Anne Chan

Alanine aminotransferase-based algorithms of liver stiffness measurement by transient elastography (Fibroscan) for liver fibrosis in chronic hepatitis B.

Summary.  The aim of this study is to know the liver stiffness measurement (LSM) cutoffs for different stages of liver fibrosis in chronic hepatitis B (CHB) and to investigate the effect of alanine aminotransferase (ALT) on LSM. We prospectively studied consecutive CHB patients undergoing liver biopsy and transient elastography examinations. Diagnostic performance of LSM for different degrees of liver fibrosis was evaluated. One hundred and sixty‐one CHB patients with adequate liver biopsy sample size were studied. Area under receiver operating characteristics curves of LSM for no fibrosis (F0 vs F1–4), bridging fibrosis (F0–2 vs F3–4) and liver cirrhosis (F0–3 vs F4) was 0.80 (95% CI: 0.68–0.92), 0.87 (95% CI: 0.82–0.93) and 0.93 (95% CI: 0.89–0.97) respectively. For liver cirrhosis, these optimal cutoff values were 8.4 kPa (98% sensitivity), 9.0 kPa (maximum sum of sensitivity and specificity), 13.4 kPa (94% specificity) and 13.4 kPa (maximum diagnostic accuracy, 85%) respectively. Patients with the same fibrosis staging but higher ALT levels tend to have higher LSM, and the diagnostic performance for low stage fibrosis was most seriously affected when ALT was elevated. Different LSM cutoff values and algorithms were derived for normal and elevated ALT levels. Based on these algorithms, liver biopsy can be avoided in 62% and 58% of patients with normal and elevated ALT respectively. In conclusion, transient elastography is a reasonable noninvasive tool to substitute liver biopsy among the lowest and highest risk patients for the assessment of liver fibrosis.

Development of a non-invasive algorithm with transient elastography (Fibroscan) and serum test formula for advanced liver fibrosis in chronic hepatitis B.

Aliment Pharmacol Ther 31, 1095–1103

Prevalence of undiagnosed diabetes and postchallenge hyperglycaemia in Chinese patients with non-alcoholic fatty liver disease.

Non‐alcoholic fatty liver disease is prevalent in affluent countries and is strongly associated with metabolic syndrome.

Metabolic and histological features of non‐alcoholic fatty liver disease patients with different serum alanine aminotransferase levels

Background  Non‐alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in affluent countries. Serum alanine aminotransferase (ALT) level is commonly performed to monitor NAFLD patients, but its clinical relevance is unclear.

Prospective outcome of rapid eye movement sleep behaviour disorder: psychiatric disorders as a potential early marker of Parkinson's disease

Increasing evidence suggests that rapid eye movement sleep behaviour disorder (RBD) is a heralding feature associated with evolving α-synucleinopathy-related neurodegenerative disorders.1–4 Several neurobiological markers such as olfactory abnormality were associated with the development of neurodegenerative disorders in ‘idiopathic’ RBD (iRBD) patients.5 On the other hand, pre-morbid psychiatric disorders were suggested as an important but often neglected preclinical marker of Parkinsons disease (PD),6 and its role is unclear in iRBD patients. The current study aimed to provide a quantitative risk estimate of neurodegenerative outcome, and to investigate the role of psychiatric disorders in predicting future neurodegenerative disorders in a prospective cohort of Hong Kong Chinese iRBD patients. Ninety-one iRBD patients (82.4% men) (recruited during 1994–2009) were prospectively followed-up with routine clinical assessments in our sleep centre for a mean duration of 5.6 years (SD 3.3).1 An additional research-based follow-up protocol has been implemented since 2008, which included neuropsychiatric examinations as conducted by the research …

PNPLA3 gene polymorphism accounts for fatty liver in community subjects without metabolic syndrome

The rs738409 GG variant in patatin‐like phospholipase 3 (PNPLA3) is associated with non‐alcoholic fatty liver disease (NAFLD) and disease severity. However, it remains unclear if it contributes to the development of NAFLD through affecting dietary pattern.

Coincidental metabolic syndrome increases the risk of liver fibrosis progression in patients with chronic hepatitis B – a prospective cohort study with paired transient elastography examinations

Metabolic syndrome is a known risk factor of cirrhosis in chronic hepatitis B (CHB).

Assessment of non-alcoholic fatty liver disease using serum total cell death and apoptosis markers.

The diagnosis of non‐alcoholic fatty liver disease (NAFLD), non‐alcoholic steatohepatitis (NASH) and fibrosis relies on liver biopsy. Non‐invasive assessments are urgently needed.

Association between serum uric acid and some cardiovascular risk factors in a Chinese population.

The association between serum uric acid concentration and some cardiovascular risk factors was examined in a working Hong Kong Chinese population (mean age 38 years), consisting of 910 men and 603 women. There was no significant age-related rise in serum uric acid concentration. Positive associations were found between serum uric acid concentration and body mass index, waist hip ratio, systolic and diastolic blood pressure, urea, creatinine, protein, glucose (fasting and 2 hours after 75 g oral glucose load), 2 hour insulin, triglycerides, and apolipoprotein B in men. Similar, but fewer, associations were seen in women, with the addition of a positive association with age. In both sexes, serum uric acid was negatively associated with high-density lipoprotein cholesterol. These findings complement the well-known clinical association between gout and cardiovascular and metabolic diseases, such as hypertension, hyperlipidaemia and diabetes mellitus, and suggest that serum uric acid may be a marker for the presence of an adverse cardiovascular risk factor profile.

Non-invasive algorithm of enhanced liver fibrosis and liver stiffness measurement with transient elastography for advanced liver fibrosis in chronic hepatitis B.

The accuracy of Enhanced Liver Fibrosis (ELF; ADVIA Centaur, Siemens Healthcare Diagnostics, Tarrytown, NY, USA) in assessing liver fibrosis in chronic hepatitis B (CHB) is to be determined.