Effect of liver steatosis on liver stiffness measurement in chronic hepatitis B patients with normal serum alanine aminotransferase levels: A multicentre cohort study
Liver steatosis is becoming increasingly common in patients with chronic hepatitis B (CHB), and its effect on liver stiffness measurement (LSM), as assessed by transient elastography, remains controversial. Seven hundred and fifty‐five patients with CHB and normal serum alanine aminotransferase leve...
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| Veröffentlicht in: | Journal of viral hepatitis 2022-03, Vol.29 (3), p.196-204 |
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| creator | Wang, Xiao‐Dong Pan, Chen‐Wei Zhou, Guang‐Yao Gao, Feng Wang, Feng‐Ling Fu, Rong‐Quan Xiao, Er‐Hui Li, Peng Zhang, Huai Zheng, Ming‐Hua |
| description | Liver steatosis is becoming increasingly common in patients with chronic hepatitis B (CHB), and its effect on liver stiffness measurement (LSM), as assessed by transient elastography, remains controversial. Seven hundred and fifty‐five patients with CHB and normal serum alanine aminotransferase levels, who underwent vibration‐controlled transient elastography and liver biopsy, were included in the study. We examined whether the histological degree of liver steatosis affects the accuracy of transient elastography‐assessed LSM in these patients. Among the 755 CHB patients included in the study, 286 (37.9%) had liver steatosis, of whom 156 had grade S1, 74 had grade S2, and 56 had grade S3 on histology. Presence of liver steatosis was independently associated with greater body mass index (BMI, adjusted‐odds ratio [OR] = 5.786, 95% CI: 3.998–8.373, p = 0.018), and higher serum total cholesterol (adjusted‐OR = 7.944, 95% CI: 4.731–13.339, p |
| doi_str_mv | 10.1111/jvh.13640 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2610074278</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2630567119</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3530-8c98c204b37d0669a5ee6c1327e69c1c5f1495f452ea92aa716c187397b877fd3</originalsourceid><addsrcrecordid>eNp1kc9uFDEMxkcIREvhwAugSFzgMG3-TCYTbm1VKKgSF-A6ymYdTVaTZIkzW-0L8Zxk2dIDEr7Yin_-YutrmteMnrMaF5vddM5E39EnzWnNsuWDFk8PteQtlbQ7aV4gbihlgkv2vDkRnaacs_60-XXjHNhCkiOz30EmWMCUhB5Jio9P3rkIiCSAwSVDgFiIj8ROOUVvyQRbU3ypM1fkUNU2kntfJhJTDmYmCHkJxMwm-gjEBB9TySaig2wQyAw7mPEDuSRhmYu3dT4DsWlKudTfl_X-ZfPMmRnh1UM-a75_vPl2fdveff30-fryrrVCCtoOVg-W024l1Jr2vTYSoLf1agW9tsxKxzotXSc5GM2NUax2ByW0Wg1KubU4a94ddbc5_VwAyxg8Wpjr5pAWHHnPKFUdV0NF3_6DbtKSY92uUoLKXjGmK_X-SNmcEDO4cZt9MHk_MjoezBureeMf8yr75kFxWQVYP5J_3arAxRG49zPs_680fvlxe5T8DbjTpmY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2630567119</pqid></control><display><type>article</type><title>Effect of liver steatosis on liver stiffness measurement in chronic hepatitis B patients with normal serum alanine aminotransferase levels: A multicentre cohort study</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Wang, Xiao‐Dong ; Pan, Chen‐Wei ; Zhou, Guang‐Yao ; Gao, Feng ; Wang, Feng‐Ling ; Fu, Rong‐Quan ; Xiao, Er‐Hui ; Li, Peng ; Zhang, Huai ; Zheng, Ming‐Hua</creator><creatorcontrib>Wang, Xiao‐Dong ; Pan, Chen‐Wei ; Zhou, Guang‐Yao ; Gao, Feng ; Wang, Feng‐Ling ; Fu, Rong‐Quan ; Xiao, Er‐Hui ; Li, Peng ; Zhang, Huai ; Zheng, Ming‐Hua</creatorcontrib><description>Liver steatosis is becoming increasingly common in patients with chronic hepatitis B (CHB), and its effect on liver stiffness measurement (LSM), as assessed by transient elastography, remains