In
NAFLD patients, LSM had significant correlation with
fibrosis (r = 0.68, p < 0.001), and increased progressively with increasing
fibrosis (p < 0.001). However, the difference between stage 1 and stage 2
fibrosis was not significant (p = 0.07). The LSM in
NAFLD without
fibrosis and healthy controls was similar (p = 0.37). The areas under receiver-operating characteristics (AUROC) curve of LSM for stages ≥1, ≥2, ≥3, and 4 were 0.82, 0.85, 0.94, and 0.96, respectively. The best LSM (kPa) cut-offs for
fibrosis stages ≥1, ≥2, ≥3 and 4 were 6.1, 7.0, 9.0, and 11.8, respectively. The negative predictive value of LSM for excluding advanced
fibrosis was 95%. For advanced
fibrosis, the AUROC curve of LSM was 0.94, followed by FIB-4 (0.75), BARD score (0.68),
NAFLD fibrosis score (0.66), and
aspartate platelet ratio index (0.60). In multivariate analysis, LSM was the only independent predictor of advanced
fibrosis (odds ratio 1.47). In patients with
NAFLD cirrhosis, LSM correlated significantly with Child-Pugh score (r = 0.40, p < 0.001), serum
bilirubin (r = 0.34, p = 0.02), and grades of
esophageal varices (r = 0.23, p = 0.04).
CONCLUSION: