Liver stiffness in extrahepatic cholestasis correlates positively with bilirubin and negatively with alanine aminotransferase

Masao Harata, Senju Hashimoto, Naoto Kawabe, Yoshifumi Nitta, Michihito Murao, Takuji Nakano, Yuko Arima, Hiroaki Shimazaki, Tetsuya Ishikawa, Akihiko Okumura, Naohiro Ichino, Keisuke Osakabe, Toru Nishikawa, Kentaro Yoshioka

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Aim: Transient elastography is a non-invasive tool to measure liver stiffness (LS), which has been reported to correlate with stage of liver fibrosis. Extrahepatic cholestasis was reported to cause elevated LS, which is considered to be attributed to the increased hydrostatic pressure in the liver. In the present study, the correlation of LS with laboratory data was investigated in extrahepatic cholestasis. The change of LS after biliary drainage was also assessed. Methods: LS was measured in 29 patients with extrahepatic cholestasis due to carcinomas in 12 and non-neoplastic diseases of biliary tract or pancreas in 17. Results: In 15 patients, LS was 11.4kPa or higher which suggested liver cirrhosis in chronic infection of hepatitis C virus. LS significantly correlated positively with serum bilirubin levels (r=0.726, P<0.0001) and negatively with serum aspartate aminotransferase (AST) levels (r=-0.481, P=0.0082) and alanine aminotransferase (ALT) levels (r=-0.631, P=0.0002). Biliary drainage led to a reduction of bilirubin by 13.5 to 0.9mg/dL which was significantly correlated with a reduction of LS by 14.3 to 0.5kPa (r=0.524, P=0.0257). Conclusion: In extrahepatic cholestasis, the elevation of LS which is probably attributed to the increased hydrostatic pressure in the liver, correlates positively with the accumulation of bilirubin but negatively with damage of hepatocytes indicated by ALT levels. Further studies on the mechanism underlying the elevation of LS should be helpful to elucidate the pathogenesis of extrahepatic cholestasis.

Original languageEnglish
Pages (from-to)423-429
Number of pages7
JournalHepatology Research
Volume41
Issue number5
DOIs
Publication statusPublished - 01-05-2011

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Extrahepatic Cholestasis
Alanine Transaminase
Bilirubin
Liver
Hydrostatic Pressure
Liver Cirrhosis
Drainage
Biliary Tract Diseases
Elasticity Imaging Techniques
Chronic Hepatitis C
Aspartate Aminotransferases
Serum
Hepacivirus

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Infectious Diseases

Cite this

Harata, Masao ; Hashimoto, Senju ; Kawabe, Naoto ; Nitta, Yoshifumi ; Murao, Michihito ; Nakano, Takuji ; Arima, Yuko ; Shimazaki, Hiroaki ; Ishikawa, Tetsuya ; Okumura, Akihiko ; Ichino, Naohiro ; Osakabe, Keisuke ; Nishikawa, Toru ; Yoshioka, Kentaro. / Liver stiffness in extrahepatic cholestasis correlates positively with bilirubin and negatively with alanine aminotransferase. In: Hepatology Research. 2011 ; Vol. 41, No. 5. pp. 423-429.
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abstract = "Aim: Transient elastography is a non-invasive tool to measure liver stiffness (LS), which has been reported to correlate with stage of liver fibrosis. Extrahepatic cholestasis was reported to cause elevated LS, which is considered to be attributed to the increased hydrostatic pressure in the liver. In the present study, the correlation of LS with laboratory data was investigated in extrahepatic cholestasis. The change of LS after biliary drainage was also assessed. Methods: LS was measured in 29 patients with extrahepatic cholestasis due to carcinomas in 12 and non-neoplastic diseases of biliary tract or pancreas in 17. Results: In 15 patients, LS was 11.4kPa or higher which suggested liver cirrhosis in chronic infection of hepatitis C virus. LS significantly correlated positively with serum bilirubin levels (r=0.726, P<0.0001) and negatively with serum aspartate aminotransferase (AST) levels (r=-0.481, P=0.0082) and alanine aminotransferase (ALT) levels (r=-0.631, P=0.0002). Biliary drainage led to a reduction of bilirubin by 13.5 to 0.9mg/dL which was significantly correlated with a reduction of LS by 14.3 to 0.5kPa (r=0.524, P=0.0257). Conclusion: In extrahepatic cholestasis, the elevation of LS which is probably attributed to the increased hydrostatic pressure in the liver, correlates positively with the accumulation of bilirubin but negatively with damage of hepatocytes indicated by ALT levels. Further studies on the mechanism underlying the elevation of LS should be helpful to elucidate the pathogenesis of extrahepatic cholestasis.",
author = "Masao Harata and Senju Hashimoto and Naoto Kawabe and Yoshifumi Nitta and Michihito Murao and Takuji Nakano and Yuko Arima and Hiroaki Shimazaki and Tetsuya Ishikawa and Akihiko Okumura and Naohiro Ichino and Keisuke Osakabe and Toru Nishikawa and Kentaro Yoshioka",
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Harata, M, Hashimoto, S, Kawabe, N, Nitta, Y, Murao, M, Nakano, T, Arima, Y, Shimazaki, H, Ishikawa, T, Okumura, A, Ichino, N, Osakabe, K, Nishikawa, T & Yoshioka, K 2011, 'Liver stiffness in extrahepatic cholestasis correlates positively with bilirubin and negatively with alanine aminotransferase', Hepatology Research, vol. 41, no. 5, pp. 423-429. https://doi.org/10.1111/j.1872-034X.2011.00797.x