controversial. Seven hundred and fifty‐five patients with CHB and normal serum alanine aminotransferase levels, who underwent vibration‐controlled transient elastography and liver biopsy, were included in the study. We examined whether the histological degree of liver steatosis affects the accuracy of transient elastography‐assessed LSM in these patients. Among the 755 CHB patients included in the study, 286 (37.9%) had liver steatosis, of whom 156 had grade S1, 74 had grade S2, and 56 had grade S3 on histology. Presence of liver steatosis was independently associated with greater body mass index (BMI, adjusted‐odds ratio [OR] = 5.786, 95% CI: 3.998–8.373, p = 0.018), and higher serum total cholesterol (adjusted‐OR = 7.944, 95% CI: 4.731–13.339, p < 0.001) and triglyceride levels (adjusted‐OR = 2.777, 95% CI: 2.050–3.761, p < 0.001). There was no significant association between liver steatosis and fibrosis stage (OR = 1.016, 95% CI: 0.905–1.140, p = 0.790). Age (B‐coefficient = 0.020, 95% CI: 0.001–0.040, p = 0.044), BMI (B‐coefficient = 0.060, 95% CI: 0.011–0.127, p = 0.019), serum gamma‐glutamyl‐transpeptidase (GGT, B‐coefficient = 0.015, 95% CI: 0.001–0.029, p = 0.032), positivity for HBeAg (B‐coefficient = −0.816, 95% CI: −1.568 to −0.064, p = 0.034), as well as liver fibrosis stage (B‐coefficient = 2.796, 95% CI: 2.501–3.090, p < 0.001), and inflammation activity grade (B‐coefficient = 0.648, 95% CI: 0.162–1.135, p = 0.009) were all independently associated with higher LSM, while no significant association was found between degree of liver steatosis and LSM. Among patients with the same histological fibrosis stage, LSM values did not show any significant difference among patients with absent, mild, moderate or severe steatosis. We conclude that liver steatosis has no significant effect on transient elastography‐measured LSM in CHB patients with normal serum alanine aminotransferase levels.</description><identifier>ISSN: 1352-0504</identifier><identifier>EISSN: 1365-2893</identifier><identifier>DOI: 10.1111/jvh.13640</identifier><identifier>PMID: 34902216</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Alanine ; alanine aminotransferase ; Alanine Transaminase ; Biopsy ; Body mass index ; Cholesterol ; chronic hepatitis B ; Cohort analysis ; Cohort Studies ; Elasticity Imaging Techniques ; Fatty liver ; Fatty Liver - pathology ; Fibrosis ; Hepatitis ; Hepatitis B ; Hepatitis B e antigen ; Hepatitis B, Chronic - complications ; Hepatitis B, Chronic - pathology ; Humans ; Interferon ; Liver ; Liver - diagnostic imaging ; Liver - pathology ; Liver Cirrhosis - complications ; liver fibrosis ; liver steatosis ; liver stiffness measurement ; Steatosis</subject><ispartof>Journal of viral hepatitis, 2022-03, Vol.29 (3), p.196-204</ispartof><rights>2021 John Wiley & Sons Ltd.</rights><rights>Copyright © 2022 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3530-8c98c204b37d0669a5ee6c1327e69c1c5f1495f452ea92aa716c187397b877fd3</citedby><cites>FETCH-LOGICAL-c3530-8c98c204b37d0669a5ee6c1327e69c1c5f1495f452ea92aa716c187397b877fd3</cites><orcidid>0000-0003-4984-2631</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjvh.13640$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjvh.13640$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34902216$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Xiao‐Dong</creatorcontrib><creatorcontrib>Pan, Chen‐Wei</creatorcontrib><creatorcontrib>Zhou, Guang‐Yao</creatorcontrib><creatorcontrib>Gao, Feng</creatorcontrib><creatorcontrib>Wang, Feng‐Ling</creatorcontrib><creatorcontrib>Fu, Rong‐Quan</creatorcontrib><creatorcontrib>Xiao, Er‐Hui</creatorcontrib><creatorcontrib>Li, Peng</creatorcontrib><creatorcontrib>Zhang, Huai</creatorcontrib><creatorcontrib>Zheng, Ming‐Hua</creatorcontrib><title>Effect