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Z Gastroenterol 2017; 55(08): 754-760
DOI: 10.1055/s-0043-111804
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Potential impact of screening for fatty liver disease by transient elastography with liver stiffness and controlled attenuation parameter measurements: a pilot study

Potentieller Einfluss von Screening auf eine Fettlebererkrankung mittels transienter Elastographie mit Bestimmung der Lebersteifigkeit und des Fettgehaltes: eine Pilotstudie
Moritz Peiseler   *
,
Anna Creutzfeldt   *
,
Insa Cassens
,
Claudia Glaubke
,
Claudia Kroll
,
Ansgar W. Lohse
,
Christina Weiler-Normann
Further Information

Publication History

16 February 2017

18 May 2017

Publication Date:
27 June 2017 (online)

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Abstract

Background The prevalence of chronic liver diseases is high in developed countries, and the leading causes are amenable to prevention. The German Lebertag is to increase awareness of the burden of chronic liver diseases in the general public. We performed a pilot study using transient elastography with liver stiffness measurement (LSM) and the controlled attenuation parameter (CAP) as a screening tool for previously unrecognized liver diseases.

Patients and methods LSM and CAP was performed in 60 individuals, and participants filled in a questionnaire reporting basic characteristics and past medical history.

Results Median LSM and CAP values were within the normal range. Participants with self-reported diabetes mellitus had significantly elevated LSM (p = 0.02) and CAP values (p = 0.002). Participants with a BMI > 30 kg/m2 or dyslipidemia had significantly elevated CAP values (p = 0.007 and p = 0.01, respectively) with normal LSM values. Overall, 35 % of participants had elevated CAP values, indicating a high prevalence of hepatic steatosis.

Discussion In a German pilot study, diabetes mellitus was a key risk factor for increased LSM and CAP values. Prevalence of steatosis was high and comparable to other Western countries. Transient elastography is a valuable tool to identify patients with increased risk for metabolic liver diseases. In people without risk factors, LSM and CAP values were within the normal range, indicating that screening for chronic liver injury was not warranted.

Zusammenfassung

Hintergrund Die Prävalenz chronischer Lebererkrankungen in entwickelten Ländern ist hoch und die Ursachen häufig vermeidbar. Der deutsche „Lebertag“ soll das Bewusstsein für chronische Lebererkrankungen in der Allgemeinbevölkerung stärken. In einer Pilotstudie wurde die transiente Elastographie mit Messung der Lebersteifigkeit (measurement of liver stiffness, LSM) und des Leberfettgehalts (controlled attenuation parameter, CAP) als Screening-Untersuchung evaluiert.

Teilnehmer und Methoden Bei sechzig Personen wurde eine Messung von LSM und CAP durchgeführt und die Teilnehmer füllten einen Fragebogen zu demographischen Daten, Vorerkrankungen und Risikofaktoren für Lebererkrankungen aus.

Ergebnisse Mediane LSM- und CAP-Werte lagen im Normbereich. Teilnehmer mit Diabetes mellitus hatten signifikant erhöhte LSM (p = 0,02) und CAP (p = 0,002). Teilnehmer mit einem BMI > 30 kg/m2 oder Fettstoffwechselstörung hatten einen signifikant erhöhten CAP (p = 0,007 und p = 0,01) mit normaler LSM. Insgesamt zeigten 35 % der Teilnehmer einen erhöhten CAP mit dem Verdacht einer Fettlebererkrankung.

Diskussion In dieser Pilotstudie war Diabetes mellitus ein Risikofaktor für eine erhöhte LSM. Die Prävalenz der Steatosis war hoch und vergleichbar mit anderen westlichen Ländern. Die nichtinvasive Messung von LSM und CAP mittels transienter Elastographie ist eine geeignete Screening-Untersuchung bei Patienten mit erhöhtem Risiko für metabolisch bedingte Lebererkrankungen. Bei Patienten ohne Risikofaktoren scheint ein Screening nicht sinnvoll zu sein.

Schlüsselwörter

Transiente Elastographie - Continued attenuation parameter - Diabetes mellitus - chronische Lebererkrankung - nicht-alkoholische Fettlebererkrankung

Key words

transient elastography - continued attenuation parameter - diabetes mellitus - chronic liver disease - nonalcoholic fatty liver disease

* Equal contribution.


 

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