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Wong YJ, Chen VL, Abdulhamid A, Tosetti G, Navadurong H, Kaewdech A, Cristiu J, Song M, Devan P, Tiong KLA, Neo JE, Prasoppokakorn T, Sripongpun P, Stedman CAM, Treeprasertsuk S, Primignani M, Ngu JH, Abraldes JG. Comparing serial and current liver stiffness measurements to predict decompensation in compensated advanced chronic liver disease patients. Hepatology 2024:01515467-990000000-00848. [PMID: 38630497 DOI: 10.1097/hep.0000000000000891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/22/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND AND AIMS The utility of serial liver stiffness measurements (LSM) to predict decompensation in patients with compensated advanced chronic liver disease (cACLD) remains unclear. We aimed to validate whether comparing serial LSM is superior to using the current LSM to predict liver-related events (LRE) in patients with cACLD. APPROACH AND RESULTS In this retrospective analysis of an international registry, patients with cACLD and serial LSM were followed up until index LRE. We compared the performance of both the dynamic LSM changes and the current LSM in predicting LRE using Cox regression analysis, considering time zero of follow-up as the date of latest liver stiffness measurement. In all, 480 patients with cACLD with serial LSM were included from 5 countries. The commonest etiology of cACLD was viral (53%) and MASLD (34%). Over a median follow-up of 68 (IQR: 45 -92) months, 32% experienced a LSM decrease to levels below 10kPa (resolved cACLD) and 5.8% experienced LRE. Resolved cACLD were more likely to be nondiabetic and had better liver function. While a higher value of the current LSM was associated with higher LREs, LSM changes over time (LSM slope) were not associated with LRE. In multivariable Cox regression, neither the prior LSM nor the LSM slope added predictive value to latest liver stiffness measurement. CONCLUSIONS Once the current LSM is known, previous LSM values do not add to the prediction of LREs in patients with cACLD.
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Affiliation(s)
- Yu Jun Wong
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore
- Duke-NUS Academic Clinical Program, SingHealth, Singapore
- Liver Unit, Division of Gastroenterology, University of Alberta, Edmonton, Canada
| | - Vincent L Chen
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Asim Abdulhamid
- University of Otago, Christchurch, New Zealand
- Christchurch Hospital, Christchurch, New Zealand
| | - Giulia Tosetti
- Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Apichat Kaewdech
- Gastroenterology and Hepatology Unit, Faculty of Medicine, Prince of Songkla University, Hatyai, Thailand
| | - Jessica Cristiu
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Michael Song
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Pooja Devan
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore
| | - Kai Le Ashley Tiong
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore
| | - Jean Ee Neo
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore
| | | | - Pimsiri Sripongpun
- Gastroenterology and Hepatology Unit, Faculty of Medicine, Prince of Songkla University, Hatyai, Thailand
| | | | | | - Massimo Primignani
- Division of Gastroenterology and Hepatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Jing Hieng Ngu
- University of Otago, Christchurch, New Zealand
- Christchurch Hospital, Christchurch, New Zealand
| | - Juan G Abraldes
- Liver Unit, Division of Gastroenterology, University of Alberta, Edmonton, Canada
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Ma R, Iwakiri Y. Lymphatic drainage dysfunction is related to clinically significant portal hypertension. Hepatol Int 2023; 17:1327-1330. [PMID: 37743398 DOI: 10.1007/s12072-023-10592-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 08/29/2023] [Indexed: 09/26/2023]
Affiliation(s)
- Ruixue Ma
- Department of Internal Medicine, Section of Digestive Diseases, Yale University School of Medicine, TAC S223B, 333 Cedar Street, New Haven, CT, 06520, USA
| | - Yasuko Iwakiri
- Department of Internal Medicine, Section of Digestive Diseases, Yale University School of Medicine, TAC S223B, 333 Cedar Street, New Haven, CT, 06520, USA.
