Transient Elastographic Values of Healthy Volunteers in a Tertiary Care Hospital

  • Bhupendra Kumar Basnet Department of Medicine NAMS, Bir Hospital, Kathmandu
  • Sudhamshu KC Department of Medicine
  • Dilip Sharma Department of Medicine
  • Dinesh Shrestha Department of Medicine


Introduction:Transient elastography is a very promising non invasive procedure to determine liver stiffness for diagnosis of fibrosis in various chronic liver diseases. However, studies on normal values of liver stiffness in apparently healthy subjects are still few. We aimed to determine liver stiffness values in healthy Nepalese volunteers.

Methods:Transient elastography (FibroScanR, Echosens, Paris, France) was performed to find out liver stiffness values in 45 apparently healthy volunteers after explaining study protocol. Complete medical examination with routine laboratory tests was performed. Subjects with normal liver biochemistries and normal liver ultrasonography were taken for analysis.

Results:Mean liver stiffness value of study subjects was 4.24±0.70 kPa. Liver stiffness value was found higher in males than in females (4.32±0.74 vs 4.07±0.61 kPa, respectively, P=0.26) but not statistically significant. Similarly, comparison between age and liver stiffness also showed positive correlation (r=0.211) but not statistically significant (P=0.164)

Conclusions: Our study showed that the mean liver stiffness value was 4.24±0.70 kPa in our population and influence of age, gender and body mass index were not significant.

Keywords: chronic liver disease; FibroScanR; healthy volunteers; liver stiffness valve; transient elastography.

Author Biographies

Bhupendra Kumar Basnet, Department of Medicine NAMS, Bir Hospital, Kathmandu

Department of Medicine
NAMS, Bir Hospital, Kathmandu

Sudhamshu KC, Department of Medicine
Department of Medicine
Dilip Sharma, Department of Medicine
Department of Medicine
Dinesh Shrestha, Department of Medicine
Department of Medicine


