LSM detects undiagnosed chronic liver disease

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LSM detects undiagnosed chronic liver disease

Published date :24-Dec-2010

MedWire News: Study findings show that liver stiffness measurement (LSM) can

detect undiagnosed chronic liver disease in apparently healthy individuals, with

the added benefit of a 100% positive predictive value for cirrhosis screening.

" So far, liver biopsy has been the gold standard for the assessment of fibrosis

in patients with chronic liver disease, " say Dominique Roulot (Avicenne

Hospital, Bobigny, France) and co-authors.

" However, in cases of suspicion of non-alcoholic fatty liver disease (NAFLD),

liver biopsy is difficult to recommend for apparently healthy patients with

normal liver tests, because of its possible complications, " they add.

A total of 1190 individuals from the general population, aged 45 years or older,

attending for a medical check-up participated in the current study. All patients

received LSM, in addition to laboratory tests and medical examinations. Those

who scored over 8 kPa on the LSM were referred to a liver unit for further

investigations.

Overall, 94 (8.5%) patients had a LSM >8 kPa, including nine patients with a LSM

>13 kPa. The researchers note that although LSM values were normal in 4% of

patients with perturbed liver tests, these tests came back as normal in 43% of

patients with LSM >8 kPa.

NAFLD and alcoholic liver disease (ALD) were diagnosed as the likely causes of

chronic liver disease in 52 and 20 patients, respectively. Hepatitis B and C

were diagnosed in nine patients, and primary biliary cirrhosis in one patient.

Liver biopsy results confirmed that all of the nine patients with LSM >13 kPa

had liver cirrhosis due to ALD or chronic hepatitis B/C. The remaining 18

biopsies showed liver fibrosis in all patients except one who presented with

isolated steatosis.

Factors significantly associated with a LSM >8 kPa included being aged 57 years

or older, having a body mass index ≥30 kg/m2, elevated waist circumference,

diabetes, alanine aminotransferase ≥40 UI/l, and γ-glutamyltranspeptidase

≥45 UI/l.

The researchers say the findings suggest that " a relatively high percentage of

liver diseases remain undiagnosed in apparently healthy individuals, and that

LSM might contribute to referring these patients to hepatologists. "

They conclude in the journal Gut: " If future studies determine that the superior

positive predictive value of LSM can be achieved at an acceptable cost, compared

with common screening methods, LSM might represent a first-line procedure for

the mass screening of liver disease in the general population. "

MedWire (www.medwire-news.md) is an independent clinical news service provided

by Current Medicine Group, a trading division of Springer Healthcare Limited. ©

Springer Healthcare Ltd; 2010

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