The correlation of serum alanine aminotransferase level and liver stiffness measurement ( FibroScan~) in patients with chronic hepatitis B flare

Objective To investigate the dynamic changes of liver stiffness measurements(LSM) in patients with chronic hepatitis B(CHB) flare and evaluate the relationship between LSM and alanine aminotransferase(ALT).Methods Forty three patients with CHB flare were enrolled and divided into two groups according to clinical data and imaging modalities: CHB group(n = 23) and liver cirrhosis group(LC,n = 20).Fibroscan was performed every 7-10 days during hospi-talization and every 1-3 months for outpatients follow-up.Abdominal ultrasound examination,hematology tests and liver function examinations were performed during hospitalization.Results In CHB patients,there was significant correlation between LSM and ALT(r = 0.324,P = 0.004),whereas there was no statistically significant difference according to the partial correlation(r = 0.190,P = 0.098).Following with continuously declined ALT,LSM fell down to lower than cirrho-sis cut-off value 14.6kPa with three distinct patterns;decrease,increase and then decrease with an irregular pattern.In LC patients,there was no significant correlation between LSM and ALT(r =-0.075,P = 0.565).Although LSM signifi-cantly declined in 11 patients after drop in ALT(P = 0.003),it was still higher than cirrhosis cut-off value.Conclusion The LSM value is largely affected by ALT in patients with non-cirrhotic CHB.Dynamic detection of LSM associated with ALT level would improve the diagnostic accuracy of FibroScan  scaning.