Meal ingestion markedly increases liver stiffness suggesting the need for liver stiffness determination in fasting conditions

Abstract

Introduction: The introduction of noninvasive liver stiffness (LS) determination has heralded a new stage in the diagnosis and treatment of liver fibrosis.

Aim: We evaluated the effect of food intake on LS in patients with different degrees of liver disease.

Patients and methods: We evaluated 24 patients (F≤1, n=11 and F> 1, n=13). LS (Fibroscan®) and portal blood flow (PBF) (Doppler ultrasound) were studied before and 30min after ingestion of a standard liquid meal.

Results: Food intake increased PBF (51±10%, p<0.001). Splanchnic hyperemia was accompanied by a significant rise in LS (from 7.8±3.3 to 10.3±4.1kPa, p<0.001). These increases were similar in patients with minimal fibrosis(F≤1) and in those with more advanced fibrosis or cirrhosis (F>1). Hemodynamic and LS values returned to baseline pre-meal levels within 2hours.

Conclusion: LS increases markedly after ingestion of a standard meal, irrespective of the degree of fibrosis. Our results strongly suggest that LS should be measured in fasting conditions.

Keywords: Condición de ayuno; Elastografía de transición; Fasting conditions; Fibroscan(®); Fibrosis; Hepatitis C; Ingesta de alimento; Meal ingestion; Transient elastography.