk of diabetic peripheral neuropathy, resulting in intolerable pain and extremity amputation that reduces the quality of life. However, the role of non‐alcoholic fatty liver disease in the pathogenesis of diabetic peripheral neuropathy remains unclear. Thus, we evaluated the correlation of liver fibrosis and steatosis, which are representative histological morphologies of non‐alcoholic fatty liver disease, with diabetic peripheral neuropathy in type 2 diabetes patients. Materials and Methods Five hundred twenty individuals with type 2 diabetes were recruited. All the patients were detected nerve conduction study for diabetic peripheral neuropathy and fibro touch for liver steatosis and fibrosis. Correlation of DPN with liver steatosis and fibrosis were analysed with binary logistic analysis. Results Among the 520 patients, the prevalence of liver steatosis, fibrosis and diabetic peripheral neuropathy was 63.0% (n = 328), 18.1% (n = 94) and 52.1% (n = 271), respectively. The prevalence of diabetic peripheral neuropathy was significantly elevated in patients with liver steatosis (55.7 vs 44.9%, P = 0.03) and fibrosis (61.5 vs 50%, P = 0.04), and it increased as liver stiffness measurement increased. Additionally, both hepatic steatosis (odds ratio 1.48, 95% confidence interval 1.04–2.11, P = 0.03) and fibrosis (odds ratio 1.60, 95% confidence interval 1.02–2.51, P = 0.04) were correlated with diabetic peripheral neuropathy. After adjusting for age, sex, weight, height, body mass index, waist hip ratio, duration of type 2 diabetes, blood glucose, homeostatic model assessment of insulin resistance, blood pressure, serum lipid, liver enzyme, urea, uric acid, creatinine and inflammatory factors, liver fibrosis remained associated with diabetic peripheral neuropathy (odds ratio 2.24, 95% confidence interval 1.11–4.53, P = 0.02). Conclusions The prevalence of diabetic peripheral neuropathy was elevated in patients with liver steatosis and fibrosis. Liver fibrosis was also independently associated with an increased risk of diabetic peripheral neuropathy.

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“…LSM is one of the most popular non-invasive measurements for evaluating liver stiffness and hepatic fibrosis ( European Association for Study of Liver, 2015 ; Duan et al, 2020 ). Still, obesity, ascites, and limited operator experience inevitably result in unreliable and inaccurate measurement results ( Castéra et al, 2010 ).…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of Inflammatory Indicators in Chronic Hepatitis B Patients With Significant Liver Fibrosis: A Multicenter Study in China

et al. 2021

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Diagnosis of significant liver fibrosis is essential to facilitate the optimal treatment decisions and improve prognosis in patients with chronic hepatitis B (CHB). We aimed to evaluate the value of inflammatory indicators and construct a nomogram that effectively predicts significant liver fibrosis among CHB patients. 563 CHB patients from two centers in China from 2014 to 2019 were divided into three cohorts (development, internal validation, and independent validation cohorts), assigned into cases with significant fibrosis (liver fibrosis stages ≥2) and those without. Multiple biochemical and serological inflammatory indicators were investigated. Inflammatory indicators, Alanine aminotransferase (ALT) and aspartate aminotransferase (AST), were significantly associated with significant liver fibrosis in CHB patients but limited predictive performance, and then we combined them with prothrombin time activity percentage (PTA) and liver stiffness measurement (LSM) were identified by multivariate logistic regression analysis. Based on these factors, we constructed the nomogram with excellent performance. The area under the receiver operating characteristic curve (AUROC) for the nomogram in the development, internal validation, and independent validation cohorts were 0.860, 0.877, and 0.811, respectively. Our nomogram based on ALT and AST that had excellent performance in predicting significant fibrosis of CHB patients were constructed.

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Multicenter prospective study to validate a new transient elastography device for staging liver fibrosis in patients with chronic hepatitis B

Cited by 14 publications

References 28 publications

Accuracy of FibroTouch in assessing liver steatosis and fibrosis in patients with metabolic-associated fatty liver disease combined with type 2 diabetes mellitus

Accuracy of FibroTouch in assessing liver steatosis and fibrosis in patients with metabolic-associated fatty liver disease combined with type 2 diabetes mellitus

Liver fibrosis is independently associated with diabetic peripheral neuropathy in type 2 diabetes mellitus

Prognostic Value of Inflammatory Indicators in Chronic Hepatitis B Patients With Significant Liver Fibrosis: A Multicenter Study in China

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