Year 2024 / Volume 116 / Number 8
Original
Prognostic value of liver stiffness in metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis

416-422

DOI: 10.17235/reed.2024.10353/2024

Yijun Mu, Cheng Peng, Huijun Chang, Shaotong Wang, Xiuli Zuo,

Abstract
Background and aims: liver stiffness measurement, assessed by vibration-controlled transient elastography, has been recognized as a powerful tool for liver fibrosis assessment. The potential of liver stiffness measurement to predict clinically relevant outcomes in fatty liver disease has received considerable attention. This study aimed to investigate the prediction of liver-related events in metabolic dysfunction-associated steatotic liver disease patients by liver stiffness measurement value on transient elastography. Methods: the electronic databases including PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov until 6 September 2023 were systematically searched. The hazard ratios adjusted for confounders were extracted and pooled by random-effects model analysis. Results: a total of 20,587 individuals from seven studies were included. The pooled hazard ratios (HRs) were 18.65 (95 % CI: 9.95-34.95, p < 0.01, I2 = 0 %) in the stratification analysis of the highest versus lowest liver stiffness measurement categories. In 1-kPa analysis, the risk of liver-related events was increased with 1 kPa increment (HR 1.05, 95 % CI: 1.03-1.07, p < 0.01, I2 = 74.47 %). Conclusions: metabolic dysfunction-associated steatotic liver disease patients with high liver stiffness measurement values were at an increased risk of liver-related events. Liver stiffness measurement can be used as a prognostic tool to achieve risk stratification in fatty liver patients.
Lay Summary
Metabolic dysfunction–associated steatotic liver disease is a widespread chronic liver disease. Liver stiffness measurement, assessed by vibration-controlled transient elastography, has been recognized as a powerful tool for liver fibrosis assessment. The potential of liver stiffness measurement to predict clinically relevant outcomes in fatty liver disease has received considerable attention. A systematic review and meta-analysis was performed to investigate the value of liver stiffness measurement in predicting liver-related events in metabolic dysfunction–associated steatotic liver disease patients. A total of 20587 individuals from 7 studies were included. The pooled HRs were 18.65 (95% CI 9.95-34.95, P < 0.01, I2 = 0%) in the stratification analysis of the highest versus lowest liver stiffness measurement categories. In 1-kPa analysis, the risk of liver-related events was increased with 1 kPa increment (HR 1.05, 95% CI 1.03-1.07, P < 0.01, I2 = 74.47%). Our study demonstrated that high liver stiffness measurement values were associated with an increased risk of liver-related events in patients with metabolic dysfunction–associated steatotic liver disease.
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References
1.Riazi K, Azhari H, Charette JH, et al. The prevalence and incidence of NAFLD worldwide: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2022;7:851-861.
2.Rinella ME, Lazarus JV, Ratziu V, et al. NAFLD Nomenclature consensus group. A multi-society Delphi consensus statement on new fatty liver disease nomenclature. Hepatology. 2023;78:1966–1986
3.Ratziu V, Boursier J. Confirmatory biomarker diagnostic studies are not needed when transitioning from NAFLD to MASLD. J Hepatol 2024;80:e51-e52.
4.Song SJ, Lai JC, Wong GL, et al. Can we use old NAFLD data under the new MASLD definition? J Hepatol 2024;80:e54-e56.
5.Ong JP, Pitts A, Younossi ZM. Increased overall mortality and liver-related mortality in non-alcoholic fatty liver disease. J Hepatol 2008;49:608-12.
6.Ekstedt M, Hagström H, Nasr P, et al. Fibrosis stage is the strongest predictor for disease-specific mortality in NAFLD after up to 33 years of follow-up. Hepatology 2015;61:1547-54.
7.Angulo P, Kleiner DE, Dam-Larsen S, et al. Liver Fibrosis, but No Other Histologic Features, Is Associated With Long-term Outcomes of Patients With Nonalcoholic Fatty Liver Disease. Gastroenterology 2015;149:389-397.e310.
8.Hagström H, Kechagias S, Ekstedt M. Risk for hepatic and extra-hepatic outcomes in nonalcoholic fatty liver disease. J Intern Med 2022;292:177-189.
9.Taylor RS, Taylor RJ, Bayliss S, et al. Association Between Fibrosis Stage and Outcomes of Patients With Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis. Gastroenterology 2020;158:1611-1625.e12.
