Value of controlled attenuation parameter in fibrosis prediction in nonalcoholic steatohepatitis

Table 1 Demographic, clinical, biochemical and histological characteristics of 184 patients with nonalcoholic steatohepatitis

Variable	NAFLD (n = 184)
Age (yr)	44.6 ± 14.5
Male gender	127 (69.0%)
Body mass index, median (range, kg/m2)	29.3 (19.8-44.5)
Body mass index ≥ 25 kg/m2	156 (84.8%)
Diabetes	69 (37.5%)
Hypertension	54 (29.3%)
Hyperlipidemia	75 (40.8%)
Fasting glucose (mg/dL)	117.9 ± 32.9
HDL cholesterol (md/dL)	47.1 ± 11.8
Triglycerides (mg/dL)	193.8 ± 127.5
LDL cholesterol (mg/dL)	131.7 ± 31.3
Alanine aminotransferase (U/L)	92.4 ± 68.1
Aspartate aminotransferase (U/L)	67.3 ± 39.2
Gamma glutamyltransferase (U/L)	74.1 ± 86.7
Platelet (× 1000/mm3)	244.8 ± 58.6
Albumin (g/dL)	4.5 ± 0.3
Liver stiffness (kPa)	10.9 ± 4.9
Stiffness IQR (kPa)	1.8 ± 3.3
CAP (dB/m)	320.9 ± 37.1
Lower tertile	223-310
Middle tertile	311-339
Higher tertile	340-400
CAP IQR (dB/m)	24.7 ± 9.5
Histology at biopsy
Steatosis grade
1 (5%-33%)	44 (23.9%)
2 (34%-66%)	81 (44.0%)
3 (> 66%)	59 (32.1%)
Stage of fibrosis (Kleiner)
0	20 (10.9%)
1	84 (45.7%)
2	53 (28.8%)
3	21 (11.4%)
4	6 (3.3%)

Data are expressed as the mean ± standard deviation, median (range) or number (%). HDL: High-density lipoprotein; LDL: Low-density lipoprotein; CAP: Controlled attenuation parameter; IQR: Interquartile range; NAFLD: Nonalcoholic fatty liver disease.

Table 2 Univariate and multivariate analysis of factors associated with liver stiffness measurements as continuous variable in 184 patients with nonalcoholic steatohepatitis by linear regression analysis

	Univariate analysis			Multivariate analysis
Variable	β	SE	P	β	SE	P
Age (yr)	0.053	0.025	0.037a	0.017	0.022	0.451
Male gender	0.957	0.792	0.228
BMI (kg/m2)	-0.032	0.083	0.700
CAP (dB/m)	0.022	0.010	0.026a	0.041	0.009	< 0.001b
LS IQR (kPa)	0.329	0.109	0.003b	0.294	0.022	0.451
Histology at biopsy
Steatosis	-0.895	0.490	0.069	-0.532	0.445	0.233
Lobular inflammation	1.134		0.082	0.152		0.776
	1.366	0.650	0.008b	0.638	0.532	0.131
Ballooning	2.769	0.509	< 0.001b	2.665	0.421	< 0.001b
Fibrosis		0.331			0.344

^aP < 0.05;

^bP < 0.01. SE: Standard error; BMI: Body mass index; CAP: Controlled attenuated parameter; LS IQR: Liver stiffness interquartile range.

Table 3 Demographic, clinical, biochemical and histological characteristics of patients with nonalcoholic steatohepatitis under either pioglitazone or ursodeoxycholic acid

Variable	Pioglitazone group (n = 80)	UDCA group (n = 50)	P value
Age (yr)	47.6 ± 14.5	44.9 ± 14.5	0.303
Male gender	60 (75.0%)	30 (60.0)	0.071
Body mass index ≥ 25 kg/m2	66 (82.5%)	41 (82.0%)	0.942
Diabetes	38 (47.5%)	15 (30.0)	0.048a
Hypertension	29 (36.2%)	10 (20.0%)	0.049a
Hyperlipidemia	36 (45.0%)	26 (52.0%)	0.437
Fasting glucose (mg/dL)	121.3 ± 34.5	112.5 ± 24.1	0.090
HDL cholesterol (md/dL)	47.9 ± 10.0	47.7 ± 14.1	0.923
Triglycerides (mg/dL)	199.5 ± 147.7	185.9 ± 105.2	0.590
LDL cholesterol (mg/dL)	130.5 ± 29.4	136.4 ± 34.8	0.435
Alanine aminotransferase (U/L)	103.0 ± 76.1	74.6 ± 48.7	0.011a
Aspartate aminotransferase (U/L)	70.2 ± 40.5	65.7 ± 42.8	0.554
Gamma glutamyltransferase (U/L)	63.9 ± 61.3	62.3 ± 41.8	0.856
Platelet (× 1000/mm3)	229.8 ± 54.8	253.2 ± 54.4	0.019a
Albumin (g/dL)	4.5 ± 0.3	4.5 ± 0.3	0.866
Liver stiffness (kPa)	11.7 ± 4.8	10.5 ± 5.4	0.183
Stiffness IQR (kPa)	2.2 ± 4.7	1.4 ± 0.9	0.387
CAP (dB/m)	318.2 ± 37.9	319.3 ± 37.1	0.873
CAP IQR (dB/m)	25.2 ± 9.0	23.0 ± 10.1	0.216
Fibrosis score (Kleiner)			0.017a
F0	2 (2.5%)	9 (18.0%)
F1	41 (51.2%)	21 (42.0%)
F2	24 (30.0%)	15 (30.0%)
F3-4	13 (16.3%)	5 (10.0%)

Data are expressed as the mean ± standard deviation or median (range) or number (%),

^aP < 0.05. UDCA: Ursodeoxycholic acid; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; CAP: Controlled attenuation parameter; IQR: Interquartile range.