scholarly journals Ability of a Combined FIB4/miRNA181a Score to Predict Significant Liver Fibrosis in NAFLD Patients

Biomedicines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1751
Author(s):  
Rodrigo Vieira Costa Lima ◽  
José Tadeu Stefano ◽  
Fernanda de Mello Malta ◽  
João Renato Rebello Pinho ◽  
Flair José Carrilho ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Roc Curve ◽  
Phenotypic Expression ◽  
Multivariate Logistic Regression Analysis ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Non Invasive ◽  
Significant Liver Fibrosis

Liver biopsy is the gold standard for assessing fibrosis, but there is a need to seek non-invasive biomarkers for this purpose. The aim of this study was to evaluate the correlation between the serum levels of the microRNAs miR-21, miR-29a, miR-122, miR-155 and miR-181a and the phenotypic expression of NAFLD. A cross-sectional study was carried out on 108 NAFLD patients diagnosed by liver biopsy. FIB-4 and NAFLD fibrosis scores were calculated. The comparison between the distributions of microRNA values according to the presence or absence of histological fibrosis (F2–F4) was performed. A multivariate logistic regression analysis was performed to build a score for predicting fibrosis using FIB-4 and Ln (miR-181a) as independent variables. Only miR-181a showed a statistical difference between patients with significant liver fibrosis (>F2) and those without (F0–F1) (p = 0.017). FIB-4 revealed an AUC on the ROC curve of 0.667 to predict clinically significant fibrosis (F2–F4). When assessed using the score in association with Ln (miR-181a), there was an improvement in the ROC curve, with an AUC of 0.71. miR-181a can be used as a non-invasive method of predicting fibrosis in NAFLD, and an association with FIB-4 has the potential to increase the accuracy of each method alone.

scholarly journals AST to Platelet Ratio Index (APRI) is an easy-to-use predictor score for cardiovascular risk in metabolic subjects

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Carlo De Matteis ◽  
Marica Cariello ◽  
Giusi Graziano ◽  
Stefano Battaglia ◽  
Patrizia Suppressa ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Liver Fibrosis ◽  
Visceral Obesity ◽  
Premenopausal Women ◽  
Cross Sectional Study ◽  
Serum Markers ◽  
Low Grade ◽  
Cross Sectional ◽  
Alcoholic Fatty Liver ◽  
Non Invasive

AbstractVisceral obesity is characterized by a low-grade inflammatory systemic state that contributes to the genesis of non-alcoholic fatty liver disease (NAFLD), frequently associated with liver fibrosis. Non-invasive serum markers have recently emerged as reliable, easy-to-use scores to predict liver fibrosis. NAFLD is often linked to metabolic and cardiovascular risk. Thus, in this cross-sectional study, we investigated in a population of 1225 subjects if AST to Platelet Ratio Index (APRI), one of the non-invasive liver fibrosis serum markers, can predict cardiovascular risk (CVR). APRI has been previously validated as an efficient score to predict liver fibrosis in viral hepatitis patients with a cut-off of 0.5 for fibrosis and 1.5 for cirrhosis. Our study showed that APRI significantly correlates with CVR and determines, when elevated, a significant increase in CVR for both genders, especially females. This spike in CVR, observed when APRI is elevated, is relatively high in patients in the age of 51–65 years, but it is significantly higher in younger and premenopausal women, approaching risk values usually typical of men at the same age. Taken together, our data highlighted the role of APRI as a reliable predictor easy-to-use score for CVR in metabolic patients.

scholarly journals Comparison of IL-6, IL-8 Concentrations in H. pylori- and non-H. pylori-associated Gastritis

2014 ◽  
Vol 6 (3) ◽  
pp. 163 ◽  
Author(s):  
Gontar Alamsyah Siregar ◽  
Sahat Salim ◽  
Ricky Rivalino Sitepu
Keyword(s):  
Helicobacter Pylori ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Bivariate Analysis ◽  
Rapid Urease Test ◽  
Serum Samples ◽  
Cross Sectional ◽  
Non Invasive ◽  
Urease Test ◽  
H Pylori

