Patologìâ (Jun 2020)

Changes in indicators of fibrosis in patients with alcoholic liver cirrhosis associated with non-alcoholic fatty liver disease depending on the stage of cirrhosis

  • N. R. Matkovska,
  • N. H. Virstiuk,
  • P. R. Herych,
  • U. V. Balan ,
  • Yu. V. Pertsovych

DOI
https://doi.org/10.14739/2310-1237.2020.1.203626
Journal volume & issue
Vol. 17, no. 1
pp. 10 – 14

Abstract

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Objective was to study changes in liver parenchyma fibrosis in patients with alcoholic liver cirrhosis associated with non-alcoholic fatty liver disease depending on decompensation using shear wave elastography and FIB-4 index. Material and methods. The study included 204 patients. Among them, 78 patients (Group I) had alcoholic liver cirrhosis (ALC) and 126 patients (Group II) had a combination of ALC with non-alcoholic fatty liver disease (NAFLD). Patients were subgrouped according to compensation classes by the Child-Pugh score (A, B, C). The degree of liver parenchyma fibrosis was assessed by calculating the FIB-4 (FibroIndex-4) and the liver parenchyma elasticity (kPa) determined by the shear wave elastography method. Results. Values of liver parenchyma elasticity in patients of group II of classes A, B, and C were higher compared to group I same classes (P < 0.05). FIB-4 indicators in patients of group II were higher than classes A, B, and C compared to group I (P < 0.05). In patients with ALC in combination with NAFLD, direct correlations were established between the value of Child-Pugh score and the elasticity of the liver parenchyma, the value of the MELD index and the elasticity of the liver parenchyma, the value of Child-Pugh score and FIB-4 index, the value of MELD index and FIB-4 index, FIB-4 index and liver parenchyma elasticity. Conclusions. In patients with ALC according to elastography and FIB-4 index, fibrosis indicators increase depending on the stage of decompensation. According to elastography and FIB-4 index in patients with ALC, fibrosis indicators were higher in combination with NAFLD at all stages of liver cirrhosis. The magnitude of fibrosis in patients with ALC in combination with NAFLD according to elastography and the FIB-4 index correlates with the severity of liver cirrhosis by Child-Pugh and MELD prognostic index. The combination of shear wave elastography and FIB-4 index are important diagnostic indicators for assessing the degree of fibrosis in the liver.

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