Controlled attenuation parameter for non-invasive assessment of hepatic steatosis in Chinese patients

doi:10.3748/wjg.v20.i16.4702

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 20, Issue 16

This Article

Academic Content and Language Evaluation of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (10934)

All Articles published online

The chart showing PDF series, WORD series, HTML series, Figures (1-2) series, Tables (1-3) series.

Item

Count

PDF

827

WORD

316

HTML

6558

Figures (1-2)

286

Tables (1-3)

273

Sum=8260

Publishing Process of This Article

The chart showing Browse series, Download series.

Item

Count

Browse

1331

Download

1343

Sum=2674

Apr 28, 2014 (publication date) through Feb 18, 2025

Times Cited of This Article

Times Cited (79)

Journal Information of This Article

Publication Name

World Journal of Gastroenterology

ISSN

1007-9327

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Brief Article

World J Gastroenterol. Apr 28, 2014; 20(16): 4702-4711
Published online Apr 28, 2014. doi: 10.3748/wjg.v20.i16.4702

Table 1 Baseline characteristics of patients with non-alcoholic fatty liver disease and chronic hepatitis B virus infection

Characteristics	All patients	NAFLD	CHB	P value
Characteristics	(n = 152)	(n = 52)	(n = 100)	P value
Demographics
Male gender, n (%)¹	106 (69.3)	36 (69.2)	70 (70.0)	0.992
Age (yr)²	35 (28-49)	39 (29-50)	35 (27-49)	0.167
Anthropometrics
BMI (kg/m²)²	24.9 (22.5-27.7)	26.0 (24.4-29.3)	23.9 (21.8-26.6)	< 0.001
< 18.5	7 (4.6)	0	7 (7.0)
18.5-24.9	70 (46.1)	18 (34.6)	52 (52.0)
25-29.9	61 (40.1)	24 (46.2)	37 (37.0)
≥ 30	14 (9.2)	10 (19.2)	4 (4.0)
WHR2	0.92 (0.88-0.96)	0.94 (0.91-0.97)	0.90 (0.86-0.95)	0.001
Laboratory findings
ALT (U/L)	64.8 (37.9-134.0)	55.0 (31.3-104.4)	69.0 (40.0-187.0)	0.022
AST (U/L)	44.0 (26.0-77.5)	33.4 (25.0-67.0)	46.3 (28.7-93.5)	0.042
ALP (U/L)	89.0 (68.0-109.0)	84.0 (63.1-109.0)	90.3 (73.3-109.0)	0.320
Γ-GT (U/L)	54.3 (28.9-104.4)	60.0 (31.6-97.1)	52.0 (26.5-117.3)	0.770
Albumin (g/L)	42.7 (39.8-45.1)	43.5 (41.5-46.8)	42.1 (38.6-44.8)	0.017
Total bilirubin (μmol/L)	14.2 (11.6-20.2)	12.6 (10.5-15.5)	15.2 (12.1-22.3)	0.003
Direct bilirubin (μmol/L)	4.9 (3.7-7.8)	4.6 (3.8-5.6)	5.2 (3.7-9.0)	0.080
Total cholesterol (mmol/L)	4.6 (4.0-5.1)	4.7 (4.3-5.1)	4.3 (3.7-5.1)	0.018
Triglyceride (mmol/L)	1.4 (0.9-2.2)	2.0 (1.3-2.7)	1.3 (0.87-2.0)	0.001
HDL-C (mmol/L)	1.2 (1.0-1.3)	1.2 (1.1-1.4)	1.1 (1.0-1.3)	0.166
LDL-C (mmol/L)	2.5 (1.9-2.9)	2.8 (2.6-3.1)	2.3 (1.8-2.6)	< 0.001
Prothrombin time (s)	12.3 (11.1-13.0)	11.9 (10.4-12.4)	12.7 (12.0-13.4)	< 0.001
Fasting glucose (μmol/L)	5.3 (4.7-5.8)	5.2 (4.5-6.0)	5.3 (4.8-5.7)	0.819
Log10 (HBV-DNA,IU/mL)	-	-	3.3 (0.92-5.9)
Liver histology
Steatosis grade, n (%)¹				< 0.001
S0 (< 5%)	63 (41.4)	0	63 (63.0)
S1 (5%-33%)	44 (28.9)	19 (36.5)	25 (25.0)
S2 (34%-66%)	32 (21.1)	23 (44.2)	9 (9.0)
S3 (≥ 67%)	13 (8.6)	10 (19.2)	3 (3.0)
Fibrosis stage, n (%)¹				0.234
F0	-	28 (53.8)	36 (36.0)
F1	-	13 (25.0)	30 (30.0)
F2	-	6 (11.5)	20 (20.0)
F3	-	4 (7.7)	8 (8.0)
F4	-	1 (1.9)	6 (6.0)
Significant fibrosis(F ≥ 2), n (%)	45 (29.6)	11 (21.2)	34 (34.0)	0.100
Moderate to severe inflammation, n (%)¹³	62 (40.8)	21 (40.4)	41 (41.0)	0.942
FibroScan^® parameters
Controlled attenuation parameter (dB/m)	262 (215-310)	310 (273-347)	236 (199-281)	< 0.001
Liver stiffness measurement (kPa)	7.5 (5.5-12.9)	6.1 (4.8-11.1)	8.0 (5.9-13.9)	0.025