Liver stiffness in extrahepatic cholestasis correlates positively with bilirubin and negatively with alanine aminotransferase. / Harata, Masao; Hashimoto, Senju; Kawabe, Naoto; Nitta, Yoshifumi; Murao, Michihito; Nakano, Takuji; Arima, Yuko; Shimazaki, Hiroaki; Ishikawa, Tetsuya; Okumura, Akihiko; Ichino, Naohiro; Osakabe, Keisuke; Nishikawa, Toru; Yoshioka, Kentaro.

In: Hepatology Research, Vol. 41, No. 5, 01.05.2011, p. 423-429.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Liver stiffness in extrahepatic cholestasis correlates positively with bilirubin and negatively with alanine aminotransferase

AU - Harata, Masao

AU - Hashimoto, Senju

AU - Kawabe, Naoto

AU - Nitta, Yoshifumi

AU - Murao, Michihito

AU - Nakano, Takuji

AU - Arima, Yuko

AU - Shimazaki, Hiroaki

AU - Ishikawa, Tetsuya

AU - Okumura, Akihiko

AU - Ichino, Naohiro

AU - Osakabe, Keisuke

AU - Nishikawa, Toru

AU - Yoshioka, Kentaro

PY - 2011/5/1

Y1 - 2011/5/1

N2 - Aim: Transient elastography is a non-invasive tool to measure liver stiffness (LS), which has been reported to correlate with stage of liver fibrosis. Extrahepatic cholestasis was reported to cause elevated LS, which is considered to be attributed to the increased hydrostatic pressure in the liver. In the present study, the correlation of LS with laboratory data was investigated in extrahepatic cholestasis. The change of LS after biliary drainage was also assessed. Methods: LS was measured in 29 patients with extrahepatic cholestasis due to carcinomas in 12 and non-neoplastic diseases of biliary tract or pancreas in 17. Results: In 15 patients, LS was 11.4kPa or higher which suggested liver cirrhosis in chronic infection of hepatitis C virus. LS significantly correlated positively with serum bilirubin levels (r=0.726, P<0.0001) and negatively with serum aspartate aminotransferase (AST) levels (r=-0.481, P=0.0082) and alanine aminotransferase (ALT) levels (r=-0.631, P=0.0002). Biliary drainage led to a reduction of bilirubin by 13.5 to 0.9mg/dL which was significantly correlated with a reduction of LS by 14.3 to 0.5kPa (r=0.524, P=0.0257). Conclusion: In extrahepatic cholestasis, the elevation of LS which is probably attributed to the increased hydrostatic pressure in the liver, correlates positively with the accumulation of bilirubin but negatively with damage of hepatocytes indicated by ALT levels. Further studies on the mechanism underlying the elevation of LS should be helpful to elucidate the pathogenesis of extrahepatic cholestasis.

AB - Aim: Transient elastography is a non-invasive tool to measure liver stiffness (LS), which has been reported to correlate with stage of liver fibrosis. Extrahepatic cholestasis was reported to cause elevated LS, which is considered to be attributed to the increased hydrostatic pressure in the liver. In the present study, the correlation of LS with laboratory data was investigated in extrahepatic cholestasis. The change of LS after biliary drainage was also assessed. Methods: LS was measured in 29 patients with extrahepatic cholestasis due to carcinomas in 12 and non-neoplastic diseases of biliary tract or pancreas in 17. Results: In 15 patients, LS was 11.4kPa or higher which suggested liver cirrhosis in chronic infection of hepatitis C virus. LS significantly correlated positively with serum bilirubin levels (r=0.726, P<0.0001) and negatively with serum aspartate aminotransferase (AST) levels (r=-0.481, P=0.0082) and alanine aminotransferase (ALT) levels (r=-0.631, P=0.0002). Biliary drainage led to a reduction of bilirubin by 13.5 to 0.9mg/dL which was significantly correlated with a reduction of LS by 14.3 to 0.5kPa (r=0.524, P=0.0257). Conclusion: In extrahepatic cholestasis, the elevation of LS which is probably attributed to the increased hydrostatic pressure in the liver, correlates positively with the accumulation of bilirubin but negatively with damage of hepatocytes indicated by ALT levels. Further studies on the mechanism underlying the elevation of LS should be helpful to elucidate the pathogenesis of extrahepatic cholestasis.

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