Korean J Hepatol > Volume 15(4); 2009 > Article
The Korean Journal of Hepatology 2009;15(4): 464-473.
doi: https://doi.org/10.3350/kjhep.2009.15.4.464
Factors associated with Liver stiffness in chronic Liver disease
Da Mi Lee, M.D., Eun Joon Moon, M.D., Joo An Hwang, M.D., Min Suk Lee, M.D., Jae Youn Cheong, M.D., Sung Won Cho, M.D., Yeong Bae Kim, M.D.1, Dong Joon Kim, M.D.2, Seong Gyu Hwang, M.D.3, Jin Mo Yang, M.D.4
Department of Gastroenterology and 1Pathology, Ajou University School of Medicine, Suwon; Department of Internal Medicine, 2Hallym University College of Medicine, Chuncheon; 3Pochon CHA University College of Medicine, Seongnam, Korea; 4St. Vincent Hospital, The Catholic University College of Medicine, Suwon, Korea
ABSTRACT
Background/Aims
Transient elastography is a new noninvasive tool for measuring liver stiffness that accurately predicts significant fibrosis and cirrhosis. However, several studies have indicated that liver stiffness can be significantly influenced by major changes in aminotransferase in patients with chronic viral hepatitis. The aim of this study was to determine the factors influencing liver stiffness in patients with chronic liver disease. Methods: We studied 158 patients with chronic liver disease who underwent transient elastography and liver biopsy sampling. Histologic findings on fibrosis and necroinflammatory activity in the biopsy specimens were evaluated according to the Korean Society of Pathologists Scoring System. Routine biochemical tests were performed according to standard methods. Results: Liver stiffness was strongly correlated with liver fibrosis stage (Spearman coefficient=0.636, P<0.001), lobular activity (Spearman coefficient=0.359, P<0.001), and portoperiportal activity grade (Spearman coefficient=0.448, P<0.001). Liver stiffness was significantly associated with serum levels of total bilirubin (P=0.025), direct bilirubin (P=0.049), gamma-glutamyl transpeptidase (P=0.014), platelet count (P=0.004), albumin (P<0.001), and international normalized ratio (P<0.001). Multivariate analysis showed that fibrosis stage (B 3.50, P=0.009) and lobular activity grade (B 3.25, P=0.047) were independently associated with liver stiffness. Conclusions: Liver stiffness as measured by transient elastography is associated with the grade of necroinflammatory activity and the stage of fibrosis, irrespective of serum ALT levels. (Korean J Hepatol 2009;15:464-473)
KeyWords: Liver stiffness; Fibrosis stage; Necroinflammatory activity; Biochemical test, Viral hepatitis

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