Evaluation of liver fibrosis in patients with chronic hepatitis B complicated with nonalcoholic fatty liver disease by transient elastography

Abstract

Abstract: Objective To evaluate transient elastography in the evaluation of liver fibrosis in patients with chronic hepatitis B (CHB) complicated with non-alcoholic fatty liver disease (NAFLD).Methods A total of 144 patients with CHB complicated with NAFLD between January 2015 and January 2020 were selected. There were 98 males and 46 females with an average age of (41.5±8.5) years.The measurement data were compared by independent t-test, and the counting data were compared by chi-square test. The subjects' working characteristic curve (ROC curve) was drawn by MedCalc 15.1 statistical software, and the area under the curve (AUC), was calculated by Z test. Spearman correlation analysis was used to compare the correlation between LSM and clinical data. The independent predictive factors are screened by multiple linear regression analysis, and the independent predictive factors are analyzed by multiple linear regression analysis, and the regression model is established.Results 144 patients with CHB complicated with NAFLD, there was significant difference among the stages of hepatic fibrosis in F0 stage, kPa, F1 stage, kPa, F2 stage, kPa, F3 stage, kPa, F4 stage and kPa, stage. The value of AUC in F4 stage was significantly higher than that in ≥ F2 stage and ≥ F3 stage, and the difference was statistically significant (P<0.05). The cutoff point, sensitivity, specificity and AUC of LSM for diagnosis of F4 liver fibrosis were 12.4 kPa, 97%, 90% and 0.92, respectively. Spearman correlation analysis showed that age, AST, Alb, TBil, ALP, PLT, PT, HA, LN, C Ⅳ were significantly correlated with the stage of liver fibrosis. Multiple linear regression analysis was carried out with the LSM value as the dependent variable and the above indexes as the independent variable. TBil, Alb, PT and C IV were independent predictors of LSM. The regression equation was Y (LSM) =-30.6+0.21×TBil-0.14×Alb+ 0.27×PT+0.17×CⅣ, and the regression model was statistically significant.Conclusion The detection of LSM by FibroScan is of high value in the diagnosis of liver fibrosis in patients with CHB complicated with NAFLD.

Key words: Nonalcoholic fatty liver disease, Chronic hepatitis B, Liver fibrosis, Transient elastography, Liver stiffness measurement

FENG Shao-yang, LI Guang-ming, SU Hang. Evaluation of liver fibrosis in patients with chronic hepatitis B complicated with nonalcoholic fatty liver disease by transient elastography[J]. Chinese Hepatolgy, 2021, 26(1): 44-46.

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