Factors affecting the accuracy of Controlled Attenuation Parameter (CAP) in assessing hepatic steatosis in patients with chronic liver disease

Kyu Sik Jung, Beom Kyung Kim, Seungup Kim, Young Eun Chon, Kyung Hyun Cheon, Sung Bae Kim, Sang Hoon Lee, Sung Soo Ahn, Junyong Park, doyoung kim, SangHoon Ahn, Young Nyun Park, KwangHyub Han

Research output: Contribution to journalArticle

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Abstract

Background & Aims: Controlled attenuation parameter (CAP) can measure hepatic steatosis. However, factors affecting its accuracy have not been described yet. This study investigated predictors of discordance between liver biopsy (LB) and CAP. Methods: A total of 161 consecutive patients with chronic liver disease who underwent LB and CAP were enrolled prospectively. Histological steatosis was graded as S0 (<5%), S1 (5-33%), S2 (34-66%), and S3 (>66% of hepatocytes). Cutoff CAP values were calculated from our cohort (250, 301, and 325 dB/m for ≥S1, ≥S2, and S3). Discordance was defined as a discrepancy of at least two steatosis stages between LB and CAP. Results: The median age (102 males and 59 females) was 49 years. Repartition of histological steatosis was as follows; S0 26.1% (n = 42), S1 49.7% (n = 80), S2 20.5% (n = 33), and S3 3.7% (n = 6). In multivariate linear regression analysis, CAP value was independently associated with steatosis grade along with body mass index (BMI) and interquartile range/median of CAP value (IQR/MCAP) (all P<0.05). Discordance was identified in 13 (8.1%) patients. In multivariate analysis, histological S3 (odd ratio [OR], 9.573; 95% confidence interval [CI], 1.207-75.931; P = 0.033) and CAP value (OR, 1.020; 95% CI, 1.006-1.034; P = 0.006) were significantly associated with discordance, when adjusting for BMI, IQR/MCAP, and necroinflammation, reflected by histological activity or ALT level. Conclusions: Patients with high grade steatosis or high CAP values have a higher risk of discordance between LB and CAP. Further studies are needed to improve the accuracy of CAP interpretation, especially in patients with higher CAP values.

Original languageEnglish
Article numbere98689
JournalPloS one
Volume9
Issue number6
DOIs
Publication statusPublished - 2014 Jun 5

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fatty liver
liver diseases
Liver
Biopsy
Liver Diseases
biopsy
Chronic Disease
liver
odds ratio
body mass index
confidence interval
Body Mass Index
Odds Ratio
Confidence Intervals
hepatocytes
multivariate analysis
regression analysis
Linear regression
Regression analysis
Hepatocytes

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Jung, Kyu Sik ; Kim, Beom Kyung ; Kim, Seungup ; Chon, Young Eun ; Cheon, Kyung Hyun ; Kim, Sung Bae ; Lee, Sang Hoon ; Ahn, Sung Soo ; Park, Junyong ; kim, doyoung ; Ahn, SangHoon ; Park, Young Nyun ; Han, KwangHyub. / Factors affecting the accuracy of Controlled Attenuation Parameter (CAP) in assessing hepatic steatosis in patients with chronic liver disease. In: PloS one. 2014 ; Vol. 9, No. 6.
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title = "Factors affecting the accuracy of Controlled Attenuation Parameter (CAP) in assessing hepatic steatosis in patients with chronic liver disease",
abstract = "Background & Aims: Controlled attenuation parameter (CAP) can measure hepatic steatosis. However, factors affecting its accuracy have not been described yet. This study investigated predictors of discordance between liver biopsy (LB) and CAP. Methods: A total of 161 consecutive patients with chronic liver disease who underwent LB and CAP were enrolled prospectively. Histological steatosis was graded as S0 (<5{\%}), S1 (5-33{\%}), S2 (34-66{\%}), and S3 (>66{\%} of hepatocytes). Cutoff CAP values were calculated from our cohort (250, 301, and 325 dB/m for ≥S1, ≥S2, and S3). Discordance was defined as a discrepancy of at least two steatosis stages between LB and CAP. Results: The median age (102 males and 59 females) was 49 years. Repartition of histological steatosis was as follows; S0 26.1{\%} (n = 42), S1 49.7{\%} (n = 80), S2 20.5{\%} (n = 33), and S3 3.7{\%} (n = 6). In multivariate linear regression analysis, CAP value was independently associated with steatosis grade along with body mass index (BMI) and interquartile range/median of CAP value (IQR/MCAP) (all P<0.05). Discordance was identified in 13 (8.1{\%}) patients. In multivariate analysis, histological S3 (odd ratio [OR], 9.573; 95{\%} confidence interval [CI], 1.207-75.931; P = 0.033) and CAP value (OR, 1.020; 95{\%} CI, 1.006-1.034; P = 0.006) were significantly associated with discordance, when adjusting for BMI, IQR/MCAP, and necroinflammation, reflected by histological activity or ALT level. Conclusions: Patients with high grade steatosis or high CAP values have a higher risk of discordance between LB and CAP. Further studies are needed to improve the accuracy of CAP interpretation, especially in patients with higher CAP values.",
author = "Jung, {Kyu Sik} and Kim, {Beom Kyung} and Seungup Kim and Chon, {Young Eun} and Cheon, {Kyung Hyun} and Kim, {Sung Bae} and Lee, {Sang Hoon} and Ahn, {Sung Soo} and Junyong Park and doyoung kim and SangHoon Ahn and Park, {Young Nyun} and KwangHyub Han",
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Factors affecting the accuracy of Controlled Attenuation Parameter (CAP) in assessing hepatic steatosis in patients with chronic liver disease. / Jung, Kyu Sik; Kim, Beom Kyung; Kim, Seungup; Chon, Young Eun; Cheon, Kyung Hyun; Kim, Sung Bae; Lee, Sang Hoon; Ahn, Sung Soo; Park, Junyong; kim, doyoung; Ahn, SangHoon; Park, Young Nyun; Han, KwangHyub.

In: PloS one, Vol. 9, No. 6, e98689, 05.06.2014.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Factors affecting the accuracy of Controlled Attenuation Parameter (CAP) in assessing hepatic steatosis in patients with chronic liver disease

AU - Jung, Kyu Sik

AU - Kim, Beom Kyung

AU - Kim, Seungup

AU - Chon, Young Eun

AU - Cheon, Kyung Hyun

AU - Kim, Sung Bae

AU - Lee, Sang Hoon

AU - Ahn, Sung Soo

AU - Park, Junyong

AU - kim, doyoung

AU - Ahn, SangHoon

AU - Park, Young Nyun

AU - Han, KwangHyub

PY - 2014/6/5

Y1 - 2014/6/5

N2 - Background & Aims: Controlled attenuation parameter (CAP) can measure hepatic steatosis. However, factors affecting its accuracy have not been described yet. This study investigated predictors of discordance between liver biopsy (LB) and CAP. Methods: A total of 161 consecutive patients with chronic liver disease who underwent LB and CAP were enrolled prospectively. Histological steatosis was graded as S0 (<5%), S1 (5-33%), S2 (34-66%), and S3 (>66% of hepatocytes). Cutoff CAP values were calculated from our cohort (250, 301, and 325 dB/m for ≥S1, ≥S2, and S3). Discordance was defined as a discrepancy of at least two steatosis stages between LB and CAP. Results: The median age (102 males and 59 females) was 49 years. Repartition of histological steatosis was as follows; S0 26.1% (n = 42), S1 49.7% (n = 80), S2 20.5% (n = 33), and S3 3.7% (n = 6). In multivariate linear regression analysis, CAP value was independently associated with steatosis grade along with body mass index (BMI) and interquartile range/median of CAP value (IQR/MCAP) (all P<0.05). Discordance was identified in 13 (8.1%) patients. In multivariate analysis, histological S3 (odd ratio [OR], 9.573; 95% confidence interval [CI], 1.207-75.931; P = 0.033) and CAP value (OR, 1.020; 95% CI, 1.006-1.034; P = 0.006) were significantly associated with discordance, when adjusting for BMI, IQR/MCAP, and necroinflammation, reflected by histological activity or ALT level. Conclusions: Patients with high grade steatosis or high CAP values have a higher risk of discordance between LB and CAP. Further studies are needed to improve the accuracy of CAP interpretation, especially in patients with higher CAP values.

AB - Background & Aims: Controlled attenuation parameter (CAP) can measure hepatic steatosis. However, factors affecting its accuracy have not been described yet. This study investigated predictors of discordance between liver biopsy (LB) and CAP. Methods: A total of 161 consecutive patients with chronic liver disease who underwent LB and CAP were enrolled prospectively. Histological steatosis was graded as S0 (<5%), S1 (5-33%), S2 (34-66%), and S3 (>66% of hepatocytes). Cutoff CAP values were calculated from our cohort (250, 301, and 325 dB/m for ≥S1, ≥S2, and S3). Discordance was defined as a discrepancy of at least two steatosis stages between LB and CAP. Results: The median age (102 males and 59 females) was 49 years. Repartition of histological steatosis was as follows; S0 26.1% (n = 42), S1 49.7% (n = 80), S2 20.5% (n = 33), and S3 3.7% (n = 6). In multivariate linear regression analysis, CAP value was independently associated with steatosis grade along with body mass index (BMI) and interquartile range/median of CAP value (IQR/MCAP) (all P<0.05). Discordance was identified in 13 (8.1%) patients. In multivariate analysis, histological S3 (odd ratio [OR], 9.573; 95% confidence interval [CI], 1.207-75.931; P = 0.033) and CAP value (OR, 1.020; 95% CI, 1.006-1.034; P = 0.006) were significantly associated with discordance, when adjusting for BMI, IQR/MCAP, and necroinflammation, reflected by histological activity or ALT level. Conclusions: Patients with high grade steatosis or high CAP values have a higher risk of discordance between LB and CAP. Further studies are needed to improve the accuracy of CAP interpretation, especially in patients with higher CAP values.

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