BACKGROUND: Helicobacter pylori is a non-invasive microorganism causing intense gastric mucosal inflammatory and immune reaction. The gastric mucosal levels of the proinflammatory cytokines Interleukin 6 (IL-6) and IL-8 have been reported to be increased in H. pylori infection, but the serum levels in H. pylori infection is still controversial. The purpose of this study was to investigate the serum levels of IL-6 and IL-8 in H. pylori infection.METHODS: A cross sectional study was done on eighty consecutive gastritis patients admitted to endoscopy units at Adam Malik General Hospital and Permata Bunda Hospital, Medan, Indonesia from May-October 2014. Histopathology was performed for the diagnosis of gastritis. Rapid urease test for diagnosis of H. pylori infection. Serum samples were obtained to determine circulating IL-6 and IL-8. Univariate and bivariate analysis (independent t test) were done.RESULTS: There were 41.25% patients infected with H. pylori. Circulatory IL-6 levels were significantly higher in H. pylori-infected patients compared to H. pylori negative, but there were no differences between serum levels of IL-8 in H. pylori positive and negative patients.CONCLUSION: The immune response to H. pylori promotes systemic inflammation, which was reflected in an increased level of serum IL-6. Serum levels of IL-8 were not significantly different between H. pylori positive and negative.KEYWORDS: Helicobacter pylori, gastritis, IL-6, IL-8, cytokine

scholarly journals The diagnostic value of non-invasive serum liver fibrosis indices in the prediction of portal hypertension in cirrhotic patients: a cross-sectional study

2020 ◽  
Vol 8 (1) ◽  
pp. 23-23
Author(s):  
Masood Faghih Dinevari ◽  
Mohammad Hossein Somi ◽  
Mohammad Kazem Tarzamni ◽  
Leila Alizadeh ◽  
Samaneh Abbasian ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Liver Fibrosis ◽  
Color Doppler ◽  
Area Under The Curve ◽  
Predictive Marker ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Non Invasive ◽  
Cirrhotic Patients

Introduction: Considering that portal hypertension is principally caused by hepatic fibrosis, some studies postulated the predictive value of serum liver fibrosis indices in the diagnosis of portal hypertension. In this study we assessed the prognostic value of serum indices in the diagnosis of portal hypertension in cirrhotic patients. Methods: One hundred two cirrhotic patients were selected according to inclusion/exclusion criteria. Cirrhosis and the Child-Pugh score was determined by the gastroenterologist. Portal hypertension was diagnosed by the radiologist using the color Doppler method. The fasting blood sample was drawn and different serum indices were determined. The following indices were calculated: FIB4, Fibroindex, APRI, FORNS, LOK. Results: The patients mean age was 54.39±6.60 years. About 52.94% of the patients were women. The mean liver enzymes level was higher in patients with portal hypertension. In 50.98% of patients, the etiology of cirrhosis was viral hepatitis. Significant differences was observed between the two groups regarding the studied indices (P<0.05). According to the results of the ROC curve, the FORNS index was a better predictive marker of portal hypertension in cirrhotic patients. The maximum AUC (area under the curve) was for the FORNS index. According to the results of diagnostic tests, the FORNS index had adequate sensitivity and specificity in the diagnosis of portal hypertension with the cut-off value of 8.51. Conclusion: The results of the present study showed that the FORNS index is a better predictor of portal hypertension in cirrhotic patients.

scholarly journals Using FIB-4 score as a screening tool in the assessment of significant liver fibrosis (F2) in patients with transfusion dependent beta thalassaemia: a cross sectional study

2022 ◽  
Author(s):  
Padmapani Padeniya ◽  
Dileepa S Ediriweera ◽  
Arjuna De Silva ◽  
Madunil Niriella ◽  
Anuja Premawardhena
Keyword(s):  
Liver Fibrosis ◽  
Screening Tool ◽  
Transient Elastography ◽  
Elevated Serum ◽  
Cross Sectional Study ◽  
Resource Poor Setting ◽  
Beta Thalassemia ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significant Liver Fibrosis

