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( Harry Yoon ),( Hana Park ),( Jeong Guil Lee ),( Kyu Sung Rim ),( Pil Won Park ),( Sung Pyo Hong ),( Kwang Hyun Ko ),( Chang Il Kwon ),( Won Hee Kim ),( Seong Gyu Hwang ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.1
Background: Until now, evaluation of steatosis by non-invasive methods has been challenging. Recently, CAP (controlled attenuation parameter) based on Fibroscan® was developed. In this paper, we report the use of CAP for the assessment of steatosis. Methods: 89 patients with chronic liver disease underwent blood tests and liver stiffness measurement (LSM) with simultaneous CAP determination using the Fibroscan®. Sonographic steatosis grade was assessed by one expert physician blinded to CAP, and compared with the steatosis grades based on CAP. Results: Characteristics of the 89 patients included were as follow: 56.2%male, median age 47.69 ± 11.26 years, BMI 23.75 ± 5.73 kg/m². Clinical and laboratory variables were well stratified according to the steatosis grades based on CAP , there were significant differences among the grades (body weight : S0 = 63.64 ± 11.82 m/s, S1=66.66 ± 7.98m/s, S2=66.09 ± 12.61m/s, S3=74.64 ± 12.75m/s, p=0.013 ; BMI : S0 = 22.84 ± 3.22m/s, S1=23.95 ± 6.49m/s, S2=20.50 ± 9.55m/s, S3=27.24 ± 3.74m/s, p=0.006 ; triglyceride: S0 = 83.62 ± 34.30m/s, S1= 126.19 ± 54.09m/s, S2=109.2 ± 55.37m/s, S3=150.25 ± 77.41 m/s, p=0.001). CAP showed positive correlations with body weight (r=0.372, p=0.001), BMI (r=0.318, p=0.004), triglyceride (r=0.344, p=0.002), and alanine aminotransferase (r=0.259, p=0.016). Although sequential differences of CAP depending on the sonographic steatosis grades were revealed (diffuse liver disease/normal = 220.37 ± 38.65m/s; mild fatty liver = 237.20 ± 56.42 m/s; moderate fatty liver = 286.43 ± 59.50 m/s; severe fatty liver = 330.33 ± 56.17 m/s, p<0.001), there were discordances between steatosis grades measured on the base of sonographic diagnosis and CAP. Conclusions: The CAP is a promising tool for the noninvasive detection of hepatic steatosis. Advantages of CAP include its ease of measurement, simultaneous availability with LSM for fibrosis assessment, and provision of additional objective information to the sonographic diagnosis.
( Harry Yoon ),( Hana Park ),( Jeong Guil Lee ),( Kyu Sung Rim ),( Pil Won Park ),( Sung Pyo Hong ),( Kwang Hyun Ko ),( Chang Il Kwon ),( Won Hee Kim ),( Seong Gyu Hwang ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-
Background: Until now, evaluation of steatosis by non-invasive methods has been challenging. Recently, CAP (controlled attenuation parameter) based on Fibroscan® was developed. In this paper, we report the use of CAP for the assessment of steatosis. Methods: 89 patients with chronic liver disease underwent blood tests and liver stiffness measurement (LSM) with simultaneous CAP determination using the Fibroscan®. Sonographic steatosis grade was assessed by one expert physician blinded to CAP, and compared with the steatosis grades based on CAP. Results: Characteristics of the 89 patients included were as follow: 56.2%male, median age 47.69 ± 11.26 years, BMI 23.75 ± 5.73 kg/m². Clinical and laboratory variables were well stratified according to the steatosis grades based on CAP , there were significant differences among the grades (body weight : S0 = 63.64 ± 11.82 m/s, S1=66.66 ± 7.98m/s, S2=66.09 ± 12.61m/s, S3=74.64 ± 12.75m/s, p=0.013 ; BMI : S0 = 22.84 ± 3.22m/s, S1=23.95 ± 6.49m/s, S2=20.50 ± 9.55m/s, S3=27.24 ± 3.74m/s, p=0.006 ; triglyceride: S0 = 83.62 ± 34.30m/s, S1= 126.19 ± 54.09m/s, S2=109.2 ± 55.37m/s, S3=150.25 ± 77.41 m/s, p=0.001). CAP showed positive correlations with body weight (r=0.372, p=0.001), BMI (r=0.318, p=0.004), triglyceride (r=0.344, p=0.002), and alanine aminotransferase (r=0.259, p=0.016). Although sequential differences of CAP depending on the sonographic steatosis grades were revealed (diffuse liver disease/normal = 220.37 ± 38.65m/s; mild fatty liver = 237.20 ± 56.42 m/s; moderate fatty liver = 286.43 ± 59.50 m/s; severe fatty liver = 330.33 ± 56.17 m/s, p<0.001), there were discordances between steatosis grades measured on the base of sonographic diagnosis and CAP. Conclusions: The CAP is a promising tool for the noninvasive detection of hepatic steatosis. Advantages of CAP include its ease of measurement, simultaneous availability with LSM for fibrosis assessment, and provision of additional objective information to the sonographic diagnosis.
Effects of Metabolic Syndrome on Fibrosis in Chronic Viral Hepatitis
( Harry Yoon ),( Jeong Guil Lee ),( Jeong Hwan Yoo ),( Myung Su Son ),( Dae Young Kim ),( Seong Gyu Hwang ),( Kyu Sung Rim ) 대한소화기학회 2013 Gut and Liver Vol.7 No.4
Background/Aims: Metabolic syndrome, comprising diabetes, hypertension, central obesity, and dyslipidemia, is increasingly prevalent worldwide. We aimed to study the relationship between metabolic syndrome and the risk of liver fibrosis in patients with chronic hepatitis B (CHB) and chronic hepatitis C (CHC). Methods: In total, 954 patients (CHB, 850; CHC, 104 patients) with liver biopsy were included in the retrospective analysis. Extensive clinical and histological data were available. Metabolic syndrome was defined using the International Diabetes Federation definition of metabolic syndrome, 2006 criteria. Histological lesions were evaluated according to the histology activity index system. Results: Metabolic syndrome was present in 6% of patients and significantly more prevalent in patients with CHC than in patients with CHB (5% vs 13%, p<0.001). Patients with metabolic syndrome were older among patients with CHB and patients with CHC, and, as expected, were mainly overweight or obese. Fibrosis was significantly more severe in patients with metabolic syndrome than in those without, regardless of whether they had CHB and CHC (CHB, 3.3±2.1 vs 2.4± 1.3, p=0.025; CHC, 2.6±1.5 vs 1.3±0.7, p=0.006). Liver fibrosis (stages 3 to 4) was independently associated with increased age, higher transaminase level and metabolic syndrome (odds ratio, 2.421; p=0.017). Conclusions: Metabolic syndrome is associated independently with severe fibrosis in patients with chronic viral hepatitis B and C. (Gut Liver 2013; 7:469-474)