of liver steatosis on liver stiffness measurement in chronic hepatitis B patients with normal serum alanine aminotransferase levels: A multicentre cohort study</title><title>Journal of viral hepatitis</title><addtitle>J Viral Hepat</addtitle><description>Liver steatosis is becoming increasingly common in patients with chronic hepatitis B (CHB), and its effect on liver stiffness measurement (LSM), as assessed by transient elastography, remains controversial. Seven hundred and fifty‐five patients with CHB and normal serum alanine aminotransferase levels, who underwent vibration‐controlled transient elastography and liver biopsy, were included in the study. We examined whether the histological degree of liver steatosis affects the accuracy of transient elastography‐assessed LSM in these patients. Among the 755 CHB patients included in the study, 286 (37.9%) had liver steatosis, of whom 156 had grade S1, 74 had grade S2, and 56 had grade S3 on histology. Presence of liver steatosis was independently associated with greater body mass index (BMI, adjusted‐odds ratio [OR] = 5.786, 95% CI: 3.998–8.373, p = 0.018), and higher serum total cholesterol (adjusted‐OR = 7.944, 95% CI: 4.731–13.339, p < 0.001) and triglyceride levels (adjusted‐OR = 2.777, 95% CI: 2.050–3.761, p < 0.001). There was no significant association between liver steatosis and fibrosis stage (OR = 1.016, 95% CI: 0.905–1.140, p = 0.790). Age (B‐coefficient = 0.020, 95% CI: 0.001–0.040, p = 0.044), BMI (B‐coefficient = 0.060, 95% CI: 0.011–0.127, p = 0.019), serum gamma‐glutamyl‐transpeptidase (GGT, B‐coefficient = 0.015, 95% CI: 0.001–0.029, p = 0.032), positivity for HBeAg (B‐coefficient = −0.816, 95% CI: −1.568 to −0.064, p = 0.034), as well as liver fibrosis stage (B‐coefficient = 2.796, 95% CI: 2.501–3.090, p < 0.001), and inflammation activity grade (B‐coefficient = 0.648, 95% CI: 0.162–1.135, p = 0.009) were all independently associated with higher LSM, while no significant association was found between degree of liver steatosis and LSM. Among patients with the same histological fibrosis stage, LSM values did not show any significant difference among patients with absent, mild, moderate or severe steatosis. We conclude that liver steatosis has no significant effect on transient elastography‐measured LSM in CHB patients with normal serum alanine aminotransferase levels.</description><subject>Alanine</subject><subject>alanine aminotransferase</subject><subject>Alanine Transaminase</subject><subject>Biopsy</subject><subject>Body mass index</subject><subject>Cholesterol</subject><subject>chronic hepatitis B</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Elasticity Imaging Techniques</subject><subject>Fatty liver</subject><subject>Fatty Liver - pathology</subject><subject>Fibrosis</subject><subject>Hepatitis</subject><subject>Hepatitis B</subject><subject>Hepatitis B e antigen</subject><subject>Hepatitis B, Chronic - complications</subject><subject>Hepatitis B, Chronic - pathology</subject><subject>Humans</subject><subject>Interferon</subject><subject>Liver</subject><subject>Liver - diagnostic imaging</subject><subject>Liver - pathology</subject><subject>Liver Cirrhosis - complications</subject><subject>liver fibrosis</subject><subject>liver steatosis</subject><subject>liver stiffness measurement</subject><subject>Steatosis</subject><issn>1352-0504</issn><issn>1365-2893</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc9uFDEMxkcIREvhwAugSFzgMG3-TCYTbm1VKKgSF-A6ymYdTVaTZIkzW-0L8Zxk2dIDEr7Yin_-YutrmteMnrMaF5vddM5E39EnzWnNsuWDFk8PteQtlbQ7aV4gbihlgkv2vDkRnaacs_60-XXjHNhCkiOz30EmWMCUhB5Jio9P3rkIiCSAwSVDgFiIj8ROOUVvyQRbU3ypM1fkUNU2kntfJhJTDmYmCHkJxMwm-gjEBB9TySaig2wQyAw7mPEDuSRhmYu3dT4DsWlKudTfl_X-ZfPMmRnh1UM-a75_vPl2fdveff30-fryrrVCCtoOVg-W024l1Jr2vTYSoLf1agW9tsxKxzotXSc5GM2NUax2ByW0Wg1KubU4a94ddbc5_VwAyxg8Wpjr5pAWHHnPKFUdV0NF3_6DbtKSY92uUoLKXjGmK_X-SNmcEDO4cZt9MHk_MjoezBureeMf8yr75kFxWQVYP5J_3arAxRG49zPs_680fvlxe5T8DbjTpmY</recordid><startdate>202203</startdate><enddate>202203</enddate><creator>Wang, Xiao‐Dong</creator><creator>Pan, Chen‐Wei</creator><creator>Zhou, Guang‐Yao</creator><creator>Gao, Feng</creator><creator>Wang, Feng‐Ling</creator><creator>Fu, Rong‐Quan</creator><creator>Xiao, Er‐Hui</creator><creator>Li, Peng</creator><creator>Zhang, Huai</creator><creator>Zheng, Ming‐Hua</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4984-2631</orcidid></search><sort><creationdate>202203</creationdate><title>Effect of liver steatosis on liver stiffness measurement in chronic hepatitis B patients with normal serum alanine aminotransferase levels: A multicentre cohort study</title><author>Wang, Xiao‐Dong ; Pan, Chen‐Wei ; Zhou, Guang‐Yao ; Gao, Feng ; Wang, Feng‐Ling ; Fu, Rong‐Quan ; Xiao, Er‐Hui ; Li, Peng ; Zhang, Huai ; Zheng, Ming‐Hua</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3530-8c98c204b37d0669a5ee6c1327e69c1c5f1495f452ea92aa716c187397b877fd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Alanine</topic><topic>alanine aminotransferase</topic><topic>Alanine Transaminase</topic><topic>Biopsy</topic><topic>Body mass index</topic><topic>Cholesterol</topic><topic>chronic hepatitis B</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Elasticity Imaging Techniques</topic><topic>Fatty liver</topic><topic>Fatty Liver - pathology</topic><topic>Fibrosis</topic><topic>Hepatitis</topic><topic>Hepatitis B</topic><topic>Hepatitis B e antigen</topic><topic>Hepatitis B, Chronic - complications</topic><topic>Hepatitis B, Chronic - pathology</topic><topic>Humans</topic><topic>Interferon</topic><topic>Liver</topic><topic>Liver - diagnostic imaging</topic><topic>Liver - pathology</topic><topic>Liver Cirrhosis - complications</topic><topic>liver fibrosis</topic><topic>liver steatosis</topic><topic>liver stiffness measurement</topic><topic>Steatosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Xiao‐Dong</creatorcontrib><creatorcontrib>Pan, Chen‐Wei</creatorcontrib><creatorcontrib>Zhou, Guang‐Yao</creatorcontrib><creatorcontrib>Gao, Feng</creatorcontrib><creatorcontrib>Wang, Feng‐Ling</creatorcontrib><creatorcontrib>Fu, Rong‐Quan</creatorcontrib><creatorcontrib>Xiao, Er‐Hui</creatorcontrib><creatorcontrib>Li, Peng</creatorcontrib><creatorcontrib>Zhang, Huai</creatorcontrib><creatorcontrib>Zheng, Ming‐Hua</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of viral hepatitis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Xiao‐Dong</au><au>Pan, Chen‐Wei</au><au>Zhou, Guang‐Yao</au><au>Gao, Feng</au><au>Wang, Feng‐Ling</au><au>Fu, Rong‐Quan</au><au>Xiao, Er‐Hui</au><au>Li, Peng</au><au>Zhang, Huai</au><au>Zheng, Ming‐Hua</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of liver steatosis on liver stiffness