Body posture can modulate liver stiffness measured by transient elastography: a prospective observational study
Abstract Background Non-invasive measurement of liver stiffness (LS), traditionally performed in the supine position, has been established to assess liver fibrosis. However, fibrosis degree is not the sole determinant of LS, necessitating the identification of relevant confounders. One often-overloo...
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2024-10-01
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| Online Access: | https://doi.org/10.1186/s12876-024-03473-8 |
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| author | Zi-Hao Huang Miao-Qin Deng Yangmin Lin Chen-Hui Ye Ming-Hua Zheng Yong-Ping Zheng |
| author_facet | Zi-Hao Huang Miao-Qin Deng Yangmin Lin Chen-Hui Ye Ming-Hua Zheng Yong-Ping Zheng |
| author_sort | Zi-Hao Huang |
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| description | Abstract Background Non-invasive measurement of liver stiffness (LS), traditionally performed in the supine position, has been established to assess liver fibrosis. However, fibrosis degree is not the sole determinant of LS, necessitating the identification of relevant confounders. One often-overlooked factor is body posture, and it remains unclear whether normal daily postures interfere with LS irrespective of fibrosis. A prospective two-group comparison study was conducted to investigate the relationship between posture and LS. Methods Sixty-two adults participated, divided into two groups: patients with chronic liver disease and healthy controls. Both groups were assessed using transient elastography (TE) under the supine, seated, and standing postures. Randomization was applied to the order of the two upright postures. A two-way mixed ANOVA was conducted to assess the posture-dependence of LS and its variations between two groups. Results Results showed that posture differentially affected LS depending on the presence of liver fibrosis. In 31 healthy individuals (baseline LS range: 3.5–6.8 kPa), a transition from the supine (5.0 ± 1.0 kPa) to seated (5.7 ± 1.4 kPa; p = 0.036) or standing (6.2 ± 1.7 kPa; p = 0.002) positions increased LS, indicating liver stiffening. Conversely, in 31 patients with varying fibrosis stages (baseline LS range: 8.8–38.2 kPa), posture decreased LS from the supine (15.9 ± 7.3 kPa) to seated (13.8 ± 6.2 kPa; p < 0.001) or standing (13.9 ± 6.2 kPa; p = 0.001) positions. No significant difference in LS was observed between the seated and standing positions in both groups (control group: 5.7 vs. 6.2 kPa, p = 0.305; patient group: 13.8 vs. 13.9 kPa, p = 1). Additionally, different postures did not elicit significant changes in the success rate (supine, 98.6 ± 4%; seated, 97.6 ± 6%; standing, 99.1 ± 3%; p = 0.258) and IQR/median value (supine, 25 ± 8%; seated, 29 ± 15%; standing, 29 ± 12%; p = 0.117), implying no impact on both measurement feasibility and reliability. Conclusions We demonstrated, for the first time, the feasibility of utilizing upright postures as an alternative measurement protocol for TE. We further unravel a previously unrecognized role of transitioning between different postures to assist the diagnosis of cirrhosis. The findings suggested that daily physiological activity of postural changes suffices to alter LS. Therefore, body positioning should be standardized and carefully considered when interpreting LS. |
| format | Article |
| id | doaj-art-c7c761dfe3954ac6bc48160dbe401b6c |
| institution | OA Journals |
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| language | English |
| publishDate | 2024-10-01 |
