Case Control Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 28, 2015; 21(4): 1158-1166
Published online Jan 28, 2015. doi: 10.3748/wjg.v21.i4.1158
Factors associated with significant liver fibrosis assessed using transient elastography in general population
Seng Chan You, Kwang Joon Kim, Seung Up Kim, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Won Jae Lee, Kwang-Hyub Han
Seng Chan You, Kwang Joon Kim, Seung Up Kim, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 120-752, South Korea
Seung Up Kim, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul 120-752, South Korea
Kwang Joon Kim, Division of Endocrinology and Metabolism, Yonsei University College of Medicine, Seoul 120-752, South Korea
Seung Up Kim, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Liver Cirrhosis Clinical Research Center, Seoul 120-752, South Korea
Won Jae Lee, Seoul Gookgwain School, Seoul 110-521, South Korea
Author contributions: You SC and Kim KJ contributed equally to this work; Kim SU, Kim BK, Park JY and Han KH designed the research; You SC and Kim KJ performed the research; Kim DY, Ahn SH and Lee WJ analyzed the data; You SC and Kim SU wrote the paper; Lee WJ revised the article.
Supported by The Liver Cirrhosis Clinical Research Center and in part by a grant from the Korea Healthcare Technology RD Project, Ministry of Health and Welfare, Republic of Korea No. HI10C2020.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Seung Up Kim, MD, Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, South Korea. ksukorea@yuhs.ac
Telephone: +82-2-22281992 Fax: +82-2-3936884
Received: June 17, 2014
Peer-review started: June 17, 2014
First decision: July 21, 2014
Revised: August 4, 2014
Accepted: September 18, 2014
Article in press: September 19, 2014
Published online: January 28, 2015
Processing time: 223 Days and 19.5 Hours
Abstract

AIM: To investigate the prevalence of significant liver fibrosis assessed using transient elastography (TE) and its predictors in asymptomatic general population.

METHODS: A total of 159 subjects without chronic viral hepatitis who underwent comprehensive medical health check-up between January 2012 and July 2012 were prospectively recruited. Significant liver fibrosis was defined as liver stiffness value > 7.0 kPa.

RESULTS: The mean age and body mass index (BMI) of the study population (men 54.7%) was 56.0 years and 24.3 kg/m2. Among the study subjects, 11 (6.9%) showed significant liver fibrosis. On univariate analysis, BMI, alanine aminotransferase (ALT), homeostasis model assessment of insulin resistance, carotid intimal media thickness (IMT), number of calcified plaques on carotid ultrasound, and visceral fat area on computed tomography were significantly higher in subjects with significant liver fibrosis than in those without (all P < 0.05). However, on multivariate analysis, BMI [odds ratio (OR) =1.487; P = 0.045], ALT (OR = 1.078; P = 0.014), carotid IMT (OR = 3.244; P = 0.027), and the number of calcified carotid plaques (OR = 1.787; P = 0.031) were independent predictors of significant liver fibrosis.

CONCLUSION: The prevalence of significant liver fibrosis assessed using TE was 6.9% in apparently healthy subjects. High BMI, high ALT, thicker carotid IMT, and higher numbers of calcified carotid plaques were independently associated with the presence of significant liver fibrosis.

Keywords: Transient elastography; Healthy subjects; Fibroscan; Liver fibrosis; Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Body mass index; Alanine aminotransferase; Carotid intimal medial thickness; Carotid artery plaque

Core tip: This is the first study which investigated the prevalence of significant liver fibrosis assessed using transient elastography and the correlation between comprehensive clinical metabolic parameters (body weight, visceral adiposity, insulin resistance, hepatic steatosis, and atherosclerosis) and the presence of significant liver fibrosis in asymptomatic general subjects. Finally, we found that the prevalence of significant liver fibrosis was fairly high (6.9%) and several factors including higher body mass index, higher alanine aminotransferase, thicker carotid intimal media thickness, and higher numbers of calcified carotid plaques on carotid sonography were significantly correlated to the risk of significant liver fibrosis.