Rule Out Eight Conditions Before Fatty Liver Disease Dx

2006 ◽  
Vol 39 (19) ◽  
pp. 50
Author(s):  
SHERRY BOSCHERT
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Rule Out

scholarly journals A188 COMPARING THE PERFORMANCE OF FIBROSIS-4 (FIB-4) AND NON-ALCOHOLIC FATTY LIVER DISEASE FIBROSIS SCORE (NFS) WITH FIBROSCAN SCORES IN NON-ALCOHOLIC FATTY LIVER DISEASE

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 59-60
Author(s):  
B D Cox ◽  
R Trasolini ◽  
C Galts ◽  
E M Yoshida ◽  
V Marquez
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Fatty Liver Disease ◽  
Scoring Systems ◽  
Alcoholic Fatty Liver ◽  
Non Invasive ◽  
Alcoholic Fatty Liver Disease ◽  
Rule Out

Abstract Background With the rates 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 the costs, risks, and availability prohibit its widespread use for at-risk patients. Fibroscan has proven to be a non-invasive and accurate way of assessing fibrosis, although the availability of this modality is often limited in the primary care setting. The Fibrosis-4 (FIB-4) and Non-Alcoholic Fatty Liver Disease Fibrosis Score (NFS) are scoring systems which incorporate commonly measured lab parameters and BMI to predict fibrosis. In this study, we compared FIB-4 and NFS values to fibroscan scores to assess the accuracy of these inexpensive and readily available scoring systems for detecting fibrosis. Aims The aim of this study was to determine if non-invasive and inexpensive scoring systems (FIB-4 and NFS) can be used to rule out fibrosis in non-alcoholic fatty liver disease with comparable efficacy to fibroscan. Ultimately, we aim to demonstrate that these scoring systems can be used as an alternative to fibroscan in some patients. Methods Data was collected from 317 patient charts from the Vancouver General Hepatology Clinic. 93 patients were removed from the study due to insufficient data (missing Fibroscan score or lab work necessary for FIB-4/NFS). For the remaining 224 patients, FIB-4 and NFS were calculated and compared to fibrosis scores both independently and in combination. Results: Using a NFS score cut-off of -1.455 and a fibroscan score cut-off of ≥8.7kPa, the NFS had a sensitivity of 71.9%, a specificity of 75%, and a negative predictive value of 94.1%. For a fibroscan score cut-off of ≥8.0kPa, the NFS had a sensitivity of 66.7%, a specificity of 75.7%, and a negative predictive value of 91.5%. Using a fibroscan score cut-off of ≥8.7kPa, the FIB-4 score had a sensitivity of 53.1%, specificity of 84.9%, and a negative predictive value of 91.6%. For a cut-off of ≥8.0kPa, it had a sensitivity of 51.3%, and 85.9%, and a negative predictive value of 89.3%. Conclusions: The NFS and FIB-4 are non-invasive scoring systems that have high sensitivity and negative predictive value for fibrosis when compared to fibroscan scores. These findings suggest that the NFS and FIB-4 can provide adequate reassurance to rule-out fibrosis in select patients, and has promising use in the primary care setting where fibroscan access is often limited. Funding Agencies None

scholarly journals Noninvasive Assessment of Fibrosis in Patients with Nonalcoholic Fatty Liver Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Elena Buzzetti ◽  
Rosa Lombardi ◽  
Laura De Luca ◽  
Emmanuel A. Tsochatzis
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Metabolic Risk ◽  
First Line ◽  
Nonalcoholic Fatty Liver ◽  
Simple Steatosis ◽  
Number Of Patients ◽  
Rule Out

Nonalcoholic fatty liver disease (NAFLD) is prevalent in 20–25% of the general population and is associated with metabolic risk factors such as obesity, diabetes mellitus, and dyslipidemia. Histologically, NAFLD ranges from simple steatosis to nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis. As NASH develops in only 10–15% of patients with NAFLD, it is not practical to biopsy all patients who present with NAFLD. Noninvasive fibrosis tests have been extensively developed recently and offer alternatives for staging fibrosis. Despite their increasing use, such tests cannot adequately differentiate simple steatosis from NASH. At present, such tests can be used as first line tests to rule out patients without advanced fibrosis and thus prevent unnecessary secondary care referrals in a significant number of patients. In this review we present the evidence for the use of noninvasive fibrosis tests in patients with NAFLD.

scholarly journals Diagnostic accuracy of non-invasive tests for advanced fibrosis in patients with NAFLD: an individual patient data meta-analysis

Gut ◽  
2021 ◽  
pp. gutjnl-2021-324243
Author(s):  
Ferenc Emil Mózes ◽  
Jenny A Lee ◽  
Emmanuel Anandraj Selvaraj ◽  
Arjun Narayan Ajmer Jayaswal ◽  
Michael Trauner ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Advanced Fibrosis ◽  
Alcoholic Fatty Liver ◽  
Liver Biopsies ◽  
Alcoholic Fatty Liver Disease ◽  
Rule Out

