Correlation of Transient Elastography With Severity of Cystic Fibrosis Related Liver Disease

Amal Aqul, Maureen M M Jonas, Sarah Harney, Roshan Raza, Gregory S S Sawicki, Paul D D Mitchell, Rima Fawaz

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

OBJECTIVE:: To evaluate whether liver stiffness measurement (LSM), determined by transient elastography (TE), correlates with presence and severity of liver disease (LD) in children and young adults with cystic fibrosis (CF). METHODS:: Subjects underwent LSM at routine CF visits. Presence and severity of CFLD was determined by clinical parameters. Subjects were classified as no CFLD, CFLD without portal hypertension (PHTN), and CFLD with PHTN. LSM was compared to AST/platelet ratio index (APRI) as a correlate to severity of CFLD. RESULTS:: 249 subjects [53%male; mean age 14?±?7y; 7(3%)?<?2y and 74(30%) 18–25y] underwent LSM. Subjects were classified as: 158(64%) with no CFLD, 73(29%) CFLD without PHTN and 18(7%) CFLD with PHTN. The median (interquartile range; IQR) LSM was different among the three groups: 4.4(3.8–5.4), 5.1(4.4–6.3) and 14.1(8.8–24.8)kPa, respectively, with all pairwise comparisons different from one another (P?<?0.0001). Similarly, median (IQR) APRI was different in groups 1 and 2 compared to CFLD with portal hypertension: 0.22(0.17–0.27), 0.24(0.17–0.33) and 0.53(0.24–0.84), respectively, (P?<?0.01). Analysis of receiver operating characteristics for discriminating CFLD with PHTN from the other groups resulted in cut-points at 6.2 kPa(LSM) and 0.35 (APRI). LSM was superior to APRI in discriminating CFLD with PHTN from other groups, with areas under the curve 0.91(LSM) vs. 0.78 (APRI) (P?=?0.05). CONCLUSIONS:: Liver stiffness, as determined by TE, correlates with the presence and severity of CFLD. Although APRI provided some information regarding severity of liver disease, LSM performed better than APRI in this population.

Original languageEnglish (US)
JournalJournal of Pediatric Gastroenterology and Nutrition
DOIs
StateAccepted/In press - Oct 25 2016

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Elasticity Imaging Techniques
Cystic Fibrosis
Liver Diseases
Portal Hypertension
Liver
Blood Platelets
ROC Curve
Area Under Curve
Young Adult

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Gastroenterology

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Correlation of Transient Elastography With Severity of Cystic Fibrosis Related Liver Disease. / Aqul, Amal; Jonas, Maureen M M; Harney, Sarah; Raza, Roshan; Sawicki, Gregory S S; Mitchell, Paul D D; Fawaz, Rima.

In: Journal of Pediatric Gastroenterology and Nutrition, 25.10.2016.

Research output: Contribution to journalArticle

Aqul, Amal ; Jonas, Maureen M M ; Harney, Sarah ; Raza, Roshan ; Sawicki, Gregory S S ; Mitchell, Paul D D ; Fawaz, Rima. / Correlation of Transient Elastography With Severity of Cystic Fibrosis Related Liver Disease. In: Journal of Pediatric Gastroenterology and Nutrition. 2016.
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abstract = "OBJECTIVE:: To evaluate whether liver stiffness measurement (LSM), determined by transient elastography (TE), correlates with presence and severity of liver disease (LD) in children and young adults with cystic fibrosis (CF). METHODS:: Subjects underwent LSM at routine CF visits. Presence and severity of CFLD was determined by clinical parameters. Subjects were classified as no CFLD, CFLD without portal hypertension (PHTN), and CFLD with PHTN. LSM was compared to AST/platelet ratio index (APRI) as a correlate to severity of CFLD. RESULTS:: 249 subjects [53{\%}male; mean age 14?±?7y; 7(3{\%})?<?2y and 74(30{\%}) 18–25y] underwent LSM. Subjects were classified as: 158(64{\%}) with no CFLD, 73(29{\%}) CFLD without PHTN and 18(7{\%}) CFLD with PHTN. The median (interquartile range; IQR) LSM was different among the three groups: 4.4(3.8–5.4), 5.1(4.4–6.3) and 14.1(8.8–24.8)kPa, respectively, with all pairwise comparisons different from one another (P?<?0.0001). Similarly, median (IQR) APRI was different in groups 1 and 2 compared to CFLD with portal hypertension: 0.22(0.17–0.27), 0.24(0.17–0.33) and 0.53(0.24–0.84), respectively, (P?<?0.01). Analysis of receiver operating characteristics for discriminating CFLD with PHTN from the other groups resulted in cut-points at 6.2 kPa(LSM) and 0.35 (APRI). LSM was superior to APRI in discriminating CFLD with PHTN from other groups, with areas under the curve 0.91(LSM) vs. 0.78 (APRI) (P?=?0.05). CONCLUSIONS:: Liver stiffness, as determined by TE, correlates with the presence and severity of CFLD. Although APRI provided some information regarding severity of liver disease, LSM performed better than APRI in this population.",
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T1 - Correlation of Transient Elastography With Severity of Cystic Fibrosis Related Liver Disease

