COMMENT:
However, in patients with non-alcoholic steatohepatitis, NAFLD’s progressive subtype, these hepatic events’ contribution to mortality rises. According to numerous biopsy-based cohort studies, hepatic fibrosis is a major predictor of liver-related events’ occurrence and thus exerts risk-modifying power on all-cause mortality in patients with NASH. Importantly, non-invasive vibration-controlled transient elastography (VCTE) has emerged as an accurate and easily used tool to estimate the degree of liver fibrosis through its estimation of a liver stiffness measurement (LSM). Although the LSM it generates has been shown to accurately detect advanced fibrosis and cirrhosis, its ability to predict clinically-relevant events in NAFLD patients has yet to be comprehensively investigated.
This systematic review and meta-analysis aims to explore the nature and magnitude of the association between LSM obtained with VCTE and all-cause mortality.
KEY LEARNINGS:
In patients with NAFLD, elevated LSM was found to be independently and significantly associated with a 2.1-fold increased risk of all-cause mortality over a mean of 3.6 years. Moreover, each 1 kPa increment in LSM was found to be associated with a 3% increase in the relative risk of all-cause mortality within this patient population. According to meta-regression analyses, the relative risk of death associated with an elevated LSM value was higher in studies that recruited younger patients as well as in those employing higher LSM cut-offs. Importantly, these findings did not differ significantly after excluding individual studies and no significant publication biases were detected.
