• Nutrition · Jul 2019

    Intestinal failure-associated liver disease in patients with short bowel syndrome: Evaluation by transient elastography.

    • Viola Knop, Sophie-Charlott Neuberger, Sabine Marienfeld, Jörg Bojunga, Eva Herrmann, Thierry Poynard, Stefan Zeuzem, Irina Blumenstein, and Mireen Friedrich-Rust.
    • Medizinische Klinik 1, Universitätsklinikum, Frankfurt, Germany. Electronic address: viola.knop@kgu.de.
    • Nutrition. 2019 Jul 1; 63-64: 134-140.

    ObjectivePatients with short bowel syndrome (SBS) receiving long-term parenteral nutrition (PN) are at risk for intestinal failure-associated liver disease (IFALD). The aim of the present study was to evaluate dynamic changes of liver fibrosis and steatosis within 12 mo by transient elastography (TE), including controlled attenuation parameter (CAP) in a cohort of patients with SBS receiving long-term PN.MethodsTwenty-five adult patients with SBS and PN requirement for ≥3 mo consecutively were included and prospectively followed. Liver stiffness by FibroScan (Echosens, Paris, France) and CAP measurement were done at study entry and after 12 mo. Clinical parameters, as well as data on underlying bowel disease and nutrition composition, were collected. Bioelectrical impedance analysis was performed in all patients.ResultsFibroScan and CAP did not show any significant differences after 12 mo (5.2 kPa [2.8-16.2 kPa]; 223dB/m [101-366 dB/m]) compared with study entry (5.3 kPa [2.7-12.3 kPa]; 237dB/m [100-344 dB/m]). There was no significant correlation between FibroScan and CAP and elevated transaminase levels. CAP significantly correlated with triacylglyceride levels (r = 0.411; P = 0.042) and body mass index (r = 0.468; P = 0.016). Patients with a remnant small bowel <100cm showed a significantly higher stiffness value by FibroScan than those having a remnant length ≥100cm (6.1 versus 4.7 kPa; P = 0.028).ConclusionIn the present study cohort, prevalence of advanced fibrosis or cirrhosis was low (<10%) without significant dynamic within the 12-mo follow-up. Short intestinal remnant length <100cm appeared to be a risk factor for development of fibrosis.Copyright © 2019 Elsevier Inc. All rights reserved.

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