Aspartate transaminase to platelet ratio index (APRI) but not FIB-5 or FIB-4 is accurate in ruling out significant fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) in an urban slum-dwelling population.

APRI FIB-4 FIB-5 non-alcoholic fatty liver disease significant fibrosis

Journal

BMJ open gastroenterology
ISSN: 2054-4774
Titre abrégé: BMJ Open Gastroenterol
Pays: England
ID NLM: 101660690

Informations de publication

Date de publication:
2019
Historique:
received: 14 02 2019
revised: 17 04 2019
accepted: 23 04 2019
entrez: 6 7 2019
pubmed: 6 7 2019
medline: 6 7 2019
Statut: epublish

Résumé

Non-invasive assessment of fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) is challenging, especially in resource-limited settings. MR or transient elastography and many patented serum scores are costly and not widely available. There are limited data on accuracy of serum-based fibrosis scores in urban slum-dwelling population, which is a unique group due to its dietary habits and socioeconomic environment. We did this study to compare the accuracy of serum-based fibrosis scores to rule out significant fibrosis (SF) in this population. Histological and clinical data of 100 consecutive urban slum-dwelling patients with NAFLD were analysed. Institutional ethics committee permission was taken. Aspartate transaminase (AST) to platelet ratio index (APRI), fibrosis-4 index (FIB-4) and FIB-5 scores were compared among those with non-significant fibrosis (METAVIR; F0 to F1; n=73) and SF (METAVIR; F2 to F4; n=27). AST (IU/mL) (68.3±45.2 vs 23.9±10.9; p<0.0001), alanine transaminase (IU/mL) (76.4±36.8 vs 27.9±11.4; p<0.0001), FIB-4 (2.40±2.13 vs 0.85±0.52; p<0.0001) and APRI (1.18±0.92 vs 0.25±0.16; p<0.0001) were higher and platelets (100 000/mm APRI but not FIB-5 or FIB-4 is accurate in ruling out SF in patients with NAFLD in an urban slum-dwelling population.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
Non-invasive assessment of fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) is challenging, especially in resource-limited settings. MR or transient elastography and many patented serum scores are costly and not widely available. There are limited data on accuracy of serum-based fibrosis scores in urban slum-dwelling population, which is a unique group due to its dietary habits and socioeconomic environment. We did this study to compare the accuracy of serum-based fibrosis scores to rule out significant fibrosis (SF) in this population.
METHODS METHODS
Histological and clinical data of 100 consecutive urban slum-dwelling patients with NAFLD were analysed. Institutional ethics committee permission was taken. Aspartate transaminase (AST) to platelet ratio index (APRI), fibrosis-4 index (FIB-4) and FIB-5 scores were compared among those with non-significant fibrosis (METAVIR; F0 to F1; n=73) and SF (METAVIR; F2 to F4; n=27).
RESULTS RESULTS
AST (IU/mL) (68.3±45.2 vs 23.9±10.9; p<0.0001), alanine transaminase (IU/mL) (76.4±36.8 vs 27.9±11.4; p<0.0001), FIB-4 (2.40±2.13 vs 0.85±0.52; p<0.0001) and APRI (1.18±0.92 vs 0.25±0.16; p<0.0001) were higher and platelets (100 000/mm
CONCLUSIONS CONCLUSIONS
APRI but not FIB-5 or FIB-4 is accurate in ruling out SF in patients with NAFLD in an urban slum-dwelling population.

Identifiants

pubmed: 31275584
doi: 10.1136/bmjgast-2019-000288
pii: bmjgast-2019-000288
pmc: PMC6577364
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e000288

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Kailash Marotrao Kolhe (KM)

Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India.

Anjali Amarapurkar (A)

Pathology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India.

Pathik Parikh (P)

Gastroenterology, Zydus Hospitals, Ahmedabad, Gujarat, India.

Alisha Chaubal (A)

Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India.

Shamsher Chauhan (S)

Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India.

Harshad Khairnar (H)

Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India.

Swapnil Walke (S)

Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India.

Meghraj Ingle (M)

Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India.

Vikas Pandey (V)

Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India.

Akash Shukla (A)

Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India.

Classifications MeSH