Abstract Objective To evaluated the performance of FIB-4 score as a screening tool to detect significant liver fibrosis (F2) compared to transient elastography (TE) among chronic transfusion-dependent beta-thalassemia (TDT) patients, in a resource-poor setting. Design A cross-sectional study Setting Adolescent and Adult Thalassaemia Care Center (University Medical Unit) Kiribathgoda Sri Lanka. Participants 45 TDT patients who have undergone more than 100 blood transfusions with elevated serum ferritin more than 2000ng/mL were selected for the study. Patients who were serologically positive for hepatitis C antibody were excluded. Outcome measures TE and FIB-4 score were estimated at the time of recruitment in all participants. Pre-defined cut-off values for F2 extracted from previous studies for TE and FIB-4 score were compared. A new cut-off value for FIB-4 score was estimated using ROC curve analysis to improve the sensitivity for F2 prediction. Results Of the selected 45 TDT patients 22(49%) were males. FIB-4 score showed a significant linear correlation with TE (r= 0.52 p< 0.0003). The FIB-4 score was improbable to lead to a false classification of TDT patients to have F2 when the FIB-4 cut-off value was 1.3. On the other hand it had a very low diagnostic yield in missing almost all (except one) of those who had F2. Using a much-lowered cut-off point of 0.32 for FIB-4 we improved the pick-up rate of F2 to 72%. Conclusions Regardless of the cut-off point FIB-4 score cannot be used as a good screening tool to pick-up F2 in patients with TDT irrespective of their splenectomy status. On the contrary at 1.3 cut off value though FIB-4 is a very poor detector for F2 fibrosis it will not erroneously diagnose F2 fibrosis in those who do not have it.

scholarly journals Comparison of non-invasive methods of assessing liver fibrosis in combination ART-experienced Zimbabweans

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Brenda Nherera ◽  
Kudakwashe Mhandire ◽  
Tinashe K. Nyazika ◽  
Alfred Makura ◽  
Cuthbert Musarurwa ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Cross Sectional Study ◽  
Early Screening ◽  
Cross Sectional ◽  
Non Invasive ◽  
Inflammatory Damage ◽  
Early Markers ◽  
High Prevalence ◽  
Clinically Significant

Background: The prevalence of morbidity and mortality associated with liver disease among HIV-infected individuals on combination antiretroviral therapy (ART) is high. Early screening of liver disease is essential, as it provides an opportunity for successful treatment. Hence, there is a need for reliable, inexpensive and non-invasive early markers of hepatic damage.Objectives: Non-invasive algorithms are available for assessing the extent of liver fibrosis as markers of ongoing inflammatory damage. This study compared the use of the FibroTest, Fibrosis-4 (FIB-4) index, APRI test and AST:ALT ratio in assessing liver fibrosis in combination ART-experienced individuals.Methods: In a comparative cross-sectional study, 79 participants between the ages of 8 and 62 years were recruited. The performance of each fibrosis algorithm was determined using established cut-off scores for clinically significant liver fibrosis.Results: The prevalence of liver fibrosis as determined by the FibroTest, FIB-4 index, APRI test and AST: ALT ratio were 19.0%, 21.5%, 12.7% and 79.7%, respectively. For individual biomarkers, A-2M concentration (p < 0.001) and AST activity (p = 0.003) remained significantly elevated in participants with fibrosis than those without as defined by FibroTest and APRI test, respectively, after adjustments for multiple comparisons.Conclusion: Our data demonstrate a high prevalence of asymptomatic liver fibrosis among combination ART-experienced individuals in Zimbabwe, and this warrants adequate monitoring of liver fibrosis in individuals on ART. Discordance of fibrosis results among the algorithms and individual biomarkers and calls for further work in identifying optimal biomarkers for detection of asymptomatic fibrosis.Keywords: Liver fibrosis; Non-invasive methods; Biomarkers; Combination anti-retroviral therapy; Zimbabwe.

A Cross Sectional Study to Assess Liver Fibrosis in Patients with Diabetes and Metabolic Syndrome

2017 ◽  
Vol 9 (5) ◽  
Author(s):  
Syed Safiullah Ghori ◽  
Hafsa Khalid ◽  
Mohammed Alim ◽  
Mohammed Abdul Quddus
Keyword(s):  
Metabolic Syndrome ◽  
Liver Fibrosis ◽  
Fatty Liver ◽  
General Hospital ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Alcoholic Fatty Liver ◽  
Non Invasive ◽  
Nafld Fibrosis Score ◽  
Patients With Diabetes

