부산대학교 도서관

Objective: We aimed to estimate the optimal cut‐off values of liver stiffness measurement (LSM) for diagnosing and staging fibrosis in non‐obese and obese patients with nonalcoholic fatty liver disease (NAFLD). Methods: NAFLD patients diagnosed by liver biopsy according to the Nonalcoholic Steatohepatitis Clinical Research Network scoring system were enrolled in this study. Non‐obesity was defined as a body mass index (BMI) less than 25 kg/m2. LSM was performed by experienced physicians within 2 weeks before or after liver biopsy. Results: A total of 158 patients were included. Average BMI of the non‐obese (n = 68) and obese (n = 90) groups was 23.2 ± 1.6 and 27.9 ± 2.5 kg/m2, respectively. After adjusted for age, fibrosis stage, steatosis grade and type 2 diabetes mellitus, the obese group had a LSM of 3.522 kPa higher than the non‐obese patients (P = 0.003). LSM values of the non‐obese patients had a lower trend when stratified by fibrosis stage, especially in cirrhosis (F4; P = 0.021). Applying separate cut‐off values for patients with NAFLD in individual fibrosis stage, 5.8 vs 7.5 kPa (≥ F1), 7.6 vs 8.5 kPa (≥ F2), 9.1 vs 11.2 kPa (≥ F3), and 12.5 vs 14.3 kPa (F4), improved their diagnostic odds ratios compared with overall cut‐off values. In the non‐obese NAFLD group, using a separate cut‐off avoided underestimating 9.1% of patients with cirrhosis. Conclusions: Non‐obese NAFLD group had lower LSM than the obese group. Different cut‐off values should be used to measure liver fibrosis stage in non‐obese and obese NAFLD patients. [ABSTRACT FROM AUTHOR]