Gaggini Melania1, Vigna Luisella2, Di Piazza Salvina2, Gori Francesca3, Tirelli Amedea Silvia4, Bamonti Fabrizia5, Maltinti Maristella6, Napolitano Filomena4, Chatzianagnostou Kyriazoula6, Cristina Vassalle7. 1. Institute of Clinical Physiology, CNR, Pisa, Italy. 2. Occupational Health Unit, Center of Obesity and Work EASO Collaborating Centers for Obesity Management, Fondazione Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 3. Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy. 4. Laboratory of Clinical Chemistry and Microbiology Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy. 5. Specialized in Clinical Chemistry and Biochemistry, Università degli Studi di Milano, Milan, Italy. 6. Fondazione CNR-Regione Toscana Gabriele Monasterio per la Ricerca Medica e di Sanità Pubblica, CNR via Moruzzi 1, 56100, Pisa, Italy. 7. Fondazione CNR-Regione Toscana Gabriele Monasterio per la Ricerca Medica e di Sanità Pubblica, CNR via Moruzzi 1, 56100, Pisa, Italy. cristina.vassalle@ftgm.it.
Abstract
BACKGROUND: The non-invasive assessment of steatosis/fibrosis tried to overcome some of peri-procedural risk of liver biopsy; for this, several indices of steatosis and fibrosis in liver have been proposed. AIM: To evaluate concordance of non-invasive fibrosis and steatosis indices in a large population of adult subjects at risk of NAFLD, and how obesity and its physio-pathological features may interact with steatosis/fibrosis indexes and related biomarkers of cardio-metabolic risk. METHODS: Indices of steatosis (fatty liver index-FLI), NAFLD liver fat score-NLFS)) and fibrosis (Fibrosis 4 (FIB-4), BARD, BAAT and FORN) were calculated in 1145 outpatients with overweight or obesity at risk for T2D and NAFLD. Indices were correlated with clinical variables. RESULTS: Concordance between tests occurred in 81% of the overall values between FLI and NLFS, but was lower when comparing the other fibrosis scores (FIB-4 vs FORN 72%, FIB-4 vs BARD 36%, BARD vs FORN 46%, BARD vs BAAT 58%, FIB-4 vs BAAT 46%, BAAT vs FORN 62%). Each index was differently correlated with anthropometric, clinical and laboratory variables. CONCLUSION: Indices evaluated retain low concordance, clinicians should be aware of these differences between steatosis/fibrosis scores when expressing a differential liver disease diagnosis or assessing the progression of a known liver disease. LEVEL OF EVIDENCE: Level V, descriptive research.
BACKGROUND: The non-invasive assessment of steatosis/fibrosis tried to overcome some of peri-procedural risk of liver biopsy; for this, several indices of steatosis and fibrosis in liver have been proposed. AIM: To evaluate concordance of non-invasive fibrosis and steatosis indices in a large population of adult subjects at risk of NAFLD, and how obesity and its physio-pathological features may interact with steatosis/fibrosis indexes and related biomarkers of cardio-metabolic risk. METHODS: Indices of steatosis (fatty liver index-FLI), NAFLD liver fat score-NLFS)) and fibrosis (Fibrosis 4 (FIB-4), BARD, BAAT and FORN) were calculated in 1145 outpatients with overweight or obesity at risk for T2D and NAFLD. Indices were correlated with clinical variables. RESULTS: Concordance between tests occurred in 81% of the overall values between FLI and NLFS, but was lower when comparing the other fibrosis scores (FIB-4 vs FORN 72%, FIB-4 vs BARD 36%, BARD vs FORN 46%, BARD vs BAAT 58%, FIB-4 vs BAAT 46%, BAAT vs FORN 62%). Each index was differently correlated with anthropometric, clinical and laboratory variables. CONCLUSION: Indices evaluated retain low concordance, clinicians should be aware of these differences between steatosis/fibrosis scores when expressing a differential liver disease diagnosis or assessing the progression of a known liver disease. LEVEL OF EVIDENCE: Level V, descriptive research.
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