Sun Linlin, Li Nan, Zhang Ligang, Chen Jingxu
Department of Ultrasound, Peking University Huilonguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, People's Republic of China.
Department of Psychiatry, Peking University Huilonguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, People's Republic of China.
Neuropsychiatr Dis Treat. 2023 Jun 30;19:1491-1502. doi: 10.2147/NDT.S409210. eCollection 2023.
To evaluate the role of elastography point quantification (ElastPQ) for the quantitative assessment of stiffness in the fatty liver disease in mental disorder patients and to provide a noninvasive detection method for non-alcoholic fatty liver (NAFLD) caused by atypical antipsychotics drugs (AAPDs).
A total number of 168 mental disorder patients treated with AAPDs and 58 healthy volunteers were enrolled in this study. All the subjects underwent ultrasound and ElastPQ tests. The basic data of the patients were analyzed.
BMI, liver function, and the value of ElastPQ were considerably higher in the patient group than that in the healthy volunteers. The values of liver stiffness obtained by ElastPQ were increased gradually from 3.48(3.14-3.81) kPa in the normal liver to 8.15(6.44-9.88) in the severe fatty liver. The receiver operating characteristic (ROC) for the diagnosis of fatty liver with ElastPQ were 0.85, 0.79, 0.80, and 0.87 for the diagnosis of normal, mild, moderate, and severe steatosis, respectively, with a sensitive/specificity of 79%/76.4%, 85.7%/78.3%, 86.2%/73%, and 81.3%/82.1%, correspondingly. Moreover, ElastPQ in the olanzapine group was higher than those in the risperidone and aripiprazole groups (5.11(3.83-5.61) kPa vs 4.35(3.63-4.98) kPa, P < 0.05; 5.11(3.83-5.61) kPa vs 4.79(4.18-5.24) kPa, P < 0.05). After one-year treatment, the value of ElastPQ was 4.43(3.85-5.22) kPa, but it was 5.81(5.09-7.33) kPa in patients treated for more than three years. This value increased with treatment prolongation (P < 0.05).
ElastPQ is a real-time, quantitative method for assessing the stiffness of NAFLD. The liver stiffness value could be varied in the different stages of fatty liver. Olanzapine has a considerable influence on liver stiffness. The long-term use of AAPDs can increase the stiffness value of fatty liver.
评估弹性成像点量化（ElastPQ）在精神障碍患者脂肪肝疾病硬度定量评估中的作用，并为非典型抗精神病药物（AAPDs）所致非酒精性脂肪肝（NAFLD）提供一种无创检测方法。
本研究纳入了168例接受AAPDs治疗的精神障碍患者和58名健康志愿者。所有受试者均接受了超声和ElastPQ检测。对患者的基本数据进行了分析。
患者组的体重指数（BMI）、肝功能和ElastPQ值均显著高于健康志愿者。ElastPQ获得的肝脏硬度值从正常肝脏的3.48（3.14 - 3.81）kPa逐渐增加到重度脂肪肝的8.15（6.44 - 9.88）kPa。ElastPQ诊断脂肪肝的受试者工作特征曲线（ROC）在诊断正常、轻度、中度和重度脂肪变性时分别为0.85、0.79、0.80和0.87，相应的敏感度/特异度分别为79%/76.4%、85.7%/78.3%、86.2%/73%和81.3%/82.1%。此外，奥氮平组的ElastPQ高于利培酮组和阿立哌唑组（5.11（3.83 - 5.61）kPa对4.35（3.63 - 4.98）kPa，P < 0.05；5.11（3.83 - 5.61）kPa对4.79（4.18 - 5.24）kPa，P < 0.05）。治疗一年后，ElastPQ值为4.43（3.85 - 5.22）kPa，但治疗超过三年的患者为5.81（5.09 - 7.33）kPa。该值随治疗时间延长而增加（P < 0.05）。
ElastPQ是一种评估NAFLD硬度的实时定量方法。肝脏硬度值在脂肪肝的不同阶段可能会有所变化。奥氮平对肝脏硬度有显著影响。长期使用AAPDs会增加脂肪肝的硬度值。
