Study highlights Risk Indicator for Liver Disease

A large scale study carried out by researchers in Vienna has shown the important value of repeated liver examinations using a novel method based on measurements of liver stiffness that can significantly improve risk assessment in patients with chronic liver disease.

While increasingly applied in clinical practice to determine the severity of chronic liver disease and inform treatment decisions, it had been unclear how to interpret changes in liver stiffness over time.

This long-term study, led by Georg Semmler, David Bauer, and Thomas Reiberger from the Division of Gastroenterology and Hepatology at the Department of Internal Medicine III at MedUni Vienna and University Hospital Vienna, was conducted amongst a large cohort of patients with chronic liver disease.

Over the average observation period of around six years, a total of 8,561 liver stiffness measurements were performed in 2,508 individual patients. The researchers monitored the progression of the disease and determined the predictive power of changes in liver stiffness concerning liver decompensation (complications associated with liver disease) or the death of patients during the observation period.

The analysis conducted by the research team showed that monitoring the progression of liver stiffness over time was a better predictor of the risk of liver decompensation than single measurements and proved to be more informative than other methods commonly used to determine the severity of liver disease, such as the FIB-4 score or the MELD score. The team was also able to demonstrate how such changes could determine the extent to which the prognosis for chronic liver disease patients improves or worsens when liver stiffness decreases or increases, respectively, by a given percentage.

“An understanding of the individual patient’s personal risk profile means that it is possible to initiate optimised, personalised treatment," notes study principal investigator Thomas Reiberger, highlighting the significance of the findings. The incidence of chronic liver disease, and particularly fatty liver disease is increasing worldwide, which is strongly linked to risk factors such as overweight and obesity or alcohol consumption.

The study was published in Gastroenterology DOI:10.1053/j.gastro.2023.06.030

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