Body posture can modulate liver stiffness measured by transient elastography: a prospective observational study

• Published in: BMC gastroenterology 2024-10, Vol.24 (1), p.386-12, Article 386
• Main Authors: Huang, Zi-Hao, Deng, Miao-Qin, Lin, Yangmin, Ye, Chen-Hui, Zheng, Ming-Hua, Zheng, Yong-Ping
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biopsy; Blood pressure; Body position; Case-Control Studies; Cholesterol; Cirrhosis; Clinical significance; Confounding (Statistics); Diabetes; Diagnosis; Diagnosis, Ultrasonic; Elasticity Imaging Techniques - methods; Female; Fibrosis; Gallbladder diseases; Health aspects; Hemodynamics; Hepatitis; Humans; Hypertension; Liver - diagnostic imaging; Liver - pathology; Liver - physiopathology; Liver cirrhosis; Liver Cirrhosis - diagnostic imaging; Liver Cirrhosis - physiopathology; Liver diseases; Liver fibrosis; Liver stiffness measurement; Male; Measuring posture; Metabolic disorders; Methods; Middle Aged; Patient positioning; Patients; Positioning; Posture; Posture - physiology; Prospective Studies; Standing Position; Supine Position; Transplants & implants; Ultrasound elastography
• ISSN: 1471-230X; 1471-230X
• DOI: 10.1186/s12876-024-03473-8

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. 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 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