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Article: Mild-to-moderate elevation of alanine aminotransferase increases liver stiffness measurement by transient elastography in patients with chronic hepatitis B

TitleMild-to-moderate elevation of alanine aminotransferase increases liver stiffness measurement by transient elastography in patients with chronic hepatitis B
Authors
Issue Date2011
PublisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ajg/index.html
Citation
American Journal Of Gastroenterology, 2011, v. 106 n. 3, p. 492-496 How to Cite?
AbstractObjectives:Liver stiffness measurement has been shown to be increased in severe acute flares of hepatitis. Whether lesser degree of hepatitis can also increase liver stiffness is not known. The present study aimed to investigate the effect of mild-to-moderate elevations of alanine aminotransferase (ALT) on liver stiffness in chronic hepatitis B.Methods:Fifty-eight patients with chronic hepatitis B with ALT levels from 1 to 10 × upper limit of normal were recruited. Liver stiffness measurements were performed at the time of ALT elevation, and liver stiffness measurement was repeated once normalization of ALT occurred after antiviral therapy. Liver biopsies were performed in 38 patients.Results:All 58 patients achieved normalization of ALT after antiviral therapy, with a median time of 3 months between the first and second liver stiffness measurement. There was a significantly lower median liver stiffness measurement after commencement of antiviral therapy, with the normalization of ALT levels compared with pre-treatment levels (6.4 vs. 7.9 kPa, respectively; P0.001). The area under the receiver operator characteristic curve for diagnosing F2 fibrosis in elevated ALT was 0.68, compared with 0.73 after ALT normalization. Twelve (32%) patients would have been misclassified as having cirrhosis using liver stiffness measurements taken at the time of ALT elevation, compared with 16% after normalization of ALT.Conclusions:Even mild-to-moderate elevation in ALT levels may increase liver stiffness independent of underlying liver fibrosis. Higher levels of ALT were associated with higher discrepancies in liver stiffness. Therefore, the timing of liver stiffness measurement is important. © 2011 by the American College of Gastroenterology.
Persistent Identifierhttp://hdl.handle.net/10722/137386
ISSN
2014 Impact Factor: 10.755
2014 SCImago Journal Rankings: 3.376
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorFung, Jen_HK
dc.contributor.authorLai, CLen_HK
dc.contributor.authorCheng, Cen_HK
dc.contributor.authorWu, Ren_HK
dc.contributor.authorWong, DKHen_HK
dc.contributor.authorYuen, MFen_HK
dc.date.accessioned2011-08-26T14:24:13Z-
dc.date.available2011-08-26T14:24:13Z-
dc.date.issued2011en_HK
dc.identifier.citationAmerican Journal Of Gastroenterology, 2011, v. 106 n. 3, p. 492-496en_HK
dc.identifier.issn0002-9270en_HK
dc.identifier.urihttp://hdl.handle.net/10722/137386-
dc.description.abstractObjectives:Liver stiffness measurement has been shown to be increased in severe acute flares of hepatitis. Whether lesser degree of hepatitis can also increase liver stiffness is not known. The present study aimed to investigate the effect of mild-to-moderate elevations of alanine aminotransferase (ALT) on liver stiffness in chronic hepatitis B.Methods:Fifty-eight patients with chronic hepatitis B with ALT levels from 1 to 10 × upper limit of normal were recruited. Liver stiffness measurements were performed at the time of ALT elevation, and liver stiffness measurement was repeated once normalization of ALT occurred after antiviral therapy. Liver biopsies were performed in 38 patients.Results:All 58 patients achieved normalization of ALT after antiviral therapy, with a median time of 3 months between the first and second liver stiffness measurement. There was a significantly lower median liver stiffness measurement after commencement of antiviral therapy, with the normalization of ALT levels compared with pre-treatment levels (6.4 vs. 7.9 kPa, respectively; P0.001). The area under the receiver operator characteristic curve for diagnosing F2 fibrosis in elevated ALT was 0.68, compared with 0.73 after ALT normalization. Twelve (32%) patients would have been misclassified as having cirrhosis using liver stiffness measurements taken at the time of ALT elevation, compared with 16% after normalization of ALT.Conclusions:Even mild-to-moderate elevation in ALT levels may increase liver stiffness independent of underlying liver fibrosis. Higher levels of ALT were associated with higher discrepancies in liver stiffness. Therefore, the timing of liver stiffness measurement is important. © 2011 by the American College of Gastroenterology.en_HK
dc.languageengen_US
dc.publisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ajg/index.htmlen_HK
dc.relation.ispartofAmerican Journal of Gastroenterologyen_HK
dc.subject.meshAlanine Transaminase - blood-
dc.subject.meshElasticity-
dc.subject.meshElasticity Imaging Techniques - methods-
dc.subject.meshHepatitis B, Chronic - enzymology - pathology-
dc.subject.meshLiver - pathology-
dc.titleMild-to-moderate elevation of alanine aminotransferase increases liver stiffness measurement by transient elastography in patients with chronic hepatitis Ben_HK
dc.typeArticleen_HK
dc.identifier.emailFung, J:jfung@sicklehut.comen_HK
dc.identifier.emailLai, CL:hrmelcl@hku.hken_HK
dc.identifier.emailWong, DKH:danywong@hku.hken_HK
dc.identifier.emailYuen, MF:mfyuen@hkucc.hku.hken_HK
dc.identifier.authorityFung, J=rp00518en_HK
dc.identifier.authorityLai, CL=rp00314en_HK
dc.identifier.authorityWong, DKH=rp00492en_HK
dc.identifier.authorityYuen, MF=rp00479en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1038/ajg.2010.463en_HK
dc.identifier.pmid21157442-
dc.identifier.scopuseid_2-s2.0-79952363500en_HK
dc.identifier.hkuros189860en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79952363500&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume106en_HK
dc.identifier.issue3en_HK
dc.identifier.spage492en_HK
dc.identifier.epage496en_HK
dc.identifier.isiWOS:000288064200016-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridFung, J=23091109300en_HK
dc.identifier.scopusauthoridLai, CL=7403086396en_HK
dc.identifier.scopusauthoridCheng, C=24802108600en_HK
dc.identifier.scopusauthoridWu, R=37666418000en_HK
dc.identifier.scopusauthoridWong, DKH=7401535819en_HK
dc.identifier.scopusauthoridYuen, MF=7102031955en_HK

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