The present study was conducted in Osmania General Hospital,Hyderabad.The study included evaluation of liver fibrosis in patients with diabetes and metabolic syndrome. Liver fibrosis is now being considered as reversible process which is characterized by excessive accumulation of extra cellular matrix. The use of non-invasive methods to assess liver fibrosis in patients with HCV, Non-Alcoholic Fatty Liver Disease (NAFLD) and alcohol abuse has been well validated. However use of these non-invasive methods in patients with diabetes mellitus and metabolic syndrome assessed might develop fibrosis during asymptomatic stages. Hence we tried to use these non-invasive methods in patients with diabetics and metabolic syndrome who are at high risk of developing NAFLD or liver fibrosis in routine clinical practice. This was a single center, prospective study. 50 patients with diabetes and metabolic syndrome attending the endocrinology department of Osmania General Hospital were assessed for fatty liver and enrolled in to the study. NAFLD fibrosis score was used to assess liver fibrosis and BARD score was used for staging of fibrosis as per metavir classificationThe mean age of the patients was 50.8 ± 8.2 with 22 males and 28 females. 90% of the population was found to have some degree of fibrosis. 56% of the patients were at advance fibrosis stage as per the BARD score.Patients with diabetes and metabolic syndrome should be constantly evaluated for liver fibrosis apart from development of diabetes and other complications and to prevent any adverse effects due to waning of liver functions.

Lysosomal Acid Lipase: Can it be a New Non-Invasive Serum Biomarker of Cryptogenic Liver Fibrosis and Cirrhosis?

2018 ◽  
Vol 17 (5) ◽  
pp. 0-10
Author(s):  
Marta Gravito-Soares ◽  
Elisa Gravito-Soares ◽  
Dário Gomes ◽  
Luis Tomé
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Liver Steatosis ◽  
Acid Lipase ◽  
Cross Sectional ◽  
Lysosomal Acid ◽  
Significant Fibrosis ◽  
Non Invasive ◽  
Lysosomal Acid Lipase ◽  
Elevated Liver Enzymes

Introduction and aim. The association between lysosomal acid lipase (LAL) activity and liver steatosis or fibrosis is poorly studied. The aim of our study was to determine the predictive power of LAL for cryptogenic liver steatosis and cryptogenic significant fibrosis/ cirrhosis. Material and methods. Cross-sectional observational study of 101 adult patients with unexplained elevated liver enzymes/hepatomegaly with or without dyslipidemia submitted to the determination of LAL activity and LIPA gene (E8SJMC. 894G→A) mutation. Seventy-one patients underwent liver biopsy or FibroScan®. Patients with an identifiable liver dysfunction cause and well-stablished NAFLD/NASH risk factors were excluded. Predictors for liver steatosis, significant fibrosis (≥ F2) or cirrosis (F4) were evaluated. Results. Liver steatosis and fibrosis were mainly assessed by liver biopsy (74.6%; n = 53). Steatosis was present in 62.0% (n = 44), significant fibrosis in 47.9% (n = 34) and cirrhosis in 39.4% (n = 28). The median LAL was 0.36 (0.21-0.46)nmol/spot/h (vs. 0.29 (0.20-0.47); p = 0.558) for liver steatosis, 0.22 (0.11-0.29) nmol/spot/h (vs. 0.40 (0.34-0.51); p < 0.001) for significant fibrosis and 0.21 (0.11-0.27) nmol/spot/h (vs. 0.40 (0.32-0.52); p < 0.001) for cirrhosis. No LIPA gene mutations were found. LAL activity was the strongest predictor of significant fibrosis (AUROC: 0.833; p < 0.001) with a cut-off of 0.265 (sensitivity: 85.9%; specificity: 75.0%) and cirrhosis (AUROC: 0.859; p < 0.001) with a cut-off of 0.235 (sensitivity: 86.2%; specificity: 75.0%), being higher than FIB4, GUCI or APRI. However, LAL activity was not associated with liver steatosis (AUROC: 0.536; p = 0.558). Conclusion. LAL activity can be considered a non-invasive new marker of cryptogenic liver fibrosis with higher accuracy than other known biomarkers. LAL activity < 0.265 nmol/spot/h was strongly associated with cryptogenic significant fibrosis and < 0.235 nmol/spot/h with cryptogenic cirrhosis. LAL activity was not associated with cryptogenic liver steatosis.

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