Transient elastography to assess liver stiffness in patients with inflammatory bowel disease

Berrie Meijer, Charlotte K. van Everdingen, Dewkoemar Ramsoekh, Catherine Stedman, Christopher M.A. Frampton, Chris J.J. Mulder, Gerd Bouma, Nanne K.H. de Boer, Richard B. Gearry

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Liver injury during inflammatory bowel disease (IBD) is primarily diagnosed by liver biopsy, which has a small but serious risk of severe complications. The aim of this study was to assess liver stiffness, and subsequently the prevalence and associations of liver fibrosis in IBD patients with thiopurine therapy and other clinical factors, by using transient elastography (TE). Methods: In this prospective, international two-center study, included IBD-patients underwent TE measurements. Laboratory results and medication reports, radiology results and historical liver biopsy results were extracted from the patient charts. Results: Transient elastography results of 168 patients were presented. Moderate and severe fibrosis were detected in 4% (7/168) and 1% (1/168) of the cohort, respectively. Factors contributing to lower liver stiffness were female gender and (historical) exposure to azathioprine. Further, there was a statistical trend towards lower liver stiffness in patients using thiopurines overall (4.7 vs. 5.2. kPa, p = 0.07). Liver stiffness correlated positively with waist circumference, liver enzyme tests, hemoglobin and 6-methylmercaptopurine concentration and negatively with platelet count. Conclusion: Exposure to thiopurine therapy was not associated with higher liver stiffness, although no clinical difference in severity of fibrosis was detected. Further research should robustly determine the accuracy of TE as an evaluation of liver fibrosis in IBD patients.

Original languageEnglish
Pages (from-to)48-53
Number of pages6
JournalDigestive and Liver Disease
Volume50
Issue number1
DOIs
Publication statusPublished - 1 Jan 2018

Cite this

Meijer, Berrie ; van Everdingen, Charlotte K. ; Ramsoekh, Dewkoemar ; Stedman, Catherine ; Frampton, Christopher M.A. ; Mulder, Chris J.J. ; Bouma, Gerd ; de Boer, Nanne K.H. ; Gearry, Richard B. / Transient elastography to assess liver stiffness in patients with inflammatory bowel disease. In: Digestive and Liver Disease. 2018 ; Vol. 50, No. 1. pp. 48-53.
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title = "Transient elastography to assess liver stiffness in patients with inflammatory bowel disease",
abstract = "Background: Liver injury during inflammatory bowel disease (IBD) is primarily diagnosed by liver biopsy, which has a small but serious risk of severe complications. The aim of this study was to assess liver stiffness, and subsequently the prevalence and associations of liver fibrosis in IBD patients with thiopurine therapy and other clinical factors, by using transient elastography (TE). Methods: In this prospective, international two-center study, included IBD-patients underwent TE measurements. Laboratory results and medication reports, radiology results and historical liver biopsy results were extracted from the patient charts. Results: Transient elastography results of 168 patients were presented. Moderate and severe fibrosis were detected in 4{\%} (7/168) and 1{\%} (1/168) of the cohort, respectively. Factors contributing to lower liver stiffness were female gender and (historical) exposure to azathioprine. Further, there was a statistical trend towards lower liver stiffness in patients using thiopurines overall (4.7 vs. 5.2. kPa, p = 0.07). Liver stiffness correlated positively with waist circumference, liver enzyme tests, hemoglobin and 6-methylmercaptopurine concentration and negatively with platelet count. Conclusion: Exposure to thiopurine therapy was not associated with higher liver stiffness, although no clinical difference in severity of fibrosis was detected. Further research should robustly determine the accuracy of TE as an evaluation of liver fibrosis in IBD patients.",
keywords = "Crohn's disease, Inflammatory bowel disease, Liver fibrosis, Liver stiffness, Thiopurines, Transient elastography, Ulcerative colitis",
author = "Berrie Meijer and {van Everdingen}, {Charlotte K.} and Dewkoemar Ramsoekh and Catherine Stedman and Frampton, {Christopher M.A.} and Mulder, {Chris J.J.} and Gerd Bouma and {de Boer}, {Nanne K.H.} and Gearry, {Richard B.}",
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doi = "10.1016/j.dld.2017.09.128",
language = "English",
volume = "50",
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journal = "Digestive and Liver Disease",
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Transient elastography to assess liver stiffness in patients with inflammatory bowel disease. / Meijer, Berrie; van Everdingen, Charlotte K.; Ramsoekh, Dewkoemar; Stedman, Catherine; Frampton, Christopher M.A.; Mulder, Chris J.J.; Bouma, Gerd; de Boer, Nanne K.H.; Gearry, Richard B.

