Antonio De Vincentis1, Luisa Costanzo2, Umberto Vespasiani-Gentilucci3, Antonio Picardi3, Stefania Bandinelli4, Luigi Ferrucci5, Raffaele Antonelli Incalzi2, Claudio Pedone2. 1. Geriatric and Gerontology Department, Campus Bio-Medico University, Rome, Italy; Clinical Medicine and Hepatology Department, Campus Bio-Medico University, Rome, Italy. Electronic address: a.devincentis@unicampus.it. 2. Geriatric and Gerontology Department, Campus Bio-Medico University, Rome, Italy. 3. Clinical Medicine and Hepatology Department, Campus Bio-Medico University, Rome, Italy. 4. Local Health Agency of Florence, Florence, Italy. 5. National Institute on Aging, National Institutes of Health, Baltimore, Maryland, United States of America.
Abstract
BACKGROUND: The relation between liver fibrosis scores and health outcomes in older people has been barely investigated. We aimed to evaluate the association of four liver fibrosis scores (fibrosis-4 -FIB-4-, NAFLD fibrosis score -NFS-, BARD and aspartate aminotransferase/alanine aminotransferase ratio -AST/ALT-) with mortality and incident disability at 6 years in an older population. METHODS: We studied 962 individuals aged ≥65 (mean age 74.4; female 55.5%) with a mean follow-up of 95.7 months, enrolled in the InCHIANTI study. The relationship between liver fibrosis scores and mortality and disability was assessed through Cox and log-binomial regressions. RESULTS: NFS and FIB-4 were associated with higher overall (aHR ranging 1.38-1.78 for intermediate risk of fibrosis and 1.60-2.02 for high risk) and cardiovascular (aHR ranging 1.76-2.90 for intermediate and 2.22-2.42 for high risk) mortality. AST/ALT and BARD were only associated with overall mortality. Only NFS and FIB-4 high risk classes were associated with incident disability (aRR ranging 1.93-2.76). Despite poor sensitivity, all scores showed high specificity (ranging 0.88-0.95). CONCLUSION: Higher risk of liver fibrosis is associated with higher risk of poor health outcomes. Liver fibrosis scores may help to stratify the risk and, mainly, identify elderly patients with favorable prognosis.
BACKGROUND: The relation between liver fibrosis scores and health outcomes in older people has been barely investigated. We aimed to evaluate the association of four liver fibrosis scores (fibrosis-4 -FIB-4-, NAFLD fibrosis score -NFS-, BARD and aspartate aminotransferase/alanine aminotransferase ratio -AST/ALT-) with mortality and incident disability at 6 years in an older population. METHODS: We studied 962 individuals aged ≥65 (mean age 74.4; female 55.5%) with a mean follow-up of 95.7 months, enrolled in the InCHIANTI study. The relationship between liver fibrosis scores and mortality and disability was assessed through Cox and log-binomial regressions. RESULTS: NFS and FIB-4 were associated with higher overall (aHR ranging 1.38-1.78 for intermediate risk of fibrosis and 1.60-2.02 for high risk) and cardiovascular (aHR ranging 1.76-2.90 for intermediate and 2.22-2.42 for high risk) mortality. AST/ALT and BARD were only associated with overall mortality. Only NFS and FIB-4 high risk classes were associated with incident disability (aRR ranging 1.93-2.76). Despite poor sensitivity, all scores showed high specificity (ranging 0.88-0.95). CONCLUSION: Higher risk of liver fibrosis is associated with higher risk of poor health outcomes. Liver fibrosis scores may help to stratify the risk and, mainly, identify elderly patients with favorable prognosis.
Authors: Umberto Vespasiani-Gentilucci; Paolo Gallo; Antonio De Vincentis; Giovanni Galati; Antonio Picardi Journal: World J Gastroenterol Date: 2014-03-21 Impact factor: 5.742
Authors: Paul Angulo; David E Kleiner; Sanne Dam-Larsen; Leon A Adams; Einar S Bjornsson; Phunchai Charatcharoenwitthaya; Peter R Mills; Jill C Keach; Heather D Lafferty; Alisha Stahler; Svanhildur Haflidadottir; Flemming Bendtsen Journal: Gastroenterology Date: 2015-04-29 Impact factor: 22.682
Authors: Edith M Koehler; Jeoffrey N L Schouten; Bettina E Hansen; Frank J A van Rooij; Albert Hofman; Bruno H Stricker; Harry L A Janssen Journal: J Hepatol Date: 2012-08-04 Impact factor: 25.083
Authors: L Ferrucci; S Bandinelli; E Benvenuti; A Di Iorio; C Macchi; T B Harris; J M Guralnik Journal: J Am Geriatr Soc Date: 2000-12 Impact factor: 5.562
Authors: Paul Angulo; Elisabetta Bugianesi; Einar S Bjornsson; Phunchai Charatcharoenwitthaya; Peter R Mills; Francisco Barrera; Svanhildur Haflidadottir; Christopher P Day; Jacob George Journal: Gastroenterology Date: 2013-07-13 Impact factor: 22.682
Authors: Paul Angulo; Jason M Hui; Giulio Marchesini; Ellisabetta Bugianesi; Jacob George; Geoffrey C Farrell; Felicity Enders; Sushma Saksena; Alastair D Burt; John P Bida; Keith Lindor; Schuyler O Sanderson; Marco Lenzi; Leon A Adams; James Kench; Terry M Therneau; Christopher P Day Journal: Hepatology Date: 2007-04 Impact factor: 17.425
Authors: Laura Pimpin; Helena Cortez-Pinto; Francesco Negro; Emily Corbould; Jeffrey V Lazarus; Laura Webber; Nick Sheron Journal: J Hepatol Date: 2018-05-17 Impact factor: 25.083
Authors: Ameer Abutaleb; Jose Antonio Almario; Saleh Alghsoon; Ji Ae Yoon; Kate Gheysens; Shyam Kottilil; Eleanor Wilson Journal: J Clin Exp Hepatol Date: 2020-08-09