Articles Vol. 67 No. CĐ8-NCKH 06/07/2026

COMPARISON OF LIVER FIBROSIS ASSESSED BY FIBROSCAN IN PATIENTS WITH ALCOHOLIC AND NON-ALCOHOLIC FATTY LIVER DISEASE

Le Thi Thao1,2, Pham Hoang Quyen1,2, Vu Thi Trang1,2
1 Hai Duong Medical Technical University
2 Trường Đại học Kỹ thuật Y tế Hải Dương
DOI: 10.52163/yhc.v67iCD8.5665
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Abstract

Objective: To compare the degree of liver fibrosis assessed by Fibroscan in patients with alcoholic fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD).

Subjects and Methods: This prospective cross-sectional study included 152 patients with NAFLD and 152 patients with AFLD who were examined and treated at at  the  Department  of Examination  and  Treatment  on  Demand,  Bach  Mai Hospital from March 2024 to June 2024.

Results: Compared with the AFLD group, the NAFLD group had a higher proportion of females (58.6%), physically inactive patients (79.6%), obesity (43.4%), diabetes mellitus (34.9%), hypertension (25.0%), and an AST/ALT ratio ≤ 1 (71.7%), with statistically significant differences (p < 0.05). The prevalence of elevated AST, ALT, and GGT levels in the NAFLD group (23.7%, 40.8%, and 37.8%, respectively) was lower than that in the AFLD group (35.5%, 46.1%, and 73.5%, respectively); differences in AST and GGT were statistically significant. Patients with AFLD showed significantly higher proportions of advanced fibrosis stages (F2, F3, and F4), higher mean liver stiffness values, and a higher prevalence of significant fibrosis compared with patients with NAFLD (31.6%, 21.1%, 11.2%; 11.1 ± 10.3 kPa; and 63.9%, respectively; p < 0.05). Significant differences between mild fibrosis (F0–F1) and significant fibrosis (F2–F4) were observed in both NAFLD and AFLD groups among patients aged over 50 years, females, non-smokers, physically inactive individuals, and patients obesity, diabetes mellitus, or hypertension (p < 0.05). A positive correlation was found between Fibroscan liver stiffness measurements and non-invasive fibrosis scores, including APRI (r = 0.66) and FIB-4 (r = 0.69).

Conclusion: AFLD is associated with more severe liver injury and more advanced liver fibrosis on Fibroscan than NAFLD. NAFLD is more prevalent among females and is commonly associated with physical inactivity, obesity, hypertension, and diabetes mellitus.

References
[1]
Jiang ZB, Gao J, Chai YH, Li W, Luo YF, Chen YZ. Astragaloside alleviates alcoholic fatty liver disease by suppressing oxidative stress. The Kaohsiung Journal of Medical Sciences. 2021;37(8):718-729. doi:10.1002/kjm2.12390 Google Scholar
[2]
European Association for the Study of the Liver (EASL) EA for the S of D (EASD) European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the Management of Non-Alcoholic Fatty Liver Disease. Obesity Facts. 2016;9(2):65-90. doi:10.1159/000443344. Google Scholar
[3]
Al Danaf L, Hussein Kamareddine M, Fayad E, Hussain A, Farhat S. Correlation between Fibroscan and laboratory tests in non-alcoholic fatty liver disease/non-alcoholic steatohepatitis patients for assessing liver fibrosis. World J Hepatol. 2022;14(4):744-753. doi:10.4254/wjh. v14.i4.744. Google Scholar
[4]
Tuyên bố của Tổ chức Gan Hoa Kỳ về việc FDA phê duyệt Resmetirom - American Liver Foundation. March 14, 2024. Accessed October 20, 2024. https://liverfoundation.org/vi Google Scholar
[5]
Vincent wai - Sun Wong. Asia-Pacific Working Party on Non-alcoholic Fatty Liver Disease guidelines 2017-Part 1: Definition, risk factors and assessment. Gastroenterol Hapatol.2018; 33(1):70-85. doi:10.1111/jgh.13857 Google Scholar
[6]
Eslam. The Asian Pacific Association for the Study of the Liver clinical practice guidelines for the diagnosis and management of metabolic associated fatty liver disease. 2020. 14(6):889-919. doi:10.1007/s12072-020-10094-2 Google Scholar
[7]
Vũ Thị Thu Trang (2019). Nghiên cứu Đặc điểm lâm sàng, một số xét nghiệm, siêu âm và mô bệnh học Bệnh gan nhiễm mỡ. Luận án Tiến sĩ Y học, Viện nghiên cứu khoa học Y Dược Lâm sàng 108. Google Scholar
[8]
Svanhildur. Long term follow-up and liver-related death rate in patients with non-alcoholic and alcoholic related fatty liver disease. BMC Gastroenterology. 2014. 166. Google Scholar
[9]
Johnston. Causes of Mortality in Non-Alcoholic Fatty Liver Disease (NAFLD) and Alcohol Related Fatty Liver Disease (AFLD). Current Pharmaceutical Design. 2020; 26 (10): 1873-4286. Google Scholar
[10]
Kotronen. Non-alcoholic and alcoholic Fatty Liver Disease - two Diseases of Affluence associated with the Metabolic Syndrome and Type 2 Diabetes: the FIN-D2D Survey. BMC Public Health. 2010; 10 (1): 237. Google Scholar
[11]
Nguyễn Minh Đức. Bệnh gan nhiễm mỡ liên quan chuyển hoá: tỷ lệ và mức độ xơ hoá gan đánh giá bằng Fibroscan. Tạp chí Y dược học Phạm Ngọc Thạch. 2024; 3(1): 159-167. Google Scholar
[12]
Morita Y, Ueno T, Sasaki N, et al. Comparison of Liver Histology Between Patients with Non-Alcoholic Steatohepatitis and Patients with Alcoholic Steatohepatitis in Japan. Alcoholism: Clinical and Experimental Research. 2005;29(s3):277S-281S. doi:10.1097/01.alc. 0000191777.36629.33 Google Scholar
[13]
Amernia B, Moosavy SH, Banookh F, Zoghi G. FIB-4, APRI, and AST/ALT ratio compared to Fibroscan for the assessment of hepatic fibrosis in patients with non-alcoholic fatty liver disease in Bandar Abbas, Iran. BMC Gastroenterol. 2021;21:453. doi:10.1186/s12876-021-02038-3 Google Scholar
[14]
Cioarca- Nedelcu. Serum biomarkers predictive of cirrhosis in alcoholic liver disease as an alternative to ARFI-SW elastography. Eur Rev Med Pharmacol Sci. 2023; 27 (12): 5590-5595. Google Scholar
[15]
European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD), European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). Obesity Facts. 2024;17(4):374-443. doi:10.1159/000539371 Google Scholar