In: Digestive and Liver Disease, Vol. 50, No. 1, 01.01.2018, p. 48-53.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Transient elastography to assess liver stiffness in patients with inflammatory bowel disease

AU - Meijer, Berrie

AU - van Everdingen, Charlotte K.

AU - Ramsoekh, Dewkoemar

AU - Stedman, Catherine

AU - Frampton, Christopher M.A.

AU - Mulder, Chris J.J.

AU - Bouma, Gerd

AU - de Boer, Nanne K.H.

AU - Gearry, Richard B.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Liver injury during inflammatory bowel disease (IBD) is primarily diagnosed by liver biopsy, which has a small but serious risk of severe complications. The aim of this study was to assess liver stiffness, and subsequently the prevalence and associations of liver fibrosis in IBD patients with thiopurine therapy and other clinical factors, by using transient elastography (TE). Methods: In this prospective, international two-center study, included IBD-patients underwent TE measurements. Laboratory results and medication reports, radiology results and historical liver biopsy results were extracted from the patient charts. Results: Transient elastography results of 168 patients were presented. Moderate and severe fibrosis were detected in 4% (7/168) and 1% (1/168) of the cohort, respectively. Factors contributing to lower liver stiffness were female gender and (historical) exposure to azathioprine. Further, there was a statistical trend towards lower liver stiffness in patients using thiopurines overall (4.7 vs. 5.2. kPa, p = 0.07). Liver stiffness correlated positively with waist circumference, liver enzyme tests, hemoglobin and 6-methylmercaptopurine concentration and negatively with platelet count. Conclusion: Exposure to thiopurine therapy was not associated with higher liver stiffness, although no clinical difference in severity of fibrosis was detected. Further research should robustly determine the accuracy of TE as an evaluation of liver fibrosis in IBD patients.

AB - Background: Liver injury during inflammatory bowel disease (IBD) is primarily diagnosed by liver biopsy, which has a small but serious risk of severe complications. The aim of this study was to assess liver stiffness, and subsequently the prevalence and associations of liver fibrosis in IBD patients with thiopurine therapy and other clinical factors, by using transient elastography (TE). Methods: In this prospective, international two-center study, included IBD-patients underwent TE measurements. Laboratory results and medication reports, radiology results and historical liver biopsy results were extracted from the patient charts. Results: Transient elastography results of 168 patients were presented. Moderate and severe fibrosis were detected in 4% (7/168) and 1% (1/168) of the cohort, respectively. Factors contributing to lower liver stiffness were female gender and (historical) exposure to azathioprine. Further, there was a statistical trend towards lower liver stiffness in patients using thiopurines overall (4.7 vs. 5.2. kPa, p = 0.07). Liver stiffness correlated positively with waist circumference, liver enzyme tests, hemoglobin and 6-methylmercaptopurine concentration and negatively with platelet count. Conclusion: Exposure to thiopurine therapy was not associated with higher liver stiffness, although no clinical difference in severity of fibrosis was detected. Further research should robustly determine the accuracy of TE as an evaluation of liver fibrosis in IBD patients.

KW - Crohn's disease

KW - Inflammatory bowel disease

KW - Liver fibrosis

KW - Liver stiffness

KW - Thiopurines

KW - Transient elastography

KW - Ulcerative colitis

UR - http://www.scopus.com/inward/record.url?scp=85031422193&partnerID=8YFLogxK

U2 - 10.1016/j.dld.2017.09.128

DO - 10.1016/j.dld.2017.09.128

M3 - Article

VL - 50

SP - 48

EP - 53

JO - Digestive and Liver Disease

JF - Digestive and Liver Disease

SN - 1590-8658

IS - 1

ER -