scholarly journals Diagnostic accuracy and limitations of non-invasive tests in patients with metabolic-associated fatty liver disease

2021 ◽  
Vol 44 (5) ◽  
pp. 168-172
Author(s):  
Y Sánchez Torrijos ◽  
A Lucena Valera ◽  
J Ampuero Herrojo
Keyword(s):  
Liver Disease ◽  
Diagnostic Accuracy ◽  
Fatty Liver ◽  
Hepatic Steatosis ◽  
Fatty Liver Disease ◽  
Fibrosis Score ◽  
Non Invasive ◽  
Fatty Liver Index ◽  
Nafld Fibrosis Score ◽  
Hepatic Steatosis Index

Resumen La incidencia de la enfermedad del hígado graso asociada al metabolismo (MAFLD) ha aumentado en los últimos años debido al estilo de vida actual. La biopsia de hígado sigue siendo la herramienta estándar de oro para detectar y estadificar MAFLD. Por otro lado, se están desarrollando múltiples biomarcadores y pruebas no invasivas para superar las limitaciones de la biopsia hepática, incluidos el costo y la invasividad. Las pruebas no invasivas se centran principalmente en la esteatosis y, en particular, en la fibrosis hepática y se pueden clasificar en pruebas patentadas y no patentadas. Si bien hepatic steatosis index y fatty liver index son las pruebas más comunes utilizadas para la detección de esteatosis, Hepamet Fibrosis Score, NAFLD fibrosis score, FIB-4, OWLiver®, y ELF® son las más utilizadas para la fibrosis hepática. Sin embargo, las pruebas no invasivas también tienen limitaciones que conviene resaltar ya que sus resultados podrían verse afectados por la presencia de diabetes, obesidad o por edades extremas que podrían dar lugar a falsos positivos o negativos. Para maximizar la precisión de los tests no invasivos, se han propuesto diferentes combinaciones integradas en algoritmos escalonados. Esta revisión tiene como objetivo destacar las fortalezas y limitaciones de dichos tests para detectar y estadificar MAFLD.

scholarly journals Step layered combination of noninvasive fibrosis models improves diagnostic accuracy of advanced fibrosis in nonalcoholic fatty liver disease

2019 ◽  
Vol 28 (3) ◽  
pp. 289-296 ◽  
Author(s):  
Mei Yang ◽  
Lina Jiang ◽  
Yijin Wang ◽  
Xi Li ◽  
Zhengsheng Zou ◽  
...  
Keyword(s):  
Liver Disease ◽  
Diagnostic Accuracy ◽  
Fatty Liver ◽  
Predictive Value ◽  
Fatty Liver Disease ◽  
Validation Cohort ◽  
Advanced Fibrosis ◽  
Alcoholic Fatty Liver ◽  
Non Invasive ◽  
Nafld Fibrosis Score

Background and Aims: Liver fibrosis is stage-dependently associated with non-alcoholic fatty liver disease (NAFLD) progression. The increased awareness of non-invasive diagnosis has led to the establishment of many fibrosis diagnosis models with various accuracies. We aimed to evaluate the diagnostic performance of nine clinical non-invasive fibrosis models in NAFLD and provide an optimal diagnostic method for advanced fibrosis by step layered combination of non-invasive models. Methods: 453 consecutive patients with biopsy-proven NAFLD were enrolled from three centers and were divided into study cohort and validation cohort randomly. Aspartate aminotransferase-to-platelet ratio index (APRI), BARD, FiB-4, FibroMeter NAFLD, Forns’ Index, Hui model, non-invasive Koeln-Essen- index (NIKEI), S Index and NAFLD fibrosis score (NFS) were calculated. The high area under the receiver operating characteristic curve (AUROC) models were stepwise combined for further diagnosing NAFLD advanced fibrosis. Results: All models had good performance with high negative predictive value (NPV) and specificity for diagnosing fibrosis, while positive predictive value (PPV) and sensitivity were low. APRI, BARD, FibroMeter NAFLD and NIKEI had higher AUROCs and their step layered combination for diagnosing advanced fibrosis showed high specificity, sensitivity, NPV and PPV up to 89.13%, 72.50%, 74.36%, and 88.17%, which also performed well in the validation cohort. Conclusions: APRI, BARD, FibroMeter NAFLD and NIKEI had better diagnostic accuracy, and could be preferred for diagnosing NAFLD fibrosis. The step layered combination of these models performed much better than each single scoring system for diagnosing advanced fibrosis, provides valuable reference for clinical practice and might be a potential substitution of liver biopsy.