10.Bruzzi JF, O'Connell M, Murray JG. Liver biopsy. N Engl J Med 2001;344:2030.
11.Mueller M, Kratzer W, Oeztuerk S, et al. Percutaneous ultrasonographically guided liver punctures: an analysis of 1961 patients over a period of ten years. BMC Gastroenterol 2012;12:173.
12.Ratziu V, Charlotte F, Heurtier A, et al. Sampling variability of liver biopsy in nonalcoholic fatty liver disease. Gastroenterology 2005;128:1898-906.
13.Vuppalanchi R, Siddiqui MS, Van Natta ML, et al. Performance characteristics of vibration-controlled transient elastography for evaluation of nonalcoholic fatty liver disease. Hepatology 2018;67:134-144.
14.Boursier J, Vergniol J, Guillet A, et al. Diagnostic accuracy and prognostic significance of blood fibrosis tests and liver stiffness measurement by FibroScan in non-alcoholic fatty liver disease. J Hepatol 2016;65:570-8.
15.Shili-Masmoudi S, Wong GL, Hiriart JB, et al. Liver stiffness measurement predicts long-term survival and complications in non-alcoholic fatty liver disease. Liver Int 2020;40:581-589.
16.Johnson AL, Hayward KL, Patel P, et al. Predicting Liver-Related Outcomes in People With Nonalcoholic Fatty Liver Disease: The Prognostic Value of Noninvasive Fibrosis Tests. Hepatol Commun 2022;6:728-739.
17.Petta S, Sebastiani G, Viganò M, et al. Monitoring Occurrence of Liver-Related Events and Survival by Transient Elastography in Patients With Nonalcoholic Fatty Liver Disease and Compensated Advanced Chronic Liver Disease. Clin Gastroenterol Hepatol 2021;19:806-815.e5.
18.Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Bmj 2021;372:n71.
19.Borenstein M, Hedges LV, Higgins JP, et al. A basic introduction to fixed-effect and random-effects models for meta-analysis. Res Synth Methods 2010;1:97-111.
20.Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. Bmj 2003;327:557-60.
21.Wells GA, Shea B, O’Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta analyses. Ottawa Hospital Research Institute, Ottawa (2011).
22.Egger M, Davey Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. Bmj 1997;315:629-34.
23.Lee JS, Sinn DH, Park SY, et al. Liver Stiffness-Based Risk Prediction Model for Hepatocellular Carcinoma in Patients with Nonalcoholic Fatty Liver Disease. Cancers (Basel) 2021;13.
24.Boursier J, Hagström H, Ekstedt M, et al.Non-invasive tests accurately stratify patients with NAFLD based on their risk of liver-related events. J Hepatol 2022;76:1013-1020.
25.Davitkov P, Hoffman K, Falck-Ytter Y, et al. Increasing liver stiffness is associated with higher incidence of hepatocellular carcinoma in hepatitis C infection and non-alcoholic fatty liver disease-A population-based study. PLoS One 2023;18(1):e0280647.
26.Pons M, Rivera-Esteban J, Manzano R, et al. Non-Invasive Tests of Liver Fibrosis Help in Predicting the Development of Hepatocellular Carcinoma among Patients with NAFLD. J Clin Med 2022;11.
27.Shalimar, Sheikh SS, Biswas S, et al. Incidence and Predictors of Liver-Related Events in Patients With Nonalcoholic Fatty Liver Disease. J Clin Exp Hepatol 2023;13:37-47.
28.Shen Y, Wu SD, Wu L, et al. The prognostic role of liver stiffness in patients with chronic liver disease: a systematic review and dose-response meta-analysis. Hepatol Int 2019;13:560-572.
29.Ciardullo S, Muraca E, Zerbini F, et al. Liver stiffness is associated with all-cause mortality in patients with NAFLD: A systematic review and meta-analysis. Liver Int 2023.
30.Roulot D, Costes JL, Buyck JF, et al. Transient elastography as a screening tool for liver fibrosis and cirrhosis in a community-based population aged over 45 years. Gut 2011;60:977-84.
31.EASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis - 2021 update. J Hepatol 2021;75:659-689.
32.Castera L, Friedrich-Rust M, Loomba R. Noninvasive Assessment of Liver Disease in Patients With Nonalcoholic Fatty Liver Disease. Gastroenterology 2019;156:1264-1281.e4.
33.de Franchis R, Bosch J, Garcia-Tsao G, Reiberger T, Ripoll C; Baveno VII Faculty. Baveno VII - Renewing consensus in portal hypertension. J Hepatol. 2022;76:959-974.
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Mu Y, Peng C, Chang H, Wang S, Zuo X. Prognostic value of liver stiffness in metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis. 10353/2024


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Publication history

Received: 20/02/2024

Accepted: 17/04/2024

Online First: 30/04/2024

Published: 01/08/2024

Article revision time: 53 days

Article Online First time: 70 days

Article editing time: 163 days


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