Sae Kyung Joo1, Won Kim1, Donghee Kim2, Jung Ho Kim3, Sohee Oh4, Kook Lae Lee1, Mee Soo Chang3, Yong Jin Jung1, Young Ho So5, Myoung Seok Lee5, Jeong Mo Bae3, Byeong Gwan Kim1. 1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea. 2. Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA. 3. Department of Pathology, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea. 4. Department of Biostatistics, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea. 5. Department of Radiology, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea.
Abstract
BACKGROUND & AIMS: Nonalcoholic fatty liver disease (NAFLD) includes a wide spectrum of heterogeneous metabolic subtypes. This study compared the diagnostic performances of noninvasive fibrosis tests in predicting advanced fibrosis among patients with NAFLD and examined the effects of the subgroups on their diagnostic performances. METHODS: Three hundred fifteen patients with biopsy-proven NAFLD were prospectively enrolled. Acoustic radiation force impulse imaging (ARFI) was performed to obtain liver stiffness measurements (LSMs). The aspartate aminotransferase-to-alanine aminotransferase ratio (AAR), aspartate aminotransferase-to-platelet ratio index (APRI), fibrosis 4 index (FIB-4), NAFLD fibrosis score (NFS) and BARD score were calculated. The diagnostic performances of noninvasive fibrosis tests were evaluated using the area under the receiver operating characteristic curve (AUROC). RESULTS: Fibrosis 4 index (FIB-4) showed the highest AUROC for advanced fibrosis (0.866; 95% CI, 0.811-0.922). AUROC subgroup analyses were performed to assess the effects of the subgroups on diagnostic performance. For patients with advanced fibrosis, the APRI, BARD, FIB-4 and NFS AUROCs were significantly different among the radiological steatosis grades. Additionally, the AUROC of ARFI tended to decrease with increasing radiological steatosis severity. FIB-4 and NFS showed significantly lower AUROCs for advanced fibrosis in obese NAFLD than in nonobese NAFLD (P = .002 and P < .001 respectively). However, only radiological steatosis severity was independently associated with advanced fibrosis in multivariable analysis. CONCLUSIONS: Steatosis severity may affect the diagnostic performances of noninvasive fibrosis tests in patients with NAFLD. The application of different tools should be tailored for various NAFLD subgroups to optimize noninvasive fibrosis assessments.
BACKGROUND & AIMS:Nonalcoholic fatty liver disease (NAFLD) includes a wide spectrum of heterogeneous metabolic subtypes. This study compared the diagnostic performances of noninvasive fibrosis tests in predicting advanced fibrosis among patients with NAFLD and examined the effects of the subgroups on their diagnostic performances. METHODS: Three hundred fifteen patients with biopsy-proven NAFLD were prospectively enrolled. Acoustic radiation force impulse imaging (ARFI) was performed to obtain liver stiffness measurements (LSMs). The aspartate aminotransferase-to-alanine aminotransferase ratio (AAR), aspartate aminotransferase-to-platelet ratio index (APRI), fibrosis 4 index (FIB-4), NAFLD fibrosis score (NFS) and BARD score were calculated. The diagnostic performances of noninvasive fibrosis tests were evaluated using the area under the receiver operating characteristic curve (AUROC). RESULTS:Fibrosis 4 index (FIB-4) showed the highest AUROC for advanced fibrosis (0.866; 95% CI, 0.811-0.922). AUROC subgroup analyses were performed to assess the effects of the subgroups on diagnostic performance. For patients with advanced fibrosis, the APRI, BARD, FIB-4 and NFS AUROCs were significantly different among the radiological steatosis grades. Additionally, the AUROC of ARFI tended to decrease with increasing radiological steatosis severity. FIB-4 and NFS showed significantly lower AUROCs for advanced fibrosis in obese NAFLD than in nonobese NAFLD (P = .002 and P < .001 respectively). However, only radiological steatosis severity was independently associated with advanced fibrosis in multivariable analysis. CONCLUSIONS:Steatosis severity may affect the diagnostic performances of noninvasive fibrosis tests in patients with NAFLD. The application of different tools should be tailored for various NAFLD subgroups to optimize noninvasive fibrosis assessments.
Authors: Daniele Pastori; Gregory Y H Lip; Alessio Farcomeni; Francesco Del Sole; Angela Sciacqua; Francesco Perticone; Rossella Marcucci; Elisa Grifoni; Pasquale Pignatelli; Francesco Violi Journal: Data Brief Date: 2018-02-06
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Authors: Ferenc Emil Mózes; Jenny A Lee; Emmanuel Anandraj Selvaraj; Arjun Narayan Ajmer Jayaswal; Michael Trauner; Jerome Boursier; Céline Fournier; Katharina Staufer; Rudolf E Stauber; Elisabetta Bugianesi; Ramy Younes; Silvia Gaia; Monica Lupșor-Platon; Salvatore Petta; Toshihide Shima; Takeshi Okanoue; Sanjiv Mahadeva; Wah-Kheong Chan; Peter J Eddowes; Gideon M Hirschfield; Philip Noel Newsome; Vincent Wai-Sun Wong; Victor de Ledinghen; Jiangao Fan; Feng Shen; Jeremy F Cobbold; Yoshio Sumida; Akira Okajima; Jörn M Schattenberg; Christian Labenz; Won Kim; Myoung Seok Lee; Johannes Wiegand; Thomas Karlas; Yusuf Yılmaz; Guruprasad Padur Aithal; Naaventhan Palaniyappan; Christophe Cassinotto; Sandeep Aggarwal; Harshit Garg; Geraldine J Ooi; Atsushi Nakajima; Masato Yoneda; Marianne Ziol; Nathalie Barget; Andreas Geier; Theresa Tuthill; M Julia Brosnan; Quentin Mark Anstee; Stefan Neubauer; Stephen A Harrison; Patrick M Bossuyt; Michael Pavlides Journal: Gut Date: 2021-05-17 Impact factor: 23.059