Diagnostic Accuracy of Controlled Attenuation Parameter for Detecting Hepatic Steatosis in Patients with Chronic Liver Disease
Autor(a) principal: | |
---|---|
Data de Publicação: | 2017 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452017000400002 |
Resumo: | Introduction: Controlled attenuation parameter (CAP), measured by transient elastography, has been suggested as a noninvasive method for the detection and quantification of steatosis. We aimed to assess the accuracy of CAP to detect steatosis in patients with chronic liver disease (CLD) compared with liver histology and to evaluate factors that correlate with the CAP value. Methods: Patients with CLD who underwent liver biopsy and simultaneous CAP determination were consecutively enrolled. CAP was measured using the M probe of FibroScan® (Echosens, Paris, France). Histologically, steatosis was categorized as absent (S0: <5%), mild (S1: 5-33%), moderate (S2: 34-66%) and severe (S3: >66% of all hepatocytes ). Results: We analyzed 159 patients with CLD (61% men, mean age 47.9 ± 12.9 years). We found a positive correlation between CAP and steatosis in histology (r s = 0.869, p < 0.001), arterial hypertension (r s = 0.222, p = .005), type 2 diabetes mellitus (r s = 0.279, p < 0.001), body mass index (BMI; r s = 0.533, p < 0.001), total cholesterol (r s = 0.442, p < 0.001), triglycerides (r s = 0.272, p = 0.001), and non-alcoholic fatty liver disease (NAFLD; r s = 0.588, p < 0.001). In the multivariate analysis, BMI >25 (odds ratio [OR] 48.4, 95% confidence interval [CI] 23.78-72.95, p < 0.001), serum total cholesterol (OR 3.803, 95% CI 2.203-13.889, p = 0.008), and NAFLD etiology (OR 40.8, 95% CI 15.01-66.66, p = 0.002) were independently associated with higher CAP values. We did not find any significant correlation between CAP and the grade of necroinflammatory activity (r s = 0.063, p = 0.808) or fibrosis (r s = 0.071, p = 0.713) in histology and with alanine aminotransferase (r s = 0.190, p = 0.356) or aspartate aminotransferase (r s = 0.117, p = 0.142). Optimal CAP cutoff values for detecting steatosis ≥ S1, ≥ S2, and ≥ S3 were 206.5, 232.5, and 282.5 dB/m, respectively. CAP performance was 0.822, 0.956, and 0.976 for diagnosing steatosis ≥ S1, ≥ S2, and ≥ S3, respectively. Conclusions: CAP had an excellent diagnostic accuracy for the detection of steatosis in diverse CLD patients. A CAP value cutoff of <282.5 dB/m excludes severe steatosis ≥ S3 with an accuracy of 98%. |
id |
RCAP_d291ab4fd9b4d8766c7e7918cd0c6410 |
---|---|
oai_identifier_str |
oai:scielo:S2341-45452017000400002 |
network_acronym_str |
RCAP |
network_name_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository_id_str |
7160 |
spelling |
Diagnostic Accuracy of Controlled Attenuation Parameter for Detecting Hepatic Steatosis in Patients with Chronic Liver DiseaseControlled attenuation parameterTransient elastographySteatosisChronic liver diseaseLiver biopsyIntroduction: Controlled attenuation parameter (CAP), measured by transient elastography, has been suggested as a noninvasive method for the detection and quantification of steatosis. We aimed to assess the accuracy of CAP to detect steatosis in patients with chronic liver disease (CLD) compared with liver histology and to evaluate factors that correlate with the CAP value. Methods: Patients with CLD who underwent liver biopsy and simultaneous CAP determination were consecutively enrolled. CAP was measured using the M probe of FibroScan® (Echosens, Paris, France). Histologically, steatosis was categorized as absent (S0: <5%), mild (S1: 5-33%), moderate (S2: 34-66%) and severe (S3: >66% of all hepatocytes ). Results: We analyzed 159 patients with CLD (61% men, mean age 47.9 ± 12.9 years). We found a positive correlation between CAP and steatosis in histology (r s = 0.869, p < 0.001), arterial hypertension (r s = 0.222, p = .005), type 2 diabetes mellitus (r s = 0.279, p < 0.001), body mass index (BMI; r s = 0.533, p < 0.001), total cholesterol (r s = 0.442, p < 0.001), triglycerides (r s = 0.272, p = 0.001), and non-alcoholic fatty liver disease (NAFLD; r s = 0.588, p < 0.001). In the multivariate analysis, BMI >25 (odds ratio [OR] 48.4, 95% confidence interval [CI] 23.78-72.95, p < 0.001), serum total cholesterol (OR 3.803, 95% CI 2.203-13.889, p = 0.008), and NAFLD etiology (OR 40.8, 95% CI 15.01-66.66, p = 0.002) were independently associated with higher CAP values. We did not find any significant correlation between CAP and the grade of necroinflammatory activity (r s = 0.063, p = 0.808) or fibrosis (r s = 0.071, p = 0.713) in histology and with alanine aminotransferase (r s = 0.190, p = 0.356) or aspartate aminotransferase (r s = 0.117, p = 0.142). Optimal CAP cutoff values for detecting steatosis ≥ S1, ≥ S2, and ≥ S3 were 206.5, 232.5, and 282.5 dB/m, respectively. CAP performance was 0.822, 0.956, and 0.976 for diagnosing steatosis ≥ S1, ≥ S2, and ≥ S3, respectively. Conclusions: CAP had an excellent diagnostic accuracy for the detection of steatosis in diverse CLD patients. A CAP value cutoff of <282.5 dB/m excludes severe steatosis ≥ S3 with an accuracy of 98%.Sociedade Portuguesa de Gastrenterologia2017-08-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articletext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452017000400002GE-Portuguese Journal of Gastroenterology v.24 n.4 2017reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452017000400002Andrade,PatríciaRodrigues,SusanaRodrigues-Pinto,EduardoGaspar,RuiLopes,JoanneLopes,SusanaMacedo,Guilhermeinfo:eu-repo/semantics/openAccess2024-02-06T17:33:46Zoai:scielo:S2341-45452017000400002Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:36:00.768481Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Diagnostic Accuracy of Controlled Attenuation Parameter for Detecting Hepatic Steatosis in Patients with Chronic Liver Disease |
