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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
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TitleMild-to-moderate elevation of alanine aminotransferase increases liver stiffness measurement by transient elastography in patients with chronic hepatitis B
 
AuthorsFung, J1
Lai, CL1
Cheng, C1
Wu, R1
Wong, DKH1
Yuen, MF1
 
Issue Date2011
 
PublisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ajg/index.html
 
CitationAmerican Journal Of Gastroenterology, 2011, v. 106 n. 3, p. 492-496 [How to Cite?]
DOI: http://dx.doi.org/10.1038/ajg.2010.463
 
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.
 
ISSN0002-9270
2013 Impact Factor: 9.213
 
DOIhttp://dx.doi.org/10.1038/ajg.2010.463
 
ISI Accession Number IDWOS:000288064200016
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorFung, J
 
dc.contributor.authorLai, CL
 
dc.contributor.authorCheng, C
 
dc.contributor.authorWu, R
 
dc.contributor.authorWong, DKH
 
dc.contributor.authorYuen, MF
 
dc.date.accessioned2011-08-26T14:24:13Z
 
dc.date.available2011-08-26T14:24:13Z
 
dc.date.issued2011
 
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.
 
dc.description.naturelink_to_subscribed_fulltext
 
dc.identifier.citationAmerican Journal Of Gastroenterology, 2011, v. 106 n. 3, p. 492-496 [How to Cite?]
DOI: http://dx.doi.org/10.1038/ajg.2010.463
 
dc.identifier.doihttp://dx.doi.org/10.1038/ajg.2010.463
 
dc.identifier.epage496
 
dc.identifier.hkuros189860
 
dc.identifier.isiWOS:000288064200016
 
dc.identifier.issn0002-9270
2013 Impact Factor: 9.213
 
dc.identifier.issue3
 
dc.identifier.pmid21157442
 
dc.identifier.scopuseid_2-s2.0-79952363500
 
dc.identifier.spage492
 
dc.identifier.urihttp://hdl.handle.net/10722/137386
 
dc.identifier.volume106
 
dc.languageeng
 
dc.publisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ajg/index.html
 
dc.publisher.placeUnited States
 
dc.relation.ispartofAmerican Journal of Gastroenterology
 
dc.relation.referencesReferences in Scopus
 
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 B
 
dc.typeArticle
 
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<contributor.author>Lai, CL</contributor.author>
<contributor.author>Cheng, C</contributor.author>
<contributor.author>Wu, R</contributor.author>
<contributor.author>Wong, DKH</contributor.author>
<contributor.author>Yuen, MF</contributor.author>
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<description.abstract>Objectives: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 &#215; 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. &#169; 2011 by the American College of Gastroenterology.</description.abstract>
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Author Affiliations
  1. The University of Hong Kong