Controlled Attenuation Parameter for Noninvasive Assessment of Hepatic Steatosis Using Fibroscan: Validation in Chronic Hepatitis B.

Background and Aim: The controlled attenuation parameter (CAP) using transient elastography (TE) was validated in chronic hepatitis C to evaluate hepatic steatosis; however, limited data are available on chronic hepatitis B (CHB). Therefore, we assessed the accuracy and the efficacy of CAP for the detection of steatosis in CHB. Methods: Consecutive CHB patients underwent liver biopsy and liver stiffness measurements (LSM) with simultaneous CAP determination using the M probe of the TE. The area under the receiver operating characteristics curve (AUROC) was used to evaluate the performance of CAP in diagnosing steatosis compared with biopsy. Results: A total of 340 patients were included: 60 % were male, the median age was 37 years; the body mass index (BMI) was ≥28 kg/m for 14 % of the subjects; and the distribution of the steatosis grade was S0 58.2 %, S1 34.2 %, S2 5.0 % and S3 2.6 %. The median (range) of CAP was 218 (100-400) dB/m, and CAP correlated with the BMI ( ρ = 3.622) and steatosis grade ( ρ = 29.203) according to a multivariate analysis (both P < 0.001). CAP could detect the different grades of steatosis: ≥S1 with AUROC of 0.81 at a cutoff of 224 dB/m, ≥S2 with AUROC of 0.90 at a cutoff of 236 dB/m and ≥S3 with AUROC of 0.97 at a cutoff of 285 dB/m. Furthermore, the LSM and fibrosis and activity grades on biopsy did not influence the CAP performance. Conclusions: CAP presented excellent diagnostic performance for severe steatosis with high sensitivity and specificity in Chinese patients with CHB. [ABSTRACT FROM AUTHOR]