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Factors Affecting the Accuracy of Controlled Attenuation Parameter (CAP) in Assessing Hepatic Steatosis in Patients with Chronic Liver Disease

Authors
 Kyu Sik Jung  ;  Beom Kyung Kim  ;  Seung Up Kim  ;  Young Eun Chon  ;  Kyung Hyun Cheon  ;  Sung Bae Kim  ;  Sang Hoon Lee  ;  Sung Soo Ahn  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Young Nyun Park  ;  Kwang-Hyub Han 
Citation
 PLOS ONE, Vol.9(6) : e98689, 2014 
Journal Title
PLOS ONE
Issue Date
2014
MeSH
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy ; Blood Chemical Analysis ; Elasticity Imaging Techniques ; Fatty Liver/complications ; Fatty Liver/diagnosis* ; Fatty Liver/pathology* ; Female ; Humans ; Liver Diseases/complications ; Liver Diseases/diagnosis* ; Liver Diseases/pathology* ; Male ; Middle Aged ; Prognosis ; Young Adult
Abstract
BACKGROUND & AIMS:
Controlled attenuation parameter (CAP) can measure hepatic steatosis. However, factors affecting its accuracy have not been described yet. This study investigated predictors of discordance between liver biopsy (LB) and CAP.
METHODS:
A total of 161 consecutive patients with chronic liver disease who underwent LB and CAP were enrolled prospectively. Histological steatosis was graded as S0 (<5%), S1 (5-33%), S2 (34-66%), and S3 (>66% of hepatocytes). Cutoff CAP values were calculated from our cohort (250, 301, and 325 dB/m for ≥ S1, ≥ S2, and S3). Discordance was defined as a discrepancy of at least two steatosis stages between LB and CAP.
RESULTS:
The median age (102 males and 59 females) was 49 years. Repartition of histological steatosis was as follows; S0 26.1% (n = 42), S1 49.7% (n = 80), S2 20.5% (n = 33), and S3 3.7% (n = 6). In multivariate linear regression analysis, CAP value was independently associated with steatosis grade along with body mass index (BMI) and interquartile range/median of CAP value (IQR/MCAP) (all P<0.05). Discordance was identified in 13 (8.1%) patients. In multivariate analysis, histological S3 (odd ratio [OR], 9.573; 95% confidence interval [CI], 1.207-75.931; P = 0.033) and CAP value (OR, 1.020; 95% CI, 1.006-1.034; P = 0.006) were significantly associated with discordance, when adjusting for BMI, IQR/MCAP, and necroinflammation, reflected by histological activity or ALT level.
CONCLUSIONS:
Patients with high grade steatosis or high CAP values have a higher risk of discordance between LB and CAP. Further studies are needed to improve the accuracy of CAP interpretation, especially in patients with higher CAP values.
Files in This Item:
T201401681.pdf Download
DOI
10.1371/journal.pone.0098689
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Sung Bae(김성배)
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Ahn, Sung Soo(안성수) ORCID logo https://orcid.org/0000-0002-9002-9880
Lee, Sang Hoon(이상훈B) ORCID logo https://orcid.org/0000-0002-3619-4340
Chun, Kyeong Hyeon(전경현) ORCID logo https://orcid.org/0000-0002-7798-658X
Jung, Kyu Sik(정규식)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98886
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