Accuracy of controlled attenuation parameter measurement for the detection of steatosis in autoimmune liver diseases

• DOI: 10.1016/j.jhepr.2023.100898
• Publication Date: 2023-08-29T16:49:12Z
• Authors: Silja Steinmann; Johannes Hartl; Sören Weidemann; Katja Füssel; Claudia Kroll; Marcial Sebode; Ansgar Wilhelm Lohse; Christoph Schramm
• Keywords: Steatosis; Autoimmune Hepatitis; Liver steatosis

Concurrent fatty liver disease represents an emerging challenge in the care of individuals with autoimmune diseases (AILD). Therefore, we aimed to validate ultrasound-based method controlled-attenuation parameter (CAP) as a non-invasive tool detect hepatic steatosis AILD.The diagnostic performance CAP determine biopsy-proven (>5%) was assessed AILD (autoimmune hepatitis [AIH], primary biliary cholangitis [PBC], [PSC], or variant syndromes) who underwent biopsy at University Medical Center Hamburg-Eppendorf between 2015-2020 by calculating area under receiver operating characteristic (AUROC) curves. In AIH, impact activity evaluated assessment upon resolution inflammation during follow-up.Overall, 433 (AIH: 218, PBC: 51, PSC: 85, PBC/AIH: 63, PSC/AIH: 16) were included. Histologically proven present 90 (20.8%). Steatosis less frequently observed people PSC (14%) than other AILD. values correlated positively grade (ρ = 0.39) and BMI 0.53). PBC PSC, ROC curves defined AUROC 0.81 0.93 for detecting optimal cut-off 276 dB/m (sensitivity: 0.71; specificity: 0.82) 254 0.91, 0.85), respectively. significantly lower (AUROC 0.72, p 0.009). However, treatment associated significant increase levels (median [IQR]: +38.0 [6-81] dB/m) considerably improved accuracy 0.85; cut-off: 288 dB/m; sensitivity: 0.67, 0.90).In can be reliably detected applying disease-specific thresholds CAP. is moderate diagnosis, but improves after acute has resolved.Non-invasive estimation fat content performed (CAP). Here, showed that presence concomitant frequent determined best predict liver. measurement shown valid PBC; however, had limited especially when inflammatory context substantial inflammation, therefore, should interpreted caution, measurements repeated resolved.