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©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 7, 2021; 27(1): 80-91
Published online Jan 7, 2021. doi: 10.3748/wjg.v27.i1.80
Evaluation of controlled attenuation parameter in assessing hepatic steatosis in patients with autoimmune liver diseases
Xi-Xi Ni, Min Lian, Hui-Min Wu, Xiao-Yun Li, Li Sheng, Han Bao, Qi Miao, Xiao Xiao, Can-Jie Guo, Hai Li, Xiong Ma, Jing Hua
Xi-Xi Ni, Hui-Min Wu, Xiao-Yun Li, Xiao Xiao, Jing Hua, Department of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai 200127, China
Min Lian, Han Bao, Can-Jie Guo, Department of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
Li Sheng, Xiong Ma, School of Medicine, Shanghai Jiao Tong University, Shanghai Cancer Institute, Shanghai Institute of Digestive Disease, Shanghai 200127, China
Qi Miao, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai 200127, China
Hai Li, Department of Gastroenterology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
Xiong Ma, Department of Gastroenterology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China
Author contributions: Ni XX, Lian M, Wu HM, and Li XY contributed equally to this work, and collected and analyzed the data; Sheng L coordinated the research; Bao H and Xiao X performed the transient elastography and coordinated the liver biopsy; Miao Q contributed to histological examination; Ma X, Hua J, Li H, and Guo CJ analyzed the data; Hua J designed the study; Ni XX, Lian M, and Hua J wrote the manuscript; all authors have read and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 81470842 and No. 81770572.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Renji Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/ Corresponding author: Jing Hua, MD, PhD, Professor, Department of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, No. 160 Pujian Road, Shanghai 200127, China.
hua_jing88@163.com
Received: September 11, 2020
Peer-review started: September 11, 2020
First decision: November 23, 2020
Revised: December 1, 2020
Accepted: December 11, 2020
Article in press: December 11, 2020
Published online: January 7, 2021
Processing time: 110 Days and 5.4 Hours
ARTICLE HIGHLIGHTS
Research background
The controlled attenuation parameter (CAP) assesses hepatic steatosis with high diagnostic accuracies among several chronic liver diseases. However, it has not been studied in patients with autoimmune liver diseases (AILDs).
Research motivation
This study aimed to investigate the performance of CAP for the diagnosis of hepatic steatosis in patients with AILDs.
Research objectives
We evaluated the performance and usefulness of CAP for detection of hepatic steatosis in patients with AILDs.
Research methods
The area under the receiver operating characteristic curve was used to evaluate the performance of CAP for diagnosing hepatic steatosis compared with biopsy. Optimal CAP cut-off values were determined based on the highest combined sensitivity and specificity.
Research results
CAP can accurately detect hepatic steatosis as a noninvasive method in patients with AILDs. Compared with patients with nonalcoholic fatty liver disease (NAFLD) presenting with autoimmune markers, patients with autoimmune hepatitis (AIH) concomitant with NAFLD were much older and had higher serum IgG levels and liver stiffness measurement (LSM) values.
Research conclusions
CAP can be used as a noninvasive diagnostic method to evaluate hepatic steatosis in patients with AILDs. Determination of LSM combined with CAP may help to identify patients with AIH concomitant with NAFLD from patients with NAFLD with autoimmune phenomena.
Research perspectives
Larger multicenter studies using both M and XL probes are needed to confirm our results.