Relationship of serum vaspin, nafld fibrosis score to ultrasonographic detection and quantification of steatosis in nonalcoholic fatty liver disease patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Essam Mohamed Byoumy ◽  
Moataz Mohamed Sayed ◽  
Shereen Abo Baker Abd El-Rahman ◽  
Sara Abd Elkader Al-Nakib ◽  
Mohamed Magdy Salama ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Liver Steatosis ◽  
Control Group ◽  
P Value ◽  
Fibrosis Score ◽  
Alcoholic Fatty Liver ◽  
Nafld Fibrosis Score ◽  
Detection And Quantification

Abstract Background Ectopic hepatic lipid accumulation is closely related to the development of insulin resistance, which is regarded as one of the most significant risk factors of non-alcoholic fatty liver disease (NAFLD). The aim of the study was to evaluate and validate the diagnostic value of serum vaspin, NAFLD Fibrosis Score and sonograghic parameters in detection and quantification of liver steatosis and determining further need for liver biopsy or other means to establish NAFLD diagnosis. Methods This study was carried out on 60 patients having bright liver in ultrasonography and 30 healthy persons as controls. The subjects were divided into the following groups; group A: 30 age and sex matched healthy volunteers (control group), group B: 20 patients with fatty liver grade I, group C: 20 patients with fatty liver grade II and group D: 20 patients with fatty liver grade III. Results serum vaspine levels and NAFLD fibrosis score, were significantly higher in patients than in controls with p-value:<0.001. There was a significant positive correlation between NAFLD fibrosis score and serum vaspin and ultrasonographic findngs of NAFLD with p-value: <0.001. Conclusion Vaspin seem to be the most suitable non-invasive biomarker in predicting both intrahepatic lipid contents in NAFLD group.

scholarly journals The Validation of Conventional Non-Invasive Fibrosis Scoring Systems in Patients with Metabolic Associated Fatty Liver Disease

2020 ◽  
Author(s):  
Yinlian Wu ◽  
Rahul Kumar ◽  
Mingfang Wang ◽  
Medha Singh ◽  
Jiaofeng Huang ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Characteristic Curve ◽  
Scoring Systems ◽  
Advanced Fibrosis ◽  
Discrimination Ability ◽  
Non Invasive ◽  
Nafld Fibrosis Score ◽  
The Difference

Abstract Background：Non-invasive fibrosis scores are not yet validated in the newly defined metabolic associated fatty liver disease (MAFLD). This study evaluated the diagnostic performance of four non-invasive scores including AST to platelet ratio index (APRI), fibrosis-4 index (FIB-4), BMI, AST/ALT ratio, and diabetes score (BARD), and NAFLD fibrosis score(NFS) in patients with MAFLD.Methods: Consecutive patients with histologically-confirmed MAFLD were included. The discrimination ability of different non-invasive scores was compared.Results: A total of 417 patients were included, 156 (37.4%) of them had advanced fibrosis (METAVIR ≥F3). The area under receiver operating characteristic curve (AUROC) of FIB-4, NFS, APRI and BARD for predicting advanced fibrosis were 0.736, 0.724, 0.671 and 0.609 respectively. The AUROC between FIB-4 and NFS were similar (P=0.523), while the difference between FIB-4 and APRI (P=0.001) and FIB-4 and BARD (P<0.001) was statistically significant. The best thresholds of FIB-4，NFS，APRI and BARD for diagnosis of advanced fibrosis in MAFLD were 1.05, -2.1, 0.42 and 2. A subgroup analysis showed that FIB-4, APRI and NFS performed worse in pure MAFLD than HBV-MAFLD group.Conclusions: APRI and BARD score do not perform well in MAFLD. The FIB-4 and NFS could be more useful but new threshold is needed. Novel non-invasive scoring system for fibrosis is required for MAFLD.

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