UEGJournal Abstracts 2021 - 665

Liver & biliary
P0663
FAST IS NOT SUPERIOR TO LSM FOR NONINVASIVE DIAGNOSIS OF
FIBROSIS STAGE OR 'ACTIVE FIBROTIC NASH' IN NONALCOHOLIC FATTY
LIVER DISEASE
R. Stauber1
, M. Eilenberg2
K. Staufer5,6
1
, A. Posch1
, K. Lackner3
, M. Trauner4
,
Medical University of Graz, Department of Internal Medicine, Graz,
Austria, 2Medical University of Vienna, Department of Surgery,
Vienna, Austria, 3Medical University of Graz, Institute for Pathology,
Graz, Austria, 4Head of Division of Gastroenterology and
Hepatology, Department of Medicine III, Wien, Austria, 5
Medical
University of Vienna, Department of Internal Medicine 4, Division
of Gastroenterology and Hepatology, Vienna, Austria, 6
Hospital of Berne, Berne, Switzerland
University
Contact E-Mail Address: rudolf.stauber@medunigraz.at
Introduction: Nonalcoholic fatty liver disease (NAFLD) with advanced
fibrosis (F≥3) shows increased liver-related mortality. Presence of nonalcoholic
steatohepatitis (NASH) with significant fibrosis (F≥2) and activity
(NAS≥4), also referred to as 'active fibrotic NASH', indicates eligibility for
experimental treatment in clinical trials. Liver stiffness measuring (LSM)
by vibration-controlled transient elastography (VCTE) is widely used for
noninvasive estimation of fibrosis. Recently, the FibroScan-AST (FAST)
score, combining LSM with controlled attenuation parameter (CAP) and
serum AST levels, has been claimed to show superior diagnostic accuracy.
Aims & Methods: The aim of the present study was to evaluate and compare
the diagnostic accuracy of FAST score and plain LSM in NAFLD. From
2012 to 2020 we enrolled consecutive patients with biopsy-proven NAFLD
in two Austrian referral centers. Nonalcoholic steatohepatitis (NASH) was
defined as presence of steatosis >5%, hepatocellular ballooning and lobular
inflammation on liver histology. Fibrosis was staged according to the
clinical research network (CRN) score. VCTE was performed using a Fibroscan
502 Touch with CAP capability. LSM, CAP and AST were prospectively
recorded for calculation of the FAST score using a published formula
(Newsome PN et al., Lancet Gastroenterol Hepatol 2020;5:362-373). The
predictive value of noninvasive fibrosis tests for various histologic endpoints
was assessed by receiver operating characteristic (ROC) analysis.
Results: Our study cohort contained 103 patients with NAFLD and complete
data on both FAST score and LSM. Liver histology revealed NASH
with significant fibrosis (F≥2) in 24 patients (23%), NASH with advanced fibrosis
(F≥3) in 17 patients (16%), and 'active fibrotic NASH' (NASH + NAS≥4
+ F≥2) in 20 patients (19%). Diagnostic accuracies of FAST score and LSM
for these endpoints are shown in the Table.
NASH F≥2
LSM
FAST score
0.80 (0.69-0.90)
0.77 (0.65-0.89)
AUROC (95% CI)
NASH F≥3
0.84 (0.72-0.95)
0.76 (0.62-0.90)
P0664
COLONIC DIVERTICULOSIS AND NON-ALCOHOLIC FATTY
LIVER DISEASE: IS THERE A CONNECTION?
I. Pantic1, S. Lugonja2
, I. Dumic3,4
,
T. Milovanovic (former Alempijevic)5
1
Clinic of Gastroenterology and Hepatology, University Clinical
Center of Serbia, Belgrade, Serbia, 2
General Hospital " Djordje
Joanovic " , Internal Medicine, Divison of Gastroenterology,
Zrenjanin, Serbia, 3
Mayo Clinic Health System, Eau Claire,
Wisconsin, United States, 4Mayo Clinic Alix School of Medicine,
Rochester, United States, 5Clinical Center of Serbia, School of
Medicine University of Belgrade, Clinic for Gastroenterology and
Hepatology, Belgrade, Serbia
NASH + NAS≥4 + F≥2
0.87 (0.79-0.94)
0.83 (0.74-0.93)
Conclusion: Based on our findings, FAST score is not superior to plain LSM
for noninvasive diagnosis of fibrosis stage or presence of 'active fibrotic
NASH' (NASH + NAS≥4 + F≥2) among patients with NAFLD at tertiary referral
centers. Further studies in larger cohorts of patients with NAFLD are
required to validate the diagnostic performance of FAST score versus LSM.
Disclosure: Nothing to disclose.
Contact E-Mail Address: ilic.ivana04@gmail.com
Introduction: It has been suggested that some of the metabolic syndrome
(MetS) components, such as central obesity, type 2 diabetes mellitus
(T2DM), and arterial hypertension (HTA) may contribute to the development
of both colonic diverticulosis and its complications. Non-alcoholic
fatty liver disease (NAFLD) was previously considered as a " hepatic manifestation "
of MetS, while the increasing data implicate that NAFLD is in
fact, a systemic disease. NAFLD often occurs together with several other
multi-organ disorders, including cardiovascular diseases, chronic kidney
disease (CDK), T2DM, and hypothyroidism, while their association is much
more complex then previously realized.
Aims & Methods: This study aimed to evaluate several components of
MetS in respect with hepatic steatosis and colonic diverticulosis and to
further evaluate a possible relationship between hepatic steatosis presence
and colonic diverticulosis severity. A retrospective study included
patients who underwent a total colonoscopy from January 2017 to December
2019, during which the diagnosis of colonic diverticulosis was
made. Abdominal computed tomography and/or ultrasonography were
performed in all patients. Data regarding patients' age, Diverticular Inflammation
and Complication Assessment (DICA) score and category,
disease localization, presence of hepatic steatosis (determined using the
aforementioned imaging methods), blood pressure value, comprehensive
metabolic panel (fasting glucose, triglycerides, high-density lipoprotein
(HDL) and total cholesterol, and C-reactive protein (CRP) values), the need
for colonic surgery, and the presence of co-morbidities (arterial hypertension
(HTA), type 2 diabetes mellitus (T2DM), hypothyroidism, and chronic
kidney disease) were collected from patients' medical records.
Results: A total of 407 patients were included (male: 53.81%), with a median
age of 68 years (range 34-89). The majority had left-sided diverticulosis
(n=367, 90.17%), and uncomplicated disease course (DICA category
1, n=347, 85.6%). Concomitant hepatic steatosis was detected in 47.42%
(n=193) of patients. Fasting glucose, systolic blood pressure, triglycerides,
total cholesterol, and C-reactive protein levels were more pronounced in
patients with hepatic steatosis (p<0.0001, p=0.036, p=0.0004, p<0.0001,
and p<0.0001, respectively). A higher prevalence of HTA, T2DM, and hypothyroidism
was noted in the same group of patients (p<0.0001, p<0.0001,
and p=0.008, respectively). A significant difference was noticed in HDL
cholesterol and CRP median values between DICA groups 1, 2, and 3
(p=0.023, and p=0.039, respectively). Hepatic steatosis was more frequent
in more severe forms of colonic diverticulosis (p=0.025).
Conclusion: Components of metabolic dysregulation are more prominent
in patients with colonic diverticulosis and concomitant hepatic steatosis,
while HTA, T2DM, and hypothyroidism are more frequent in the same
group of patients. Fatty liver was more commonly detected in more severe
forms of colonic diverticulosis.
Disclosure: Nothing to disclose.
Vol. 9 | October 2021
665
UEGJournal Abstracts 2021

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