Using liver stiffness to predict and monitor the risk of decompensation and mortality in patients with alcohol-related liver disease

被引：16

作者：

Thorhauge, Katrine Holtz ^{[1
,2
]}

Semmler, Georg ^{[3
]}

Johansen, Stine ^{[1
,2
]}

Lindvig, Katrine Prier ^{[1
,2
]}

Kjaergaard, Maria ^{[1
,2
]}

Hansen, Johanne Kragh ^{[1
,2
]}

Torp, Nikolaj ^{[1
,2
]}

Hansen, Camilla Dalby ^{[1
,2
]}

Andersen, Peter ^{[1
]}

Hofer, Benedikt Silvester ^{[3
]}

Gu, Wenyi ^{[4
]}

Israelsen, Mads ^{[1
,2
]}

Mandorfer, Mattias ^{[3
]}

Reiberger, Thomas ^{[3
]}

Trebicka, Jonel ^{[4
]}

Thiele, Maja ^{[1
,2
]}

Krag, Aleksander ^{[1
,2
]}

机构：

[1] Odense Univ Hosp, Fibrosis Fatty Liver & Steatohepatitis Res Ctr Ode, Dept Gastroenterol & Hepatol, Klovervaenget 10,Entrance 112, DK-5000 Odense C, Denmark

[2] Univ Southern Denmark, Fac Hlth Sci, Dept Clin Res, Odense, Denmark

[3] Med Univ Vienna, Dept Internal Med 3, Div Gastroenterol & Hepatol, Spitalgasse 23, A-1090 Vienna, Austria

[4] Univ Munster, Munster Univ Hosp, Dept Internal Med B, Munster, Germany

来源：

JOURNAL OF HEPATOLOGY | 2024年 / 81卷 / 01期

关键词：

ALD; transient elastography; cACLD; Fibroscan; Baveno VII; MAGNETIC-RESONANCE ELASTOGRAPHY; PERFORMANCE; FIBROSIS; BIOPSY; TESTS;

D O I：

10.1016/j.jhep.2024.02.019

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background & Aims: Liver stiffness measurement (LSM) is recommended for disease prognostication and monitoring. We evaluated if LSM, using transient elastography, and LSM changes predict decompensation and mortality in patients with alcohol- related liver disease (ALD). Methods: We performed an observational cohort study of compensated patients at risk of ALD from Denmark and Austria. We evaluated the risk of decompensation and all-cause mortality, stratified for compensated advanced chronic liver disease (cACLD: baseline LSM >-10 kPa) and LSM changes after a median of 2 years. In patients with cACLD, we defined LSM changes as (A) LSM increase >-20% ("cACLD increasers") and (B) follow-up LSM <10 kPa or <20 kPa with LSM decrease >-20% ("cACLD decreasers"). In patients without cACLD, we defined follow-up LSM >-10 kPa as an LSM increase ("No cACLD increasers"). The remaining patients were considered LSM stable. Results: We followed 536 patients for 3,008 patient-years-median age 57 years (IQR 49-63), baseline LSM 8.1 kPa (IQR 4.921.7)-371 patients (69%) had follow-up LSM after a median of 25 months (IQR 17-38), 41 subsequently decompensated and 55 died. Of 125 with cACLD at baseline, 14% were "cACLD increasers" and 43% "cACLD decreasers", while 13% of patients without cACLD were "No cACLD increasers" (n = 33/246). Baseline LSM, follow-up LSM and LSM changes accurately predicted decompensation (C-index: baseline LSM 0.85; follow-up LSM 0.89; LSM changes 0.85) and mortality (C-index: baseline LSM 0.74; follow-up LSM 0.74; LSM changes 0.70). When compared to "cACLD decreasers", "cACLD increasers" had significantly lower decompensation-free survival and higher risks of decompensation (subdistribution hazard ratio 4.39, p = 0.004) and mortality (hazard ratio 3.22, p = 0.01). Conclusion: LSM by transient elastography predicts decompensation and all-cause mortality in patients with compensated ALD both at diagnosis and when used for monitoring.

引用

页码：23 / 32

页数：11

共 30 条

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