title |
Diagnostic Accuracy of Controlled Attenuation Parameter for Detecting Hepatic Steatosis in Patients with Chronic Liver Disease |
spellingShingle |
Diagnostic Accuracy of Controlled Attenuation Parameter for Detecting Hepatic Steatosis in Patients with Chronic Liver Disease Andrade,Patrícia Controlled attenuation parameter Transient elastography Steatosis Chronic liver disease Liver biopsy |
title_short |
Diagnostic Accuracy of Controlled Attenuation Parameter for Detecting Hepatic Steatosis in Patients with Chronic Liver Disease |
title_full |
Diagnostic Accuracy of Controlled Attenuation Parameter for Detecting Hepatic Steatosis in Patients with Chronic Liver Disease |
title_fullStr |
Diagnostic Accuracy of Controlled Attenuation Parameter for Detecting Hepatic Steatosis in Patients with Chronic Liver Disease |
title_full_unstemmed |
Diagnostic Accuracy of Controlled Attenuation Parameter for Detecting Hepatic Steatosis in Patients with Chronic Liver Disease |
title_sort |
Diagnostic Accuracy of Controlled Attenuation Parameter for Detecting Hepatic Steatosis in Patients with Chronic Liver Disease |
author |
Andrade,Patrícia |
author_facet |
Andrade,Patrícia Rodrigues,Susana Rodrigues-Pinto,Eduardo Gaspar,Rui Lopes,Joanne Lopes,Susana Macedo,Guilherme |
author_role |
author |
author2 |
Rodrigues,Susana Rodrigues-Pinto,Eduardo Gaspar,Rui Lopes,Joanne Lopes,Susana Macedo,Guilherme |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Andrade,Patrícia Rodrigues,Susana Rodrigues-Pinto,Eduardo Gaspar,Rui Lopes,Joanne Lopes,Susana Macedo,Guilherme |
dc.subject.por.fl_str_mv |
Controlled attenuation parameter Transient elastography Steatosis Chronic liver disease Liver biopsy |
topic |
Controlled attenuation parameter Transient elastography Steatosis Chronic liver disease Liver biopsy |
description |
Introduction: Controlled attenuation parameter (CAP), measured by transient elastography, has been suggested as a noninvasive method for the detection and quantification of steatosis. We aimed to assess the accuracy of CAP to detect steatosis in patients with chronic liver disease (CLD) compared with liver histology and to evaluate factors that correlate with the CAP value. Methods: Patients with CLD who underwent liver biopsy and simultaneous CAP determination were consecutively enrolled. CAP was measured using the M probe of FibroScan® (Echosens, Paris, France). Histologically, steatosis was categorized as absent (S0: <5%), mild (S1: 5-33%), moderate (S2: 34-66%) and severe (S3: >66% of all hepatocytes ). Results: We analyzed 159 patients with CLD (61% men, mean age 47.9 ± 12.9 years). We found a positive correlation between CAP and steatosis in histology (r s = 0.869, p < 0.001), arterial hypertension (r s = 0.222, p = .005), type 2 diabetes mellitus (r s = 0.279, p < 0.001), body mass index (BMI; r s = 0.533, p < 0.001), total cholesterol (r s = 0.442, p < 0.001), triglycerides (r s = 0.272, p = 0.001), and non-alcoholic fatty liver disease (NAFLD; r s = 0.588, p < 0.001). In the multivariate analysis, BMI >25 (odds ratio [OR] 48.4, 95% confidence interval [CI] 23.78-72.95, p < 0.001), serum total cholesterol (OR 3.803, 95% CI 2.203-13.889, p = 0.008), and NAFLD etiology (OR 40.8, 95% CI 15.01-66.66, p = 0.002) were independently associated with higher CAP values. We did not find any significant correlation between CAP and the grade of necroinflammatory activity (r s = 0.063, p = 0.808) or fibrosis (r s = 0.071, p = 0.713) in histology and with alanine aminotransferase (r s = 0.190, p = 0.356) or aspartate aminotransferase (r s = 0.117, p = 0.142). Optimal CAP cutoff values for detecting steatosis ≥ S1, ≥ S2, and ≥ S3 were 206.5, 232.5, and 282.5 dB/m, respectively. CAP performance was 0.822, 0.956, and 0.976 for diagnosing steatosis ≥ S1, ≥ S2, and ≥ S3, respectively. Conclusions: CAP had an excellent diagnostic accuracy for the detection of steatosis in diverse CLD patients. A CAP value cutoff of <282.5 dB/m excludes severe steatosis ≥ S3 with an accuracy of 98%. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-08-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452017000400002 |
url |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452017000400002 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452017000400002 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Gastrenterologia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Gastrenterologia |
dc.source.none.fl_str_mv |
GE-Portuguese Journal of Gastroenterology v.24 n.4 2017 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
|
_version_ |
1799137412361748480 |