measurement in chronic hepatitis B patients with normal serum alanine aminotransferase levels: A multicentre cohort study</atitle><jtitle>Journal of viral hepatitis</jtitle><addtitle>J Viral Hepat</addtitle><date>2022-03</date><risdate>2022</risdate><volume>29</volume><issue>3</issue><spage>196</spage><epage>204</epage><pages>196-204</pages><issn>1352-0504</issn><eissn>1365-2893</eissn><abstract>Liver steatosis is becoming increasingly common in patients with chronic hepatitis B (CHB), and its effect on liver stiffness measurement (LSM), as assessed by transient elastography, remains controversial. Seven hundred and fifty‐five patients with CHB and normal serum alanine aminotransferase levels, who underwent vibration‐controlled transient elastography and liver biopsy, were included in the study. We examined whether the histological degree of liver steatosis affects the accuracy of transient elastography‐assessed LSM in these patients. Among the 755 CHB patients included in the study, 286 (37.9%) had liver steatosis, of whom 156 had grade S1, 74 had grade S2, and 56 had grade S3 on histology. Presence of liver steatosis was independently associated with greater body mass index (BMI, adjusted‐odds ratio [OR] = 5.786, 95% CI: 3.998–8.373, p = 0.018), and higher serum total cholesterol (adjusted‐OR = 7.944, 95% CI: 4.731–13.339, p < 0.001) and triglyceride levels (adjusted‐OR = 2.777, 95% CI: 2.050–3.761, p < 0.001). There was no significant association between liver steatosis and fibrosis stage (OR = 1.016, 95% CI: 0.905–1.140, p = 0.790). Age (B‐coefficient = 0.020, 95% CI: 0.001–0.040, p = 0.044), BMI (B‐coefficient = 0.060, 95% CI: 0.011–0.127, p = 0.019), serum gamma‐glutamyl‐transpeptidase (GGT, B‐coefficient = 0.015, 95% CI: 0.001–0.029, p = 0.032), positivity for HBeAg (B‐coefficient = −0.816, 95% CI: −1.568 to −0.064, p = 0.034), as well as liver fibrosis stage (B‐coefficient = 2.796, 95% CI: 2.501–3.090, p < 0.001), and inflammation activity grade (B‐coefficient = 0.648, 95% CI: 0.162–1.135, p = 0.009) were all independently associated with higher LSM, while no significant association was found between degree of liver steatosis and LSM. Among patients with the same histological fibrosis stage, LSM values did not show any significant difference among patients with absent, mild, moderate or severe steatosis. We conclude that liver steatosis has no significant effect on transient elastography‐measured LSM in CHB patients with normal serum alanine aminotransferase levels.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>34902216</pmid><doi>10.1111/jvh.13640</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-4984-2631</orcidid></addata></record> |
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| subjects | Alanine alanine aminotransferase Alanine Transaminase Biopsy Body mass index Cholesterol chronic hepatitis B Cohort analysis Cohort Studies Elasticity Imaging Techniques Fatty liver Fatty Liver - pathology Fibrosis Hepatitis Hepatitis B Hepatitis B e antigen Hepatitis B, Chronic - complications Hepatitis B, Chronic - pathology Humans Interferon Liver Liver - diagnostic imaging Liver - pathology Liver Cirrhosis - complications liver fibrosis liver steatosis liver stiffness measurement Steatosis |
| title | Effect of liver steatosis on liver stiffness measurement in chronic hepatitis B patients with normal serum alanine aminotransferase levels: A multicentre cohort study |
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