ObjectiveLiver biopsy is still needed for fibrosis staging in many patients with non-alcoholic fatty liver disease. The aims of this study were to evaluate the individual diagnostic performance of liver stiffness measurement by vibration controlled transient elastography (LSM-VCTE), Fibrosis-4 Index (FIB-4) and NAFLD (non-alcoholic fatty liver disease) Fibrosis Score (NFS) and to derive diagnostic strategies that could reduce the need for liver biopsies.DesignIndividual patient data meta-analysis of studies evaluating LSM-VCTE against liver histology was conducted. FIB-4 and NFS were computed where possible. Sensitivity, specificity and area under the receiver operating curve (AUROC) were calculated. Biomarkers were assessed individually and in sequential combinations.ResultsData were included from 37 primary studies (n=5735; 45% women; median age: 54 years; median body mass index: 30 kg/m2; 33% had type 2 diabetes; 30% had advanced fibrosis). AUROCs of individual LSM-VCTE, FIB-4 and NFS for advanced fibrosis were 0.85, 0.76 and 0.73. Sequential combination of FIB-4 cut-offs (<1.3; ≥2.67) followed by LSM-VCTE cut-offs (<8.0; ≥10.0 kPa) to rule-in or rule-out advanced fibrosis had sensitivity and specificity (95% CI) of 66% (63–68) and 86% (84–87) with 33% needing a biopsy to establish a final diagnosis. FIB-4 cut-offs (<1.3; ≥3.48) followed by LSM cut-offs (<8.0; ≥20.0 kPa) to rule out advanced fibrosis or rule in cirrhosis had a sensitivity of 38% (37–39) and specificity of 90% (89–91) with 19% needing biopsy.ConclusionSequential combinations of markers with a lower cut-off to rule-out advanced fibrosis and a higher cut-off to rule-in cirrhosis can reduce the need for liver biopsies.

Vitamin D levels are not associated with non-alcoholic fatty liver disease severity in a Brazilian population

2020 ◽  
pp. 1-8
Author(s):  
Jeniffer Danielle M. Dutra ◽  
Quelson Coelho Lisboa ◽  
Silvia Marinho Ferolla ◽  
Carolina Martinelli M. L. Carvalho ◽  
Camila Costa M. Mendes ◽  
...  
Keyword(s):  
Vitamin D ◽  
Liver Disease ◽  
Fatty Liver ◽  
Disease Severity ◽  
Fatty Liver Disease ◽  
Hypovitaminosis D ◽  
Alcoholic Fatty Liver ◽  
Vitamin D Levels ◽  
The Mean ◽  
Alcoholic Fatty Liver Disease

Abstract. Some epidemiological evidence suggests an inverse correlation between non-alcoholic fatty liver disease (NAFLD) frequency and vitamin D levels. Likewise, a beneficial effect of vitamin D on diabetes mellitus (DM) and insulin resistance has been observed, but this is an unsolved issue. Thus, we aimed to investigate the prevalence of hypovitaminosis D in a NAFLD Brazilian population and its association with disease severity and presence of comorbidities. In a cross-sectional study, the clinical, biochemical and histological parameters of 139 NAFLD patients were evaluated according to two different cut-off points of serum 25-hydroxyvitamin D levels (20 ng/mL and 30 ng/mL). The mean age of the population was 56 ± 16 years, most patients were female (83%), 72% had hypertension, 88% dyslipidemia, 46% DM, 98% central obesity, and 82% metabolic syndrome. Serum vitamin D levels were < 30 ng/mL in 78% of the patients, and < 20 ng/mL in 35%. The mean vitamin D level was 24.3 ± 6.8 ng/mL. The comparison between the clinical, biochemical and histological characteristics of the patients according to the levels of vitamin D showed no significant difference. Most patients with NAFLD had hypovitaminosis D, but low vitamin D levels were not related to disease severity and the presence of comorbidities.

Non-Alcoholic Fatty Liver Disease in Overweight Children and its Relationship with Retinol Serum Levels

2008 ◽  
Vol 78 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Suano de Souza ◽  
Silverio Amancio ◽  
Saccardo Sarni ◽  
Sacchi Pitta ◽  
Fernandes ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Liver Disease ◽  
Fatty Liver ◽  
Lipid Profile ◽  
Fatty Liver Disease ◽  
Thiobarbituric Acid ◽  
Serum Levels ◽  
Control Group ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Objectives: To evaluate the frequency of non-alcoholic fatty liver disease, the retinol serum levels, lipid profile, and insulin resistance in overweight/obese children. To relate these biochemical variables with the risk of this disease in the population studied. Methods: The study was cross-sectional and prospective, with 46 overweight/obese school children (28 female, 18 male; mean age 8.6 years). The control group consisted of 45 children, paired by age and gender. Hepatic steatosis, evaluated by ultrasound, was classified as normal, mild, moderate, or severe. Also evaluated were serum retinol levels; thiobarbituric acid reactive substances; lipid profile; and fasting glucose and serum insulin levels, used for the calculation of the Homeostasis Model Assessment. Results: Hepatic ultrasound alterations were found in 56.5% and 48,9% of the overweight/obese and control group children, respectively. Presence of obesity was associated with high levels of triglycerides (OR = 4.6; P = 0.002). In the studied children, the risk of steatosis was related to a trend to a higher percentage of retinol inadequacy (OR = 2.8; p = 0.051); there was no association with thiobarbituric acid reactive substances, lipid profile, or insulin resistance. Conclusions: The high frequency of non-alcoholic fatty liver disease in both groups, evaluated by hepatic ultrasound, in low-socioeconomic level children, independent of nutritional condition and without significant association with insulin resistance, emphasizes that especially in developing countries, other risk factors such as micronutrient deficiencies (e.g. vitamin A) are involved.

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