Comparing the performance of Fibrosis-4 and Non-Alcoholic Fatty Liver Disease Fibrosis Score with transient elastography scores of people with non-alcoholic fatty liver disease.

cirrhosis fibrosis liver non-alcoholic fatty liver transient elastography

Journal

Canadian liver journal
ISSN: 2561-4444
Titre abrégé: Can Liver J
Pays: Canada
ID NLM: 101778326

Informations de publication

Date de publication:
2021
Historique:
received: 17 01 2021
accepted: 18 03 2021
entrez: 22 8 2022
pubmed: 23 8 2022
medline: 23 8 2022
Statut: epublish

Résumé

With the rate of non-alcoholic fatty liver disease (NAFLD) on the rise, the necessity of identifying patients at risk of cirrhosis and its complications is becoming ever more important. Liver biopsy remains the gold standard for assessing fibrosis, although costs, risks, and availability prohibit its widespread use with at-risk patients. Transient elastography has proven to be a non-invasive and accurate way of assessing fibrosis, although the availability of this modality is often limited in primary care settings. The Fibrosis-4 (FIB-4) and Non-Alcoholic Fatty Liver Disease Fibrosis Score (NFS) are scoring systems that incorporate commonly measured lab parameters and BMI to predict fibrosis. In this study, we compared FIB-4 and NFS scores with transient elastography scores to assess the accuracy of these inexpensive and readily available scoring systems in detecting fibrosis. Using an NFS score cut-off of -1.455 and a FibroScan score cut-off of ≥8.7 kPa, the NFS score had a negative predictive value of 94.1%. Using a FibroScan score cut-off of ≥8.7 kPa, the FIB-4 score had a negative predictive value of 91.6%. The NFS and FIB-4 are non-invasive, inexpensive scoring systems that have high negative predictive value for fibrosis compared with transient elastography scores. These findings suggest that the NFS and FIB-4 can provide adequate reassurance to rule out fibrosis in patients with NAFLD and can be used with select patients to circumvent the need for transient elastography or liver biopsy.

Sections du résumé

Background UNASSIGNED
With the rate of non-alcoholic fatty liver disease (NAFLD) on the rise, the necessity of identifying patients at risk of cirrhosis and its complications is becoming ever more important. Liver biopsy remains the gold standard for assessing fibrosis, although costs, risks, and availability prohibit its widespread use with at-risk patients. Transient elastography has proven to be a non-invasive and accurate way of assessing fibrosis, although the availability of this modality is often limited in primary care settings. The Fibrosis-4 (FIB-4) and Non-Alcoholic Fatty Liver Disease Fibrosis Score (NFS) are scoring systems that incorporate commonly measured lab parameters and BMI to predict fibrosis.
Method UNASSIGNED
In this study, we compared FIB-4 and NFS scores with transient elastography scores to assess the accuracy of these inexpensive and readily available scoring systems in detecting fibrosis.
Results UNASSIGNED
Using an NFS score cut-off of -1.455 and a FibroScan score cut-off of ≥8.7 kPa, the NFS score had a negative predictive value of 94.1%. Using a FibroScan score cut-off of ≥8.7 kPa, the FIB-4 score had a negative predictive value of 91.6%.
Conclusion UNASSIGNED
The NFS and FIB-4 are non-invasive, inexpensive scoring systems that have high negative predictive value for fibrosis compared with transient elastography scores. These findings suggest that the NFS and FIB-4 can provide adequate reassurance to rule out fibrosis in patients with NAFLD and can be used with select patients to circumvent the need for transient elastography or liver biopsy.

Identifiants

pubmed: 35992256
doi: 10.3138/canlivj-2021-0004
pmc: PMC9202768
doi:

Types de publication

Journal Article

Langues

eng

Pagination

275-282

Informations de copyright

Copyright © 2021 Canadian Association for the Study of the Liver.

Déclaration de conflit d'intérêts

The authors have nothing to disclose.

Références

Hepatol Int. 2016 Jul;10(4):632-9
pubmed: 26558795
World J Gastroenterol. 2015 Oct 21;21(39):11077-87
pubmed: 26494963
Lancet. 2019 Dec 14;394(10215):2184-2196
pubmed: 31813633
Clin Gastroenterol Hepatol. 2015 Nov;13(12):2062-70
pubmed: 26226097
N Engl J Med. 2010 May 6;362(18):1675-85
pubmed: 20427778
BMC Gastroenterol. 2019 Jul 11;19(1):122
pubmed: 31296161
Gastroenterology. 2005 Jul;129(1):113-21
pubmed: 16012941
Aliment Pharmacol Ther. 2011 Aug;34(3):274-85
pubmed: 21623852
Clin Gastroenterol Hepatol. 2011 Jun;9(6):524-530.e1; quiz e60
pubmed: 21440669
Gut. 2010 Sep;59(9):1265-9
pubmed: 20801772
J Hepatol. 2016 Sep;65(3):570-8
pubmed: 27151181
Clin Gastroenterol Hepatol. 2009 Oct;7(10):1104-12
pubmed: 19523535
J Hepatol. 2019 Aug;71(2):371-378
pubmed: 30965069
Gastroenterology. 2015 Mar;148(3):547-55
pubmed: 25461851
Liver Int. 2017 Jan;37 Suppl 1:81-84
pubmed: 28052624
Hepatology. 2012 Jun;55(6):2005-23
pubmed: 22488764
Hepatology. 2007 Apr;45(4):846-54
pubmed: 17393509
Gastroenterology. 2008 Oct;135(4):1176-84
pubmed: 18718471
Hepatology. 2006 Jun;43(6):1317-25
pubmed: 16729309
Hepatology. 2010 Feb;51(2):454-62
pubmed: 20101745

Auteurs

Ben Cox (B)

Division of General Internal Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.

Roberto Trasolini (R)

Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada.

Ciaran Galts (C)

Division of General Internal Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.

Eric M Yoshida (EM)

Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada.

Vladimir Marquez (V)

Division of General Internal Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.

Classifications MeSH