The new combined parameter of hepatic and splenic elastography in patients with non-alcoholic fatty liver disease
Objective of this study was is estimate the SSM/LSM ratio (SSM - splenic stiffness measurement, LSM - liver stiffness measurement) for patients with nonalcoholic fatty liver disease (NAFLD) who had evidence of fibrosis on elastography as determined by the ARFI technique with a view to searching for a possible relationship between the calculated readings, clinical, and laboratory parameters defining its impact on morbidity status. Materials and methods. Three hundred patients with NAFLD at different stages of fibrosis underwent liver stiffness and splenic stiffness measurements by ARFI. Results. SSM/LSM decreased from 5.02 (in F0 patients) to 1.11 (in F4) (p<0.001). The ratio showed moderate negative correlation with ALT (р=-0,324, p<0,001), AST (р=-0,373, p<0,001), APRI (AST/platelet count) (р=-0,431, p<0,001) and weak positive correlation with PLT count (р=0,274, p<0,001). In patients with fibrosis this ratio was higher in the presence of obesity (3,43±1,34) than in patients without it (2,61±1,21) (p=0,025). Conclusion. The numerical parameter SSM/LSM calculated from liver stiffness and splenic stiffness can be significantly reduced at advanced stages of fibrosis (1,34 (1,08;0,96;1,58) for F3 and 1,11 (0,81;0,69;1,33) for F4 providing a positive indicator of deteriorating liver disease in patients with NAFLD. In addition, the presence or absence of obesity as co-morbidity affects the degree of SSM/LSM reduction in patients with NAFLD.