Food intake increases liver stiffness in patients with chronic or resolved hepatitis C virus infection
Food intake increases liver stiffness in patients with chronic or resolved hepatitis C virus infection
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DOI：
10.1111/j.1478-3231.2009.02100.x
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发表时间：
2009-11-01
影响因子：
6.7
通讯作者：
Bahr, Matthias J.
中科院分区：
文献类型：
--
作者：
Mederacke, Ingmar;Wursthorn, Karsten;Bahr, Matthias J.
背景和目的瞬时弹性成像越来越多地用于慢性肝病患者。它已被证明对识别晚期纤维化或肝硬化患者特别有用，而无纤维化或轻度纤维化的分类似乎很困难。一般来说，硬度值< 6 kPa被认为是正常的，而硬度值较高的患者则需要进行特定疾病的治疗或进一步的诊断评估。影响肝脏硬度的参数可能包括增加肝脏血流的食物摄入量。方法在一项初步研究中，对8名慢性丙型肝炎患者进行了短暂弹性成像，在禁食和连续摄入标准化早餐后180分钟。验证，56例患者和19例对照组分别在空腹、餐后直接和早餐后1小时进行肝硬度测定。结果银硬度在进食60 min后立即显著升高（P=0.01）， 180 min后恢复正常。个体内部分析显示，43例初始肝硬度< 10 kPa的患者中有22例显著增加。43例初始僵硬度< 10 kPa的患者中有24例（56%）在进食后至少增加1 kPa。值得注意的是，23例（39%）初始肝硬度正常（< 6 kPa）的患者中有9例在食物摄入后的值为bbbb6 kPa，这可能导致不必要的治疗或诊断程序。结论食物摄入可增加丙型肝炎病毒感染者和健康对照者的肝脏僵硬度。为了使肝硬度评估标准化，我们建议在禁食状态下进行测量。
Background and aimsTransient elastography is increasingly being used in patients with chronic liver disease. It has proven particularly useful to identify patients with advanced fibrosis or cirrhosis, while classification of no or little fibrosis appears to be difficult. In general, stiffness values < 6 kPa are considered normal, whereas patients with higher levels are candidates for a disease-specific treatment or further diagnostic evaluation. Parameters influencing liver stiffness may include food intake that increases liver blood flow.MethodsIn a pilot study, transient elastography was performed in eight patients with chronic hepatitis C at fasting and serially for 180 min after intake of a standardized breakfast. Confirmatory, 56 patients and 19 controls underwent liver stiffness determination at fasting, directly after meal intake and 1 h after breakfast.ResultsLiver stiffness significantly increased immediately after food intake for up to 60 min (P=0.01) before normalizing after 180 min. An intraindividual analysis showed a significant increase in 22 out of 43 patients with an initial liver stiffness < 10 kPa. An increase of at least 1 kPa after food intake was found in 24 out of 43 (56%) patients with initial stiffness < 10 kPa. Notably, nine out of 23 (39%) patients with normal initial liver stiffness (< 6 kPa) had a value of > 6 kPa after food intake, potentially leading to unnecessary treatment or diagnostic procedures.ConclusionFood intake increases liver stiffness in patients with hepatitis C virus infection and healthy controls. To standardize liver stiffness evaluation, we suggest measurement in the fasting condition.