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
2011 Impact Factor: 7.282
2011 SCImago Journal Rankings: 0.573
DOIhttp://dx.doi.org/10.1038/ajg.2010.463
ISI Accession Number IDWOS:000288064200016
ReferencesReferences in Scopus
DC Field
Value
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
2011 Impact Factor: 7.282
2011 SCImago Journal Rankings: 0.573
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
Author Affiliations
  1. The University of Hong Kong