Roulot Dominique, Czernichow Sébastien, Le Clésiau Hervé, Costes Jean-Luc, Vergnaud Anne-Claire, Beaugrand Michel
Unité d'Hépatologie, Hopital Avicenne, Assistance Publique, Hôpitaux de Paris, Bobigny, France.
J Hepatol. 2008 Apr;48(4):606-13. doi: 10.1016/j.jhep.2007.11.020. Epub 2008 Jan 3.
BACKGROUND/AIMS: Liver stiffness measurement by transient elastography is a very promising non-invasive method for the diagnosis of fibrosis in chronic liver diseases. However, studies on normal values of liver stiffness in healthy subjects are still lacking. The aim of the present study was to prospectively assess liver stiffness values in the general population and to determine potential factors, which may influence these values.
Liver stiffness measurements were performed in 429 consecutive apparently healthy subjects, without overt cause of liver disease and normal liver enzymes, undergoing a free medical check-up.
Mean liver stiffness value was 5.49+/-1.59 kPa. Transient elastography failure was observed in 4.6% of the cases. The failure rate increased with BMI, reaching 88% for values above 40 kg/m2. Liver stiffness values were higher in men than in women (5.81+/-1.54 vs 5.23+/-1.59 kPa, p=0.0002) and in subjects with BMI>30 kg/m2 (6.26+/-1.89 vs 5.37+/-1.51 kPa, p=0.0003). Metabolic syndrome was diagnosed in 59 (13.7%) subjects. After adjustment for gender and BMI, liver stiffness values were higher in subjects with metabolic syndrome than in those without (6.51+/-1.64 vs 5.33+/-1.51 kPa, p<0.0001).
Liver stiffness values in the general population are influenced independently by gender, BMI and metabolic syndrome.
背景/目的:通过瞬时弹性成像测量肝脏硬度是诊断慢性肝病纤维化的一种非常有前景的非侵入性方法。然而,关于健康受试者肝脏硬度正常值的研究仍然缺乏。本研究的目的是前瞻性评估普通人群的肝脏硬度值,并确定可能影响这些值的潜在因素。
对429名连续的看似健康的受试者进行肝脏硬度测量,这些受试者没有明显的肝病病因且肝酶正常,正在接受免费体检。
平均肝脏硬度值为5.49±1.59 kPa。4.6%的病例观察到瞬时弹性成像失败。失败率随体重指数增加而升高,体重指数高于40 kg/m²时达到88%。男性的肝脏硬度值高于女性(5.81±1.54对5.23±1.59 kPa,p = 0.0002),体重指数>30 kg/m²的受试者也是如此(6.26±1.89对5.37±1.51 kPa,p = 0.0003)。59名(13.7%)受试者被诊断为代谢综合征。在对性别和体重指数进行调整后,患有代谢综合征的受试者的肝脏硬度值高于未患代谢综合征的受试者(6.51±1.64对5.33±1.51 kPa,p<0.0001)。
普通人群的肝脏硬度值独立受到性别、体重指数和代谢综合征的影响。