Effect of ALT level on liver stiffness measurement in patients with hepatitis B cirrhosis

Objective To investigate the effect of alanine aminotransferase ( ALT) level on liver stiffness measurement ( LSM) in patients with hepatitis B cirrhosis. Methods The patients who were diagnosed with hepatitis B cirrhosis by liver biopsy in Beijing Friendship Hospital from January 2012 to May 2015 and did not receive antiviral therapy were enrolled. Their demographic characteristics, routine blood test results, biochemical parameters, hepatitis B virus ( HBV) DNA level, alpha-fetoprotein level, LSM, abdominal ultrasound findings, and liver biopsy data were collected. LSM was compared between hepatitis B cirrhosis patients with different ALT levels. The one-way analysis of variance or rank sum test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data. Pearson correlation analysis and partial correlation analysis were performed. Results A total of 104 patients were recruited and divided into three groups according to their ALT levels ( ≤2 × upper limit of normal [ULN], 2-5 × ULN, and ≥5 × ULN) . There were no significant differences between the three groups in sex ratio, body mass index, HBeAg status, HBV DNA level, albumin level, and platelet count ( all P > 0. 05) . The median values of LSM for the three groups were 15. 4 k Pa, 18. 8 k Pa, and 29. 9 k Pa, respectively, suggesting that LSM increased as the ALT level increased, and there was a significant difference in LSM between the three groups ( χ2= 10. 07, P < 0. 05) . After adjusting for age, which was significantly different between the three groups, LSM was still found to be positively correlated with ALT level ( r = 0. 220, 95% confidence interval: 0. 101-0. 468, P < 0. 05) . Conclusion In patients with hepatitis B cirrhosis, LSM increased with the increasing ALT level, and the positive correlation remains after adjusting for age.