Meal ingestion markedly increases liver stiffness suggesting the need for liver stiffness determination in fasting conditions / / La ingesta de una comida ocasiona un aumento de la rigidez hepática, lo que sugiere que esta determinación debe ser siempre evaluada en ayuna

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 30 min 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 ± 4.1 kPa, 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 2 hours. 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 (AU)

Introducción: El desarrollo de nuevos métodos que permiten la determinación no invasiva de la rigidez hepática ha abierto una nueva era en el manejo de la fibrosis hepática. Objetivo: El objetivo del trabajo fue evaluar el efecto de ingesta de una comida sobre la rigidez hepática en pacientes con diferentes grados de fibrosis. Pacientes y métodos: Se evaluaron 24 pacientes (F ≤ 1, n = 11, y F > 1, n = 13), que fueron estudiados basalmente y 30 min después de la ingesta de una comida estándar (Ensure Plus®). La rigidez hepática se midió por Fibroscan®, y los parámetros hemodinámicos portales, mediante Doppler. La ingesta de una comida ocasionó un aumento del flujo sanguíneo portal (51 ± 10%, p < 0,001). La hiperemia esplácnica fue acompañada por un marcado incremento en la rigidez hepática (7,8 ± 3,3 a 10,3 ± 4,1 kPa, p < 0,001). Este efecto fue similar en pacientes con fibrosis mínima (F ≤ 1) y con fibrosis significativa (F > 1). Los valores de ambos parámetros retornaron a niveles similares a los basales a las 2 h luego de la ingesta. Conclusión: Este estudio demuestra que la respuesta vascular posprandial se acompaña de aumento de la rigidez hepática. Los cambios son independientes del grado de fibrosis. Nuestros resultados sugieren fuertemente que los estudios deben realizarse en condiciones de ayuno (AU)

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

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.