Association of liver stiffness measurement and serum biochemical parameters with nonalcoholic steatohepatitis

Objective To investigate the association of liver stiffness measurement( LSM) and serum biochemical parameters with hepatic steatosis,liver inflammation,and liver fibrosis in patients with nonalcoholic steatohepatitis( NASH). Methods A total of 520 patients with NASH who were treated in The Fifth Medical Center of Chinese PLA General Hospital from January 2007 to December 2018 were enrolled,and according to body mass index( BMI) with a cut-off value of 28 kg/m2,the patients were divided into obese group with 151 patients and non-obese group with 369 patients. All patients underwent liver biopsy,and LSM was measured within 3 days before biopsy. Serum biochemical parameters and general clinical data were collected before liver biopsy,and the noninvasive indices aspartate aminotransferase to platelet ratio index( APRI) and fibrosis-4( FIB-4) were calculated. The t-test was used for comparison of normally distributed continuous between groups,the nonparametric Mann-Whitney U test was used for comparison of non-normally distributed continuous between groups; the chi-square test was used for comparison of categorical data between groups. A Spearman rank correlation analysis was also performed. Results Alanine aminotransferase( ALT),aspartate aminotransferase,LSM,controlled attenuation parameter( CAP),spleen length,and APRI gradually increased with the increase in BMI( all P < 0. 05). The Spearman correlation analysis showed that LSM,ALT,BMI,and CAP were positively correlated with the degree of hepatic steatosis( r = 0. 263,0. 327,0. 184,and 0. 452,all P < 0. 05); LSM,ALT,and CAP were positively correlated with the degree of liver inflammation( r = 0. 357,0. 278,and 0. 121,all P < 0. 05); LSM,ALT,BMI,and CAP were positively correlated with the degree of liver fibrosis( r = 0. 500,0. 216,0. 248,and 0. 101,all P < 0. 05); age was negatively correlated with the degree of hepatic steatosis,liver inflammation,and liver fibrosis( r =-0. 344,-0. 129,and-0. 163,all P < 0. 05). Conclusion LSM,CAP,ALT,and age are significantly correlated with the degree of liver inflammation,liver fibrosis,and hepatic steatosis in NASH patients,and therefore,they can be used in noninvasive diagnostic and predictive models to access the severity of liver injury.