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Shear wave elastography reveals a high prevalence of liver fibrosis in overweight or obese Hispanic youth Cover

Shear wave elastography reveals a high prevalence of liver fibrosis in overweight or obese Hispanic youth

Journal of Ultrasonography
Volume 20 (2020): Issue 82 (January 2020)
By: Sanjeet Sandhu,  Carisse Orsi,  Gary L. Francis,  Zhu Wang,  Roman Fernandez and  Naim Alkhouri  
Open Access
|Sep 2020

Figures & Tables

Fig. 1.

The association between serum AST (U/L) and SWE score as measured using SWE in kPa. The overall association was not significant (p = 0.08) and there were several patients with elevation in SWE score, but normal AST, while others had marked elevations in AST, but no elevation in SWE score. AST – aspartate aminotransferase; SWE Score – liver stiffness measured in kilopascals (kPa)
The association between serum AST (U/L) and SWE score as measured using SWE in kPa. The overall association was not significant (p = 0.08) and there were several patients with elevation in SWE score, but normal AST, while others had marked elevations in AST, but no elevation in SWE score. AST – aspartate aminotransferase; SWE Score – liver stiffness measured in kilopascals (kPa)

Fig. 2.

The association between serum ALT (U/L) and SWE score as measured using SWE in kPa. The overall association was not significant (p = 0.07) and there were several patients with elevation in SWE score, but normal ALT, while others had marked elevations in ALT, but no elevation in SWE score. ALT – alanine aminotransferase; SWE Score – liver stiffness measured in kilopascals (kPa)
The association between serum ALT (U/L) and SWE score as measured using SWE in kPa. The overall association was not significant (p = 0.07) and there were several patients with elevation in SWE score, but normal ALT, while others had marked elevations in ALT, but no elevation in SWE score. ALT – alanine aminotransferase; SWE Score – liver stiffness measured in kilopascals (kPa)

Fig. 3.

The association between A1c (%) and SWE score as measured using SWE in kPa. The overall association was not significant (p = 0.44) and there were several patients with elevation in SWE score, but normal A 1c , while others had marked elevations in A 1c , but no elevation in SWE score. A 1c – glycohemoglobin; SWE Score – liver stiffness measured in kilopascals (kPa)
The association between A1c (%) and SWE score as measured using SWE in kPa. The overall association was not significant (p = 0.44) and there were several patients with elevation in SWE score, but normal A 1c , while others had marked elevations in A 1c , but no elevation in SWE score. A 1c – glycohemoglobin; SWE Score – liver stiffness measured in kilopascals (kPa)

Fig. 4.

The association between BMI SD and SWE score as measured using SWE in kPa. The overall association was not significant (p = 0.43) and there were several patients with elevation in SWE score, but only modest elevation in BMI SD (1.5–2.0), while others had marked elevations in BMI-SD (2.0–3.5), but no elevation in SWE score. BMI SD – body mass index standard deviation score for age; SWE Score – liver stiffness measured in kilopascals (kPa)
The association between BMI SD and SWE score as measured using SWE in kPa. The overall association was not significant (p = 0.43) and there were several patients with elevation in SWE score, but only modest elevation in BMI SD (1.5–2.0), while others had marked elevations in BMI-SD (2.0–3.5), but no elevation in SWE score. BMI SD – body mass index standard deviation score for age; SWE Score – liver stiffness measured in kilopascals (kPa)

Fig. 5.

The association between APRI and SWE score as measured using SWE in kPa. The overall association was not significant (p = 0.16) and there were several patients with elevation in SWE score, but normal APRI, while others had marked elevations in APRI, but no elevation in SWE score. SWE Score – liver stiffness measured in kilopascals (kPa); APRI – aspartate aminotransferase (AST)/platelet ratio index
The association between APRI and SWE score as measured using SWE in kPa. The overall association was not significant (p = 0.16) and there were several patients with elevation in SWE score, but normal APRI, while others had marked elevations in APRI, but no elevation in SWE score. SWE Score – liver stiffness measured in kilopascals (kPa); APRI – aspartate aminotransferase (AST)/platelet ratio index

