In:
Journal of Gastroenterology and Hepatology, Wiley, Vol. 32, No. 10 ( 2017-10), p. 1746-1753
Abstract:
Transient elastography is the reference method for liver stiffness measurement (LSM) in the general population, having lower applicability in obese patients. We evaluated the applicability and diagnostic accuracy of the M and XL probes in overweight/obese patients to establish the most appropriate approach. Methods From May 2013 to March 2015, we evaluated patients with a body mass index (BMI) ≥ 28 kg/m 2 . We constructed an algorithm with variables independently related to unreliable LSM with the M probe. Results A total of 1084 patients were evaluated. M and XL probe applicability was 88.8% and 98%, respectively. Waist circumference (WC) (OR; 95% CI; P ) (0.97; 0.94–0.99; P 〈 0.001) and skin‐capsule distance (SCD) (0.83; 0.79–0.87; P 〈 0.001) were independently related to unreliable LSM (M probe). The SCD was 〉 25 mm in 5.5% of individuals with a BMI ≤ 35 kg/m 2 and a WC ≤ 117 cm, with LSM (M probe) applicability rising to 94.3%. In contrast, 36.9% of patients with a BMI 〉 35 kg/m 2 and/or a WC 〉 117 cm presented an SCD 〉 25 mm, with M probe applicability being 73.1%. The diagnostic accuracy (area under the receiver operator characteristic) using the M probe to identify significant steatosis (0.76), fibrosis (0.89), and cirrhosis (0.96) was very high in patients with a BMI ≤ 35 kg/m 2 and a WC ≤ 117 cm. Conclusions The applicability and accuracy of the FibroScan ® M probe to identify fibrosis and steatosis was excellent in overweight and obesity grade I (BMI ≤ 35 kg/m 2 ) with a WC ≤ 117 cm. The XL probe increased the applicability of transient elastography in obesity grade II–III (BMI 〉 35 kg/m 2 ).
Type of Medium:
Online Resource
ISSN:
0815-9319
,
1440-1746
DOI:
10.1111/jgh.2017.32.issue-10
Language:
English
Publisher:
Wiley
Publication Date:
2017
detail.hit.zdb_id:
2006782-3
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