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, 10 (9), e0139227

Relationship Between Cerebral Microbleeds and Liver Stiffness Determined by Transient Elastography


Relationship Between Cerebral Microbleeds and Liver Stiffness Determined by Transient Elastography

Young Dae Kim et al. PLoS One.


Background & aims: Liver fibrosis is a multifactorial disease that can affect the development of cerebral small vessel diseases (SVDs) including cerebral microbleeds (CMBs), leukoaraiosis, and silent infarctions. Transient elastography can accurately assess the degree of liver fibrosis by measuring liver stiffness (LS). In the present study, we investigated the association between SVDs and LS values.

Methods: We recruited 300 participants (mean age 56 years, 170 men) who underwent a comprehensive medical health check-up between January 2011 and December 2012. Transient elastography was taken on the right lobe of the liver through intercostal space with patients lying in the dorsal decubitus position with the right arm in maximal abduction. Mild and significant fibrosis were defined as LS values >5.6 and >8.0 kPa, respectively. The presence of each SVD was determined using the FLAIR, GRE MR imaging as well as T1-, T2-weighted MR images. We tested whether the presence and burden of each type of SVD were different by LS values.

Results: Of the different types of SVDs, only the presence (p = 0.001) and number of CMBs (p<0.001) were positively associated with LS values. Multivariate analysis revealed that significant fibrosis (>8.0 kPa) was an independent predictor of CMBs (odds ratio 6.079, 95% confidence interval 1.489-24.819, p = 0.012). However, leukoaraiosis and silent infarctions were not associated with LS values (all p>0.05).

Conclusions: The degree of liver fibrosis, as assessed using transient elastography, was independently associated with the presence and burden of CMBs in healthy, asymptomatic participants. Understanding the link between the brain and liver may advance future research on the pathomechanisms of CMBs.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.


Fig 1
Fig 1. Increasing number of CMBs in lobar (A) and non-lobar (B) areas with higher LS values.

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Grant support

This study was supported by the Liver Cirrhosis Clinical Research Center, in part by a grant from the Korea Healthcare technology R & D project, Ministry of Health and Welfare, Republic of Korea (no. HI10C2020). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The funding does not alter the authors' adherence to all the journal policies on sharing data and materials.