Lee Hye Won, Kim Kun Hee, Ahn Sang Hoon, Lee Han Chu, Choi Jonggi
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Liver Int. 2024 Jun;44(6):1448-1455. doi: 10.1111/liv.15897. Epub 2024 Mar 15.
The prognosis of metabolic dysfunction-associated steatotic liver disease (MASLD) is associated with liver fibrosis. We investigated the associations between changes in liver stiffness measurement (LSM) over 3-year period and the development of cirrhosis or hepatocellular carcinoma (HCC) in patients with MASLD.
This study involved patients with MASLD who underwent transient elastography at baseline and 3 years after baseline from 2012 to 2020. Low (L), indeterminate (I) and high (H) LSM values were classified as <8 kPa, 8-12 kPa and >12 kPa respectively.
Among 1738 patients, 150 (8.6%) were diagnosed with cirrhosis or HCC. The proportions of patients with L, I and H risk were 69.7%, 19.9% and 10.5% at baseline, and 78.8%, 12.8% and 8.4% at 3 years after baseline, respectively. The incidence rates of cirrhosis or HCC per 1000 person-years were 3.7 (95% confidence interval [CI], 2.4-5.5) in the L → L + I group, 23.9 (95% CI, 17.1-32.6) in the I → L + I group, 38.3 (95% CI, 22.3-61.3) in the H → L + I group, 62.5 (95% CI, 32.3-109.2) in the I → H group, 67.8 (95% CI, 18.5-173.6) in the L → H group and 93.9 (95% CI 70.1-123.1) in the H → H group. Two risk factors for the development of cirrhosis or HCC were LSM changes and low platelet counts.
LSM changes could predict clinical outcomes in patients with MASLD. Thus, it is important to monitor changes in the fibrotic burden by regular assessment of LSM values.
代谢功能障碍相关脂肪性肝病（MASLD）的预后与肝纤维化有关。我们研究了MASLD患者3年内肝脏硬度测量值（LSM）的变化与肝硬化或肝细胞癌（HCC）发生之间的关联。
本研究纳入了2012年至2020年期间在基线和基线后3年接受瞬时弹性成像检查的MASLD患者。低（L）、不确定（I）和高（H）LSM值分别定义为<8kPa、8 - 12kPa和>12kPa。
在1738例患者中，150例（8.6%）被诊断为肝硬化或HCC。基线时L、I和H风险患者的比例分别为69.7%、19.9%和10.5%，基线后3年分别为78.8%、12.8%和8.4%。L→L + I组每1000人年肝硬化或HCC的发病率为3.7（95%置信区间[CI]，2.4 - 5.5），I→L + I组为23.9（95%CI，17.1 - 32.6），H→L + I组为38.3（95%CI，22.3 - 61.3），I→H组为62.5（95%CI，32.3 - 109.2），L→H组为67.8（95%CI，18.5 - 173.6），H→H组为93.9（95%CI，70.1 - 123.1）。肝硬化或HCC发生的两个危险因素是LSM变化和血小板计数低。
LSM变化可预测MASLD患者的临床结局。因此，定期评估LSM值以监测纤维化负担的变化很重要。
