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Controlled Attenuation Parameter for Noninvasive Assessment of Hepatic Steatosis Using Fibroscan®: Validation in Chronic Hepatitis B

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Abstract

Background and Aim

The controlled attenuation parameter (CAP) using transient elastography (TE) was validated in chronic hepatitis C to evaluate hepatic steatosis; however, limited data are available on chronic hepatitis B (CHB). Therefore, we assessed the accuracy and the efficacy of CAP for the detection of steatosis in CHB.

Methods

Consecutive CHB patients underwent liver biopsy and liver stiffness measurements (LSM) with simultaneous CAP determination using the M probe of the TE. The area under the receiver operating characteristics curve (AUROC) was used to evaluate the performance of CAP in diagnosing steatosis compared with biopsy.

Results

A total of 340 patients were included: 60 % were male, the median age was 37 years; the body mass index (BMI) was ≥28 kg/m2 for 14 % of the subjects; and the distribution of the steatosis grade was S0 58.2 %, S1 34.2 %, S2 5.0 % and S3 2.6 %. The median (range) of CAP was 218 (100–400) dB/m, and CAP correlated with the BMI (ρ = 3.622) and steatosis grade (ρ = 29.203) according to a multivariate analysis (both P < 0.001). CAP could detect the different grades of steatosis: ≥S1 with AUROC of 0.81 at a cutoff of 224 dB/m, ≥S2 with AUROC of 0.90 at a cutoff of 236 dB/m and ≥S3 with AUROC of 0.97 at a cutoff of 285 dB/m. Furthermore, the LSM and fibrosis and activity grades on biopsy did not influence the CAP performance.

Conclusions

CAP presented excellent diagnostic performance for severe steatosis with high sensitivity and specificity in Chinese patients with CHB.

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Acknowledgments

We wish to thank all the patients and medical staff who participated in the study. This work was financially supported by the State Key Development Program for Basic Research of China (2012CB517501), the Chinese Foundation for Hepatitis Prevention and Control—“Wang Bao-en liver fibrosis research fund (XJS20120501)” and the Science and Technology Foundation of Tianjin Municipal Health Bureau (12KG119).

Conflict of interest

None.

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Authors and Affiliations

  1. Department II of Chinese Integrative Medicine, Tianjin Second People’s Hospital, Tianjin Medical University, Tianjin, China

    Yu-Qiang Mi, Liang Xu, Ping Li & Wei Lu

  2. Tianjin Second People’s Hospital, School of Graduate, Tianjin Medical University, Tianjin, China

    Qi-Yu Shi

  3. Department of Pathology, Tianjin Second People’s Hospital, Tianjin Medical University, Tianjin, China

    Rui-Fang Shi & Yong-Gang Liu

  4. Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Feng Shen & Jian-Gao Fan

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  1. Yu-Qiang Mi
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Correspondence to Wei Lu or Jian-Gao Fan.

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Mi, YQ., Shi, QY., Xu, L. et al. Controlled Attenuation Parameter for Noninvasive Assessment of Hepatic Steatosis Using Fibroscan®: Validation in Chronic Hepatitis B. Dig Dis Sci 60, 243–251 (2015). https://doi.org/10.1007/s10620-014-3341-x

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