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| spelling | doaj-art-c7c761dfe3954ac6bc48160dbe401b6c2025-08-20T02:18:35ZengBMCBMC Gastroenterology1471-230X2024-10-0124111210.1186/s12876-024-03473-8Body posture can modulate liver stiffness measured by transient elastography: a prospective observational studyZi-Hao Huang0Miao-Qin Deng1Yangmin Lin2Chen-Hui Ye3Ming-Hua Zheng4Yong-Ping Zheng5Department of Biomedical Engineering, The Hong Kong Polytechnic UniversityDepartment of Biomedical Engineering, The Hong Kong Polytechnic UniversityDepartment of Biomedical Engineering, The Hong Kong Polytechnic UniversityMAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical UniversityMAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical UniversityDepartment of Biomedical Engineering, The Hong Kong Polytechnic UniversityAbstract Background Non-invasive measurement of liver stiffness (LS), traditionally performed in the supine position, has been established to assess liver fibrosis. However, fibrosis degree is not the sole determinant of LS, necessitating the identification of relevant confounders. One often-overlooked factor is body posture, and it remains unclear whether normal daily postures interfere with LS irrespective of fibrosis. A prospective two-group comparison study was conducted to investigate the relationship between posture and LS. Methods Sixty-two adults participated, divided into two groups: patients with chronic liver disease and healthy controls. Both groups were assessed using transient elastography (TE) under the supine, seated, and standing postures. Randomization was applied to the order of the two upright postures. A two-way mixed ANOVA was conducted to assess the posture-dependence of LS and its variations between two groups. Results Results showed that posture differentially affected LS depending on the presence of liver fibrosis. In 31 healthy individuals (baseline LS range: 3.5–6.8 kPa), a transition from the supine (5.0 ± 1.0 kPa) to seated (5.7 ± 1.4 kPa; p = 0.036) or standing (6.2 ± 1.7 kPa; p = 0.002) positions increased LS, indicating liver stiffening. Conversely, in 31 patients with varying fibrosis stages (baseline LS range: 8.8–38.2 kPa), posture decreased LS from the supine (15.9 ± 7.3 kPa) to seated (13.8 ± 6.2 kPa; p < 0.001) or standing (13.9 ± 6.2 kPa; p = 0.001) positions. No significant difference in LS was observed between the seated and standing positions in both groups (control group: 5.7 vs. 6.2 kPa, p = 0.305; patient group: 13.8 vs. 13.9 kPa, p = 1). Additionally, different postures did not elicit significant changes in the success rate (supine, 98.6 ± 4%; seated, 97.6 ± 6%; standing, 99.1 ± 3%; p = 0.258) and IQR/median value (supine, 25 ± 8%; seated, 29 ± 15%; standing, 29 ± 12%; p = 0.117), implying no impact on both measurement feasibility and reliability. Conclusions We demonstrated, for the first time, the feasibility of utilizing upright postures as an alternative measurement protocol for TE. We further unravel a previously unrecognized role of transitioning between different postures to assist the diagnosis of cirrhosis. The findings suggested that daily physiological activity of postural changes suffices to alter LS. Therefore, body positioning should be standardized and carefully considered when interpreting LS.https://doi.org/10.1186/s12876-024-03473-8Body positionMeasuring posturePatient positioningLiver fibrosisLiver stiffness measurementUltrasound elastography |
| spellingShingle | Zi-Hao Huang Miao-Qin Deng Yangmin Lin Chen-Hui Ye Ming-Hua Zheng Yong-Ping Zheng Body posture can modulate liver stiffness measured by transient elastography: a prospective observational study BMC Gastroenterology Body position Measuring posture Patient positioning Liver fibrosis Liver stiffness measurement Ultrasound elastography |
| title | Body posture can modulate liver stiffness measured by transient elastography: a prospective observational study |
| title_full | Body posture can modulate liver stiffness measured by transient elastography: a prospective observational study |
| title_fullStr | Body posture can modulate liver stiffness measured by transient elastography: a prospective observational study |
| title_full_unstemmed | Body posture can modulate liver stiffness measured by transient elastography: a prospective observational study |
| title_short | Body posture can modulate liver stiffness measured by transient elastography: a prospective observational study |
| title_sort | body posture can modulate liver stiffness measured by transient elastography a prospective observational study |
| topic | Body position Measuring posture Patient positioning Liver fibrosis Liver stiffness measurement Ultrasound elastography |
| url | https://doi.org/10.1186/s12876-024-03473-8 |
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