AU - Aqul, Amal

AU - Jonas, Maureen M M

AU - Harney, Sarah

AU - Raza, Roshan

AU - Sawicki, Gregory S S

AU - Mitchell, Paul D D

AU - Fawaz, Rima

PY - 2016/10/25

Y1 - 2016/10/25

N2 - OBJECTIVE:: To evaluate whether liver stiffness measurement (LSM), determined by transient elastography (TE), correlates with presence and severity of liver disease (LD) in children and young adults with cystic fibrosis (CF). METHODS:: Subjects underwent LSM at routine CF visits. Presence and severity of CFLD was determined by clinical parameters. Subjects were classified as no CFLD, CFLD without portal hypertension (PHTN), and CFLD with PHTN. LSM was compared to AST/platelet ratio index (APRI) as a correlate to severity of CFLD. RESULTS:: 249 subjects [53%male; mean age 14?±?7y; 7(3%)?<?2y and 74(30%) 18–25y] underwent LSM. Subjects were classified as: 158(64%) with no CFLD, 73(29%) CFLD without PHTN and 18(7%) CFLD with PHTN. The median (interquartile range; IQR) LSM was different among the three groups: 4.4(3.8–5.4), 5.1(4.4–6.3) and 14.1(8.8–24.8)kPa, respectively, with all pairwise comparisons different from one another (P?<?0.0001). Similarly, median (IQR) APRI was different in groups 1 and 2 compared to CFLD with portal hypertension: 0.22(0.17–0.27), 0.24(0.17–0.33) and 0.53(0.24–0.84), respectively, (P?<?0.01). Analysis of receiver operating characteristics for discriminating CFLD with PHTN from the other groups resulted in cut-points at 6.2 kPa(LSM) and 0.35 (APRI). LSM was superior to APRI in discriminating CFLD with PHTN from other groups, with areas under the curve 0.91(LSM) vs. 0.78 (APRI) (P?=?0.05). CONCLUSIONS:: Liver stiffness, as determined by TE, correlates with the presence and severity of CFLD. Although APRI provided some information regarding severity of liver disease, LSM performed better than APRI in this population.

AB - OBJECTIVE:: To evaluate whether liver stiffness measurement (LSM), determined by transient elastography (TE), correlates with presence and severity of liver disease (LD) in children and young adults with cystic fibrosis (CF). METHODS:: Subjects underwent LSM at routine CF visits. Presence and severity of CFLD was determined by clinical parameters. Subjects were classified as no CFLD, CFLD without portal hypertension (PHTN), and CFLD with PHTN. LSM was compared to AST/platelet ratio index (APRI) as a correlate to severity of CFLD. RESULTS:: 249 subjects [53%male; mean age 14?±?7y; 7(3%)?<?2y and 74(30%) 18–25y] underwent LSM. Subjects were classified as: 158(64%) with no CFLD, 73(29%) CFLD without PHTN and 18(7%) CFLD with PHTN. The median (interquartile range; IQR) LSM was different among the three groups: 4.4(3.8–5.4), 5.1(4.4–6.3) and 14.1(8.8–24.8)kPa, respectively, with all pairwise comparisons different from one another (P?<?0.0001). Similarly, median (IQR) APRI was different in groups 1 and 2 compared to CFLD with portal hypertension: 0.22(0.17–0.27), 0.24(0.17–0.33) and 0.53(0.24–0.84), respectively, (P?<?0.01). Analysis of receiver operating characteristics for discriminating CFLD with PHTN from the other groups resulted in cut-points at 6.2 kPa(LSM) and 0.35 (APRI). LSM was superior to APRI in discriminating CFLD with PHTN from other groups, with areas under the curve 0.91(LSM) vs. 0.78 (APRI) (P?=?0.05). CONCLUSIONS:: Liver stiffness, as determined by TE, correlates with the presence and severity of CFLD. Although APRI provided some information regarding severity of liver disease, LSM performed better than APRI in this population.

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