{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T22:37:16Z","timestamp":1792103836950,"version":"4.4.0"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,5,16]],"date-time":"2019-05-16T00:00:00Z","timestamp":1557964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81470840"],"award-info":[{"award-number":["81470840"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81873565"],"award-info":[{"award-number":["81873565"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81600464"],"award-info":[{"award-number":["81600464"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Liver stiffness measurement (LSM) by transient elastography is a noninvasive method for the diagnosis of hepatic fibrosis. The impact of hepatic steatosis on LSM remains to be explored.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine whether LSM is affected by hepatic steatosis in patients with chronic hepatitis B (CHB).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Consecutive patients with biopsy\u2010proven CHB were prospectively enrolled. Hepatic steatosis was classified by pathology as none (S0, &lt;5%), mild (S1, 5%\u201033%), and moderate\u2010severe (S2\u20103, &gt;33%), and quantitatively by controlled attenuation parameter (CAP) as CAP S0 (\u2264247\u00a0dB\/m), CAP S1 (248\u2010267\u00a0dB\/m) and CAP S2\u20103 (\u2265268\u00a0dB\/m). Liver fibrosis was assessed by METAVIR classification and noninvasively by LSM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of non\u2010alcoholic fatty liver disease (n\u00a0=\u00a0223) in CHB patients (n\u00a0=\u00a0593) was 37.6%. Forty\u2010eight belonged to S2\u20103 and 127 belonged to CAP S2\u20103. In patients without significant fibrosis (F0\u20101), the median LSM (kPa) was 7.4 in S2\u20103 and 7.1 in CAP S2\u20103, which was significantly higher than that in S0\/S1 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.005) and CAP S0\/S1 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.003). No significant difference was found in significant fibrosis (F2\u20104). For LSM identifying significant fibrosis (F2\u20104), the negative predictive value was higher in CHB patients with CAP\u00a0\u2265\u00a0268 compared to those with CAP\u00a0&lt;\u00a0268 (0.81 vs 0.73); the positive predictive value was lower in CAP\u00a0\u2265\u00a0268 than its counterpart (0.65 vs 0.76).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Moderate\u2010severe steatosis increased the LSM value in CHB patients without significant fibrosis. A CAP\u00a0\u2265\u00a0268 did not affect LSM for ruling out, but it slightly affected LSM for ruling in significant fibrosis. Trial Registration: ChiCTR\u2010DDT\u201013003983.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.15298","type":"journal-article","created":{"date-parts":[[2019,5,16]],"date-time":"2019-05-16T07:39:40Z","timestamp":1557992380000},"page":"93-102","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Moderate to severe hepatic steatosis leads to overestimation of liver stiffness measurement in chronic hepatitis B patients without significant fibrosis"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7782-2211","authenticated-orcid":false,"given":"Feng","family":"Shen","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Center for Fatty Liver Xinhua Hospital, Shanghai Jiaotong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Qiang","family":"Mi","sequence":"additional","affiliation":[{"name":"Research Institute of Liver Diseases, Tianjin Second People's Hospital Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Xu","sequence":"additional","affiliation":[{"name":"Research Institute of Liver Diseases, Tianjin Second People's Hospital Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong\u2010Gang","family":"Liu","sequence":"additional","affiliation":[{"name":"Research Institute of Liver Diseases, Tianjin Second People's Hospital Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao\u2010Ying","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pathology Xinhua Hospital, Shanghai Jiaotong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Center for Fatty Liver Xinhua Hospital, Shanghai Jiaotong 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