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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Increased Liver Stiffness in Systemic Sclerosis: A Single-Centre Transient Elastography Study

  • Nicola Ortalli1,2
  • Alberto Civolani3
  • Simone Aldo Lari1,2
  • Emanuela Vargiu1,3
  • Erika Meleddu1,2
  • Maria Maddalena Angioni1
  • Alberto Floris1,2
  • Sara Onali1,3
  • Matteo Piga1,2
  • Massimo Claudio Fantini1,3
  • Alessandra Vacca1,4
  • Alberto Cauli1,2
4 affiliations
  1. 1Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, Italy
  2. 2Rheumatology Unit, Azienda Ospedaliero Universitaria di Cagliari, 09042 Monserrato, Italy
  3. 3Gastroenterology Unit, Azienda Ospedaliero Universitaria di Cagliari, 09042 Monserrato, Italy
  4. 4Rheumatology Unit, ASL Sulcis Iglesiente, 09012 Iglesias, Italy
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Abstract

Background/Objectives: This study aimed to evaluate whether liver stiffness (LS), as assessed by transient elastography (TE), is increased in patients with systemic sclerosis (SSc) and to identify the factors associated with LS. Methods: In this exploratory cross-sectional study, the LS value and the prevalence of LS ≥ 5.3 and LS ≥ 7.5 kPa in 94 SSc patients and 50 healthy controls (HCs) were compared by univariate and multivariate analyses (adjusted for age and sex). TE was performed using FibroScan® and LS values were expressed in kPa. Clinical and laboratory variables were analysed as factors potentially associated with LS, LS ≥ 5.3 kPa and LS ≥ 7.5 kPa, in exploratory analyses adjusted for a pre-specified set of confounders. Results: Among the 94 SSc patients, 79 (84%) were female; median age was 59 (49–70) years, and median disease duration was 8 (3–13) years. LS was significantly higher in SSc patients than in HCs in both univariate (5.12 ± 1.95 vs. 4.18 ± 0.98 kPa, p < 0.001) and multivariate analyses (β = 0.289, p = 0.001), with a higher prevalence of LS ≥ 5.3 kPa (40.4% vs. 10.0%, adjOR 6.85, p = 0.001) and LS ≥ 7.5 kPa (11.7% vs. 0%, p = 0.009). Only a limited number of factors were associated with LS abnormalities: telangiectasias (β = 0.222, p = 0.044) and glutamic–oxaloacetic transaminase (GOT) (β = 0.278, p = 0.012) for LS, and GOT (adjOR 1.082, p = 0.020) and anti-centromere antibodies (adjOR 4.09, p = 0.017) for LS ≥ 5.3 kPa. In univariate analysis, LS ≥ 7.5 kPa was associated with pulmonary hypertension (p = 0.049), pre-capillary pulmonary hypertension (p = 0.011), and GOT (p = 0.032); no multivariate model was fitted because of the few events. Conclusions: SSc patients show increased LS values and a higher prevalence of both LS ≥ 5.3 kPa and LS ≥ 7.5 kPa than HCs, easily detectable by TE. These findings are exploratory and require confirmation in larger cohorts to determine whether increased LS in SSc reflects hepatic fibrosis and whether it carries clinical and prognostic implications.

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Cite

BibTeXRIS
BibTeX
@article{ortalli2026increased,
  title = {{Increased Liver Stiffness in Systemic Sclerosis: A Single-Centre Transient Elastography Study}},
  author = {Nicola Ortalli and Alberto Civolani and Simone Aldo Lari and Emanuela Vargiu and Erika Meleddu and Maria Maddalena Angioni and Alberto Floris and Sara Onali and Matteo Piga and Massimo Claudio Fantini and Alessandra Vacca and Alberto Cauli},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = nov,
  doi = {10.3390/jcm15218593},
  url = {https://www.mdpi.com/2077-0383/15/21/8593},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Increased Liver Stiffness in Systemic Sclerosis: A Single-Centre Transient Elastography Study
AU  - Nicola Ortalli
AU  - Alberto Civolani
AU  - Simone Aldo Lari
AU  - Emanuela Vargiu
AU  - Erika Meleddu
AU  - Maria Maddalena Angioni
AU  - Alberto Floris
AU  - Sara Onali
AU  - Matteo Piga
AU  - Massimo Claudio Fantini
AU  - Alessandra Vacca
AU  - Alberto Cauli
PY  - 2026
DA  - 2026/11/04
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218593
UR  - https://www.mdpi.com/2077-0383/15/21/8593
AB  - Background/Objectives: This study aimed to evaluate whether liver stiffness (LS), as assessed by transient elastography (TE), is increased in patients with systemic sclerosis (SSc) and to identify the factors associated with LS. Methods: In this exploratory cross-sectional study, the LS value and the prevalence of LS ≥ 5.3 and LS ≥ 7.5 kPa in 94 SSc patients and 50 healthy controls (HCs) were compared by univariate and multivariate analyses (adjusted for age and sex). TE was performed using FibroScan® and LS values were expressed in kPa. Clinical and laboratory variables were analysed as factors potentially associated with LS, LS ≥ 5.3 kPa and LS ≥ 7.5 kPa, in exploratory analyses adjusted for a pre-specified set of confounders. Results: Among the 94 SSc patients, 79 (84%) were female; median age was 59 (49–70) years, and median disease duration was 8 (3–13) years. LS was significantly higher in SSc patients than in HCs in both univariate (5.12 ± 1.95 vs. 4.18 ± 0.98 kPa, p < 0.001) and multivariate analyses (β = 0.289, p = 0.001), with a higher prevalence of LS ≥ 5.3 kPa (40.4% vs. 10.0%, adjOR 6.85, p = 0.001) and LS ≥ 7.5 kPa (11.7% vs. 0%, p = 0.009). Only a limited number of factors were associated with LS abnormalities: telangiectasias (β = 0.222, p = 0.044) and glutamic–oxaloacetic transaminase (GOT) (β = 0.278, p = 0.012) for LS, and GOT (adjOR 1.082, p = 0.020) and anti-centromere antibodies (adjOR 4.09, p = 0.017) for LS ≥ 5.3 kPa. In univariate analysis, LS ≥ 7.5 kPa was associated with pulmonary hypertension (p = 0.049), pre-capillary pulmonary hypertension (p = 0.011), and GOT (p = 0.032); no multivariate model was fitted because of the few events. Conclusions: SSc patients show increased LS values and a higher prevalence of both LS ≥ 5.3 kPa and LS ≥ 7.5 kPa than HCs, easily detectable by TE. These findings are exploratory and require confirmation in larger cohorts to determine whether increased LS in SSc reflects hepatic fibrosis and whether it carries clinical and prognostic implications.
SN  - 2077-0383
ER  -