All data are expressed as medians (IQR), or n (%), as appropriate;

¹Either χ² test or Fisher’s exact test was used;

²Mann-Whitney test was used;

³METAVIR grades A2-A3 in patients with viral hepatitis and NAS score ≥ 5 in patients with NAFLD. BMI: Body mass index; WHR: Waist-to-hip ratio; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; γ-GT: γ-glutamyl transpeptidase; HDL-C: High density lipoprotein cholesterol; LDL-C: Low density lipoprotein cholesterol; NAFLD: Non-alcoholic fatty liver disease; CHB: Chronic hepatitis B.

Table 2 Correlation and multivariate linear regression analyses for controlled attenuation parameter with other different parameters

	Spearman correlation		Multivariate linear regression
Parameter	r	P value	OR	95%CI:	P value
BMI	0.49	< 0.001	6.20	2.92-9.48	< 0.001
WHR	0.32	< 0.001	-
ALT	-0.25	0.002	-
AST	-0.25	0.002	-
Albumin	0.27	0.001	-
Total bilirubin	-0.24	0.003	-
Direct bilirubin	-0.17	0.039	-
Total cholesterol	0.18	0.034	-
Triglyceride	0.31	< 0.001	-
LDL-C	0.39	< 0.001	-
Steatosis grade	0.76	< 0.001	37.12	21.63-52.60	< 0.001

OR: Odds ratio; CI: Confidence interval; BMI: Body mass index; WHR: Waist-to-hip ratio; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; LDL-C: Low density lipoprotein cholesterol.

Table 3 Diagnostic accuracy of controlled attenuation parameter and its suggested optimal cut-off values

Steatosis	AUC (95%CI)	P value	Cut-off (dB/m)	Sensitivity (95%CI), %	Specificity (95%CI), %	PPV (95%CI), %	NPV (95%CI), %
S0 vs S1-S3 (≥ 5%)	0.92 (0.88-0.97)	< 0.001	253	88.8 (79.9-94.2)	82.5 (70.5-90.6)	87.8 (78.8-93.4)	83.9 (71.9-91.6)
S0-S1 vs S2-S3 (≥ 34%)	0.92 (0.87-0.97)	< 0.000	285	93.3 (80.7-98.3)	83.2 (74.4-89.5)	70.0 (56.6-80.8)	96.7 (90.1-99.2)
S0-S2 vs S3 (≥ 67%)	0.88 (0.82-0.94)	< 0.001	310	92.3 (62.1-99.6)	79.1 (71.3-85.4)	29.3 (16.6-45.7)	99.1 (94.4-99.9)

AUC: Areas under the curve; PPV: Positive predictive value; NPV: Negative predictive value.

Citation: Shen F, Zheng RD, Mi YQ, Wang XY, Pan Q, Chen GY, Cao HX, Chen ML, Xu L, Chen JN, Cao Y, Zhang RN, Xu LM, Fan JG. Controlled attenuation parameter for non-invasive assessment of hepatic steatosis in Chinese patients. World J Gastroenterol 2014; 20(16): 4702-4711
URL: https://www.wjgnet.com/1007-9327/full/v20/i16/4702.htm
DOI: https://dx.doi.org/10.3748/wjg.v20.i16.4702