1. Bugianesi E, Leone N, Vanni E, Marchesini G, Brunello F, Carucci P, et al. Expanding the natural history of nonalcoholic steatohepatitis: from cryptogenic cirrhosis to hepatocellular carcinoma. Gastroenterology. 2002;123:134-140.
2. Hui AY, Wong VW, Chan HL, Liew CT, Chan JL, Chan FK, et al. Histological progression of non-alcoholic fatty liver disease in Chinese patients. Aliment PharmacolTher. 2005;21:407-413.
3. NIH Consensus Statement on Management of Hepatitis C. 2002.Hepatology. 2002;36:S3-20.
4. Bravo AA, Sheth SG, Chopra S. Liver biopsy. N Engl J Med. 2001;344:495-500.
5. Cadranel JF, Rufat P, Degos F. Practices of liver biopsy in France: results of a prospective nationwide survey. For the Group of Epidemiology of the French Association for the Study of the Liver (AFEF).Hepatology. 2000;32:477–481.
6. Castera L, Negre I, Samii K, Buffet C. Pain experienced during percutaneous liver biopsy. Hepatology. 1999;30:1521-1530.
7. Fontana RJ, Lok AS. Noninvasive monitoring of patients with chronic hepatitis C. Hepatology. 2002;36:S57-64.
8.Sandrin L, Fourquet B, Hasquenoph JM, et al. Transient elastography: a new noninvasive method for assessment of hepatic fibrosis. Ultrasound Med Biol. 2003;29:1705-13.
9. Kettaneh A, Marcellin P, Douvin C, Poupon R, Ziol M, Beaugrand M, de Ledinghen
V. Features associated with success rate and performance of fibroscan measurements
for the diagnosis of cirrhosis in HCV patients: A prospective study of 935 patients. J
Hepatol. 2007;46:628-634.
10. Misra A,Chowbey P, Makkar BM, et al. Consensus Statement for Diagnosis of Obesity, Abdominal Obesity and the Metabolic Syndrome for Asian Indians and Recommendations for Physical Activity, Medical and Surgical Management. JAPI. 2009;57:163-170.
11. Ziol M, Handra-Luca A, Kettaneh A, et al. Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with chronic hepatitis C. Hepatology. 2005;41:48-54.
12. Castéra L, Vergniol J, Foucher J, et al. Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology. 2005;128:343-350.
13. Nitta Y, Kawabe N, Hashimoto S, et al. Liver stiffness measured by transient elastography correlates with fibrosis area in liver biopsy in patients with chronic hepatitis C. Hepatol Res. 2009;39:675-684.
14. Lupşor M, Badea R, Stefănescu H, et al. Analysis of histopathological changes that influence liver stiffness in chronic hepatitis C. Results from a cohort of 324 patients. J Gastrointestin Liver Dis. 2008;17:155-163.
15. Chan HL, Wong GL, Choi PC, et al. Alanine aminotransferase-based algorithms of liver stiffness measurement by transient elastography (Fibroscan) for liver fibrosis in chronic hepatitis B. J Viral Hepat. 2009;16:36-44.
16. Marcellin P, Ziol M, Bedossa P, et al. Non-invasive assessment of liver fibrosis by stiffness measurement in patients with chronic hepatitis B. Liver Int. 2009;29:242-247.
17. Lédinghen V, Douvin C, Kettaneh A, et al. Diagnosis of hepatic fibrosis and cirrhosis by transient elastography in HIV/hepatitis C virus-coinfected patients. J Acquir Immune Defi c Syndr. 2006;41:175-179.
18. Vergara S, Macías J, Rivero A, et al. The use of transient elastometry for assessing liver fibrosis in patients with HIV and hepatitis C virus coinfection.Clin Infect Dis. 2007;45:969-974.
19. Carrion JA, Navasa M, Bosch J, Bruguera M, Gilabert R, Forns X. Transient elastography for diagnosis of advanced fibrosis and portal hypertension in patients with hepatitis C recurrence after liver transplantation. Liver Transpl. 2006;12:1791-1798.
20. Rigamonti C, Donato MF, Fraquelli M, et al. Transient elastography predicts fibrosis progression in patients with recurrent hepatitis C after liver transplantation. Gut. 2008;57:821-827.
21. Corradi F, Piscaglia F, Flori S, et al. Assessment of liver fibrosis in transplant recipients with recurrent HCV infection: usefulness of transient elastography. Dig Liver Dis. 2009;41:217-225.
22. Harada N, Soejima Y, Taketomi A, et al. Assessment of graft fibrosis by transient elastography in patients with recurrent hepatitis C after living donor liver transplantation. Transplantation. 2008;85:69-74.
23. Corpechot C, El Naggar A, Poujol-Robert A, et al. Assessment of biliary fibrosis by transient elastography in patients with PBC and PSC. Hepatology. 2006;43:1118-1124.
24. Adhoute X, Foucher J, Laharie D, et al. Diagnosis of liver fibrosis using FibroScan and other noninvasive methods in patients with hemochromatosis: a prospective study. GastroenterolClin Biol. 2008;32:180-187.
25. Kim SU, Choi GH, Han WK, Kim BK, Park JY, Kim do Y, et al. What are ‘true normal’ liver stiffness values using FibroScan: a prospective study in healthy living liver and kidney donors in South Korea. Liver Int. 2010;30:268-274.
26. Fung J, Lai CL, Chan SC, But D, Seto WK, Cheng C, et al. Correlation of liver stiffness and histological features in healthy persons and in patients with occult hepatitis B, chronic active hepatitis B, or hepatitis B cirrhosis. Am J Gastroenterol. 2010;105:1116-1122.
27. Roulot D, Czernichow S, Le Clésiau H, Costes JL, Vergnaud AC, Beaugrand M. Liver stiffness values in apparently healthy subjects: influence of gender and metabolic syndrome. J Hepatol. 2008;48:606-613.
28. Colombo S, Belloli L, Buonocore M, et al. Liver stiffness values in the normal population: a studying voluntaryblood donors. Hepatology. 2008;48(Suppl):A995.
29. Sirli R, Sporea I, Tudora A, et al. Transient elastographic evaluation of subjects without known hepatic pathology: does age change the liver stiffness? J Gastrointestin Liver Dis. 2009; 18:57-60.
30.Corpechot C, El Naggar A, Poupon R. Gender and liver: is the liver stiffness weaker in weaker sex? Hepatology. 2006;44:513-4.
31.Berzigotti A , Seijo S, Arena U, Abrajdes JG, Vizzutti F,Garcia-Pagan JC ,Pinzani M, Bosch J. Elastography, spleen size, and platelet count identify portal hypertension in patients with compensated cirrhosis.Gastroenterology,2013;144:102-111.
How to Cite
Basnet, B. K., KC, S., Sharma, D., & Shrestha, D. (2014). Transient Elastographic Values of Healthy Volunteers in a Tertiary Care Hospital. Journal of Nepal Medical Association, 52(193), 661-667.
Original Article