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Chen Q, Mei L, Zhong R, Han P, Wen J, Han X, Zhai L, Zhao L, Li J. Serum liver fibrosis markers predict hepatic decompensation in compensated cirrhosis. BMC Gastroenterol 2023; 23:317. [PMID: 37726681 PMCID: PMC10510279 DOI: 10.1186/s12876-023-02877-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 07/10/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND AND AIM The literature is sparse on the association between serum liver fibrosis markers and the development of hepatic decompensation in patients with compensated cirrhosis. We aimed to assessed whether the serum liver fibrosis markers are predictive of the occurrence of hepatic decompensation. METHODS We ascertained 688 cirrhotic patients with varying etiologies, between December 2015 to December 2019. Serum hyaluronic acid (HA), laminin (LN), collagen IV (CIV), and N-terminal propeptide of type III collagen (PIIINP) levels were measured at enrollment. All subjects were followed for at least 6 months for occurrence of hepatic decompensation. Cox proportional hazard regression models were used to estimate the hazard ratios (HRs) of hepatic decompensation during follow-up. RESULTS During a median follow-up of 22.0 (13.0-32.0) months, decompensation occurred in 69 (10.0%) patients. Multivariate analysis indicated that higher LN (HR: 1.008, 95% confidence interval [CI]: 1.002-1.014, P = 0.011) and CIV (HR: 1.004, 95% CI: 1.001-1.007, P = 0.003) levels were independently associated with hepatic decompensation. Furthermore, patients in the tertile 2 and tertile 3 groups for CIV levels had HRs of 4.787 (1.419, 16.152) (P = 0.012) and 5.153 (1.508, 17.604) (P = 0.009), respectively, for occurrence of decompensation event compared with those in the tertile 1 group. CONCLUSION Serum liver fibrosis markers, particularly in CIV, appeared to be reliable biomarkers of disease progression and liver decompensation in patients with compensated cirrhosis with varying etiologies.
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Affiliation(s)
- Qingling Chen
- Clinical School of the Second People's Hospital, Tianjin Medical University, Tianjin, China
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, No.7, Sudi South Road, Nankai District, Tianjin, 300192, China
| | - Ling Mei
- Clinical School of the Second People's Hospital, Tianjin Medical University, Tianjin, China
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, No.7, Sudi South Road, Nankai District, Tianjin, 300192, China
| | - Rui Zhong
- Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Ping Han
- Clinical School of the Second People's Hospital, Tianjin Medical University, Tianjin, China
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, No.7, Sudi South Road, Nankai District, Tianjin, 300192, China
| | - Jun Wen
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, No.7, Sudi South Road, Nankai District, Tianjin, 300192, China
| | - Xu Han
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, No.7, Sudi South Road, Nankai District, Tianjin, 300192, China
| | - Lu Zhai
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, No.7, Sudi South Road, Nankai District, Tianjin, 300192, China
| | - Lili Zhao
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, No.7, Sudi South Road, Nankai District, Tianjin, 300192, China.
| | - Jia Li
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, No.7, Sudi South Road, Nankai District, Tianjin, 300192, China.
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Wong YJ, Chen Z, Li J, Liu C, Qi X, Chan YH. Reply: CHESS-ALARM score: Is it a 5-year prediction score? J Gastroenterol Hepatol 2022; 37:1405. [PMID: 35514323 DOI: 10.1111/jgh.15885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/02/2022] [Indexed: 02/05/2023]
Affiliation(s)
- Y J Wong
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore.,Duke-NUS Academic Medical Program, SingHealth, Singapore
| | - Z Chen
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - J Li
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, Tianjin, China
| | - C Liu
- CHESS Center Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou, China
| | - X Qi
- CHESS Center Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou, China
| | - Y H Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Wong YJ, Li J, Chen Z, Liu C, Qi X. Reply: CHESS-ALARM score: Can it raise the alarm accurately? J Gastroenterol Hepatol 2022; 37:1169. [PMID: 35434833 DOI: 10.1111/jgh.15863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 04/09/2022] [Indexed: 02/05/2023]
Affiliation(s)
- Y J Wong
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore.,Duke-NUS Academic Medical Program, SingHealth, Singapore
| | - J Li
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, Tianjin, China
| | - Z Chen
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - C Liu
- CHESS Center, Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou, China
| | - X Qi
- CHESS Center, Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou, China
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Giri S, Angadi S, Agrawal D. CHESS-ALARM Score: Can it raise the ALARM accurately? J Gastroenterol Hepatol 2022; 37:955. [PMID: 35352409 DOI: 10.1111/jgh.15840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 03/28/2022] [Indexed: 12/09/2022]
Affiliation(s)
- S Giri
- Department of Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - S Angadi
- Department of Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - D Agrawal
- Department of Gastroenterology, PACE Hospital, Hyderabad, India
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Tan CK. CHESS-ALARM score: Is it a 5-year prediction score? J Gastroenterol Hepatol 2022; 37:956. [PMID: 35373380 DOI: 10.1111/jgh.15845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 03/28/2022] [Indexed: 12/09/2022]
Affiliation(s)
- C-K Tan
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore
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