Ayşe Selcan KOÇ, Derya DEMIRTAS, Hilmi Erdem SUMBUL

Non-Alkolik Yağlı Karaciğer Hastalığında Fibrozisin Değerlendirilmesinde Karaciğer Elastografi Point Quantification Ölçümünün Rolü ve Diğer Non-İnvazif Yöntemlerle Karşılaştırılması

Amaç: Bu çalışmanın amacı; yeni bir karaciğer sertlik LS ölçümü incelemesi olan elastografi point quantification ElastPQ yönteminin non-alkolik yağlı karaciğer hastalığında NAFLD kullanılabilirliğinin tespiti ve bu incelemenin diğer non-invaziv karaciğer fibrozis LF incelemeleri ile karşılaştırılmasıdır.Gereç ve Yöntemler: Çalışmaya NAFLD olan ve olmayan 108 hasta alındı. LS ölçümü ElastPQ yöntemi ile yapıldı. Hastalara noninvaziv LF incelemelerinden; AST/Platelet oranı indeksi APRI , Fibrosis-4 FIB-4 indeksi, NAFLD fibrozis skoru, AST/ALT oranı ve BARD skoru değerlendirildi.Bulgular: Karaciğer boyutu, LS, APRI, FIB-4 indeksi, NAFLD fibrozis skoru, AST/ALT oranı ve BARD skoru değerlerinin hepsi NAFLD olan hastalarda olmayanlara göre belirgin olarak yüksekti. Bu parametrelerden sadece LS’ nin NAFLD olma durumunu bağımsız olarak belirlediği saptandı. LS’ da her 0.5 kPa artış NAFLD olma durumunu 2.12 kat artırdığı tespit edildi. LS’ nin NAFLD belirlemesi için ROC analizi yapıldığında, ROC eğri altında kalan alanın 0.967 olduğu ve LS için sınır değer 5 kPa olarak alındığında NAFLD olma riskini %88.9 duyarlılık ve %94.4 özgüllük ile belirlediği saptandı. Ayrıca HbA1c, LDL kolesterol, FIB-4 indeksi, NAFLD fibrosis skoru ve BARD skorunun, LS ile yakın ve bağımsız ilişkili olduğu bulundu.Sonuç: ElastoPQ yöntemi ile ölçülen LS değeri NAFLD varlığını diğer non-invasiv LF incelmelerinden daha iyi ve bağımsız olarak belirler. Aynı zamanda, LS değeri non-invasiv LF belirleyicilerinden FIB-4 indeks, NAFLD fibrozis skoru ve BARD skoru ile yakın olarak ilişkilidir

Anahtar Kelimeler:

Non-alkolik yağlı karaciğer hastalığı, Karaciğer sertliği, Karaciğer elastografi, Non-invaziv karaciğer fibrozis incelemeleri

The Role of Liver Elastography Point Quantification in the Assessment of Fibrosis in Non-Alcoholic Fatty Liver Disease and Comparison with Other Non-Invasive Methods

Objective: The aim of this study was to determine the availability of a new liver stiffness LS measurement, the elastography point quantification ElastPQ method, in non-alcoholic fatty liver disease NAFLD and to compare it with other noninvasive Liver fibrosis LF investigations.Material and Methods: A total of 108 patients with or without NAFLD were included in this study. LS measurement was done by the ElastPQ method. Noninvasive LF investigations; the AST/Platelet-ratio-index APRI , Fibrosis-4 FIB-4 index, NAFLD fibrosis score, AST/ALT ratio and BARD score were evaluated. Results: Liver size, LS, APRI, FIB-4 index, NAFLD fibrosis score, AST/ALT ratio and BARD score were all significantly higher in NAFLD patients. It was determined that only LS among these parameters independently determined the NAFLD status. It was found that each 0.5-kPa increase in LS increased the risk of having NAFLD 2.12 fold. When the ROC analysis was performed for the NAFLD determination of the LS value, it was determined that the area under the ROC curve was 0.967, and when the limit value for LS was taken as 5-kPa, the risk of having NAFLD was determined with 88.9% sensitivity and 94.4% specificity. Conclusion: The LS value obtained by ElastPQ has high diagnostic accuracy for NAFLD and performs better than other noninvasive laboratory methods in the assessment of NAFLD. At the same time, the LS value is closely related to the FIB-4 index, NAFLD fibrosis score and BARD score

Keywords:

Non-alcoholic fatty liver disease, Liver stiffness, Elastography, Non-invasive liver fibrosis investigations,

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