Demographic and laboratory features of patients stratified by A1c

Entire cohort N = 67Group CNormal A1c (<5.7%) N = 35Mean ± SD (range)Group DAbnormal A1c (≥5.7%) N = 32Mean ± SD (range) P = for Group Cvs. Group D
Age (yr)13.59(8–18)12.97(8–18)14.25(8–18)0.087
GenderMale = 35Female = 32Males = 18Female = 14Males = 17Female = 180.529
BMI SDS2.49 ± 0.39(1.45–3.37)2.39 ± 0.38(1.45–3.11)2.53 ± 0.40(1.94–3.37)0.169
Serum ALT (U/L)78.48 ± 44.75(19–189)82.41 ± 45.63(19–185)74.16 ± 44.10(23–189)0.462
Serum AST (U/L)40.1 ± 22.1(11–110)40.09 ± 18.54(19–110)40.13 ± 25.74(11–106)0.994
A1c (%)5.77 ± 0.64(4.5–7.9)5.36 ± 0.23(4.5–5.6)6.19 ± 0.66(5.7–7.9)<0.001
SWE Score (kPa)5.61 ± 1.43(1.47–10.45)5.82 ± 1.48(2.69–10.45)5.39 ± 1.36(1.47–9.85)0.233
HOMA-IR10.62 ± 10.19(2.84–49.24)10.49 ± 12.04(2.84–49.24)10.84 ± 6.47(4.61–25.25)0.940
Vitamin D, 25OH (ng/mL)14.23 ± 5.44(6–28)11.80 ± 4.18(6–20)15.75 ± 5.65(7–28)0.025
Platelets (× 109 per liter)310 ± 75.50(187–490)299.89 ± 66.38(217–455)326.46 ± 76.01(187–490)0.303
APRI0.40 ± 0.25(0.12–1.19)0.42 ± 0.24(0.16–1.19)0.36 ± (0.28)(0.12–1.01)0.494
Metformin users81 patient7 patients0.016

Demographic and laboratory features of patients with (SWE Score >5_10 kPa) and without (SWE Score <5_1 kPa) suspected hepatic fibrosis

Entire cohort N = 67Group ANo suspected fibrosis(SWE score <5.10 kPa) N = 25Mean ± SD (range)Group BSuspected fibrosis(SWE score ≥5.10 kPa) N = 42Mean ± SD (range) P = for Group Avs. Group B
Age (yr)13.59(8–18)13.12 ± 2.80(8–18)13.88 ± 3.10(8–18)0.328
GenderMale = 35Female = 32Male = 15Female = 10Male = 20Female = 220.326
BMI SDS2.49 ± 0.39(1.45–3.37)2.42 ± 0.40(1.45–3.37)2.48 ± 0.38(1.66–3.22)0.603
Serum ALT (U/L)78.48 ± 44.75(19–189)60.04 U/L ± 41.01(19–181)89.27 U/L ± 43.75(23–189)0.010
Serum AST (U/L)40.1 ± 22.1(11–110)31.12 U/L ± 14.92(14–75)45.37 U/L ± 23.99(11–110)0.011
A1c (%)5.77 ± 0.64(4.5–7.9)5.71 ± 074(5.0–7.0)5.80 ± 0.74(4.5–7.9)0.557
SWE Score (kPa)5.61 ±1.43(1.47–10.45)4.47 ±0.83(1.47–5.06)6.28 ± 1.28(5.2–10.45)<0.001
HOMA-IR10.62 ± 10.19(2.84–49.24)14.25 ± 14.85(3.38–49.24)8.55 ± 4.36(2.84–17.40)0.215
Vitamin D, 25OH (ng/mL)14.23 ± 5.44(6–28)14.60 ± 5.42(7–28)14.00 ± 5.55(6–25)0.742
Platelets (× 109 per liter)310 ± 75.50(187–490)325.67 ± 45.40(276–452)301.70 ± 81.79(187–490)0.360
APRI0.40 ± 0.25(0.12–1.19)0.25± 0.13(0.12–0.38)0.49 ± 0.27(0.16–1.19)0.011
Metformin users82 patients6 patients0.442

Demographic and laboratory features of patients who underwent liver biopsy

Subjects with liver biopsy N = 5
Age (yr)14.00 (8–17)
Fibrosis stageStage 1= 4 patientsStage 2 = 1 patient
GenderMale = 3Female = 2
BMI SDS2.44 ± 0.55 (1.66–3.11)
Serum ALT (U/L)133.20 ± 49.70 (86–189)
Serum AST (U/l)76.40 ± 33.20 (34–110)
A1c (%)6.15 ± 0.93 (5.4–7.4)
SWE score (kPa)7.45 ± 1.43 (6.05–10.45)
Vitamin D 25OH (ng/mL)9.75 ± 2.22 (9–13)
Platelets (× 109 per liter)277.10 ± 76.07 (187–431)
AST/PLT ratio0.64 ± 0.41 (0.33–1.52)
Metformin users N = 2
DOI: https://doi.org/10.15557/jou.2020.0027 | Journal eISSN: 2451-070X | Journal ISSN: 2084-8404
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Language: English
Page range: 162 - 168
Submitted on: Mar 9, 2020
Accepted on: Jul 7, 2020
Published on: Sep 28, 2020
Published by: MEDICAL COMMUNICATIONS Sp. z o.o.
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
prediabetes,
fibrosis,
diabetes,
elastography,
Hispanic
Related subjects:
Medicine,
Basic medical science,
Basic medical science, other

© 2020 Sanjeet Sandhu, Carisse Orsi, Gary L. Francis, Zhu Wang, Roman Fernandez, Naim Alkhouri, published by MEDICAL COMMUNICATIONS Sp. z o.o.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

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