Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Kristof, A.
Non-invasive diagnosis of hepatic fibrosis in patients during alcohol detoxification therapy.
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2020. pp. 75
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Stauber Rudolf
- Altmetrics:
- Abstract:
- Introduction Alcohol-related liver disease is a common disease. Despite its high prevalence, research has not been focused on the topic. Simple, non-invasive detection methods must be evaluated and optimized in order to detect alcohol-related fibrosis in potentially reversible stages. The aim of this study was to determine the presence of fibrosis by non-invasive means in mostly asymptomatic alcoholics undergoing detoxification. Additionally, investigation of alterations in liver stiffness due to abstinence in a follow-up visit 3 months after the respective baseline visit was conducted. Finally, the role of PNPLA3 and SERPINA1 genotypes in fibrosis development was investigated. Methods 31 consecutive patients admitted for alcohol detoxification were enrolled. FIB-4 index was calculated using laboratory and clinical routine parameters. ELF-test was carried out on Advia Centaur XP (Siemens Healthcare Diagnostics, Vienna, Austria). SERPINA1 and PNPLA3 genotypes were analyzed in a routine laboratory test by 5'-exonuclease assays (TaqMan). VCTE was performed in patients after a fasting period of at least two hours with FibroScan® 502 Touch (Echosens, Paris, France). Statistical analyses were performed using IBM SPSS Statistics version 25 and 26. Results About 16% of the initial study population showed advanced fibrosis according to VCTE using a threshold of 15 kPa. Using a LS of 15 kPa as reference, for the detection of advanced fibrosis (F3, F4), ELF worked best using 10.5 as a cut-off (TPR = 80%, TNR = 100%, PPV = 100%, NPV = 96,2%). A FIB-4 cut-off value of 1.30 was found to be adequate for ruling out advanced fibrosis (TPR = 60%, TNR = 80,8%, PPV = 37,5%, NPV = 91,3%). FIB-4 increased, whilst ELF score and LS dropped after a period of 3 months. ALT (p = 0,020) and MCV (p = 0,016) significantly decreased following abstinence. Conclusion Introducing asymptomatic alcoholics to a liver clinic could be beneficial for their treatment. ELF and FIB-4 are adequate non-invasive tools for the detection of advanced fibrosis as defined by LS ≥ 15 kPa. The role of PNPLA3 and SERPINA1 genotypes could not adequately be determined in this study. A larger cohort must be investigated to generate reliable results on the topic.