Assessment of liver stiffness and steatosis in patients with intestinal failure: a cross-sectional study

A total of 33 patients (median age, 57 years; BMI, 23 kg/m²) and 14 controls (median age, 58 years; BMI, 24 kg/m²) were examined. Patients had higher LSMs compared to controls (5.6 kPa vs. 4.3 kPa; <i>p</i> = 0.0079). Elevated LSMs (>7 kPa) were seen in 37% of patients vs. 0% in controls (<i>p</i> = 0.0085). LSMs were associated with HPS energy (<i>p</i> = 0.026) and lipid content (<i>p</i> = 0.029). Median MRI-PDFF was 1.8% in patients and 1.5% in controls (<i>p</i> = 0.43). Nineteen percent of patients exhibited elevated MRI-PDFF (≥8%) vs. 7% in controls (<i>p</i> = 0.41). Alkaline phosphatase and gamma-glutamyltransferase levels >1.5x the ULN were observed in 21 and 45% of patients, respectively. Overall, these results indicate that in this adult IF population, elevated LSMs and a cholestatic pattern in liver enzymes were more prevalent than steatosis as assessed by MRI-PDFF. Patients at risk of increased liver stiffness appeared to have severe IF as indicated by high HPS energy and lipid requirements.