Acoustic radiation force impulse elastography and liver fibrosis risk scores in severe obesity

Silva, Roberto Gomes da; Miranda, Maria Luiza Queiroz de; Brant, Paulo Eugênio de Araújo Caldeira; Schulz, Perla; Nascimento, Maria de Fátima Araujo; Schmillevitch, Joel; Vieira, Andréa; Freitas, Wilson Rodrigues de; Szutan, Luiz Arnaldo

doi:10.20945/2359-3997000000397

Cited by 3 publications

(2 citation statements)

References 33 publications

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“…However, the strong impact of an elevated AST/ALT ratio on BARD score has to be considered, which is not specific for hepatic damage. In a recently published study, the BARD score displayed a lack of specificity for hepatic fibrosis compared to FIB-4, which is in line with our present results [ 30 ]. Furthermore, BARD is primarily applicable in order to predict manifested and advanced fibrosis in NAFLD, whereas NFS represents a reliable tool for the exclusion of individuals with a low risk of fibrosis [ 31 ].…”

Section: Discussionsupporting

confidence: 93%

Improvement of Type 2 Diabetes Mellitus and Attenuation of NAFLD Are Associated with the Success of Obesity Therapy

Schmid

Arians

Karrasch

et al. 2022

JCM

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Obesity and type 2 diabetes mellitus (T2D) represent important comorbidities of the metabolic syndrome, which are associated with non-alcoholic fatty liver disease (NAFLD)-related hepatic fibrosis. In total, 160 morbidly obese patients—81 following a low-calorie formula diet (LCD) program and 79 undergoing bariatric surgery (Roux-en-Y gastric bypass, RYGB)—were examined for anthropometric and metabolic parameters at base-line and during 12 months of weight loss, focusing on a putative co-regulation of T2D parameters and liver fibrosis risk. High NAFLD fibrosis scores (NFS) before intervention were associated with elevated HbA1c levels and T2D. Loss of weight and body fat percentage (BFL) were associated with improved glucose and lipid metabolism and reduced risk of NAFLD-related fibrosis, with particularly beneficial effects by RYGB. Both T2D improvement and NFS decrease were positively associated with high BFL. A highly significant correlation of NFS reduction with BFL was restricted to male patients while being absent in females, accompanied by generally higher BFL in men. Overall, the data display the relation of BFL, T2D improvement, and reduced NAFLD-related fibrosis risk during weight loss in morbidly obese individuals induced by diet or RYGB. Furthermore, our data suggest a considerable sexual dimorphism concerning the correlation of fat loss and improved risk of liver fibrosis.

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Section: Discussionsupporting

confidence: 93%

Improvement of Type 2 Diabetes Mellitus and Attenuation of NAFLD Are Associated with the Success of Obesity Therapy

Schmid

Arians

Karrasch

et al. 2022

JCM

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“…Most studies found that Forns and S-index had a greater diagnostic accuracy than other models, even if the AUROC values of models in various studies were substantially diverse. 35 , 36 Currently, however, the study sample size is too small, and the majority of studies are focused on NAFLD or HCV instead. In this study, we looked at a large group of HBV-positive individuals, a total of 436.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Evaluation of Non-Invasive Assessment Based on Routine Laboratory Markers for Assessing Advanced Liver Fibrosis in Chronic Hepatitis B Patients

Wang¹,

Zhou²,

Yu³

et al. 2022

IJGM

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Background At present, there is a lack of cheap, effective and convenient detection methods for hepatitis B-related liver fibrosis, especially in the developing area. Aim To evaluate the non-invasive methods for the significant and advanced fibrosis stage in chronic hepatitis B virus (HBV) patients in basic hospitals and to assess their diagnostic utility. Methods The study included 436 consecutive naive HBV individuals who had their livers biopsied. They were examined in one week using aspartate aminotransferase-to-aspartate aminotransferase ratio (AAR), age-platelet index (API), aspartate aminotransferase-to-platelet ratio index (APRI), fibrosis-4 (FIB-4), Forns, gamma-glutamyl transpeptidase-to-platelet ratio (GPR), S-index and transient elastography (TE). Scheuer scoring system was used to determine the histologic fibrosis grades (S0–S4). The diagnostic effectiveness was assessed using AUROCs and the DeLong test, both of which were based on statistical comparisons. Results For both substantial (≧S2) and advanced (≧S3) fibrosis phases, TE had good diagnostic performance in determining the hepatic fibrosis. Similar diagnostic performance was shown with Forns and S-index when it came to detecting fibrosis stages lower than S3. One model’s diagnostic value was not significantly improved by combining serum models. Correlation coefficients between clinical features and fibrosis phases were greatest for Forns ( r = 0.397), S-index ( r = 0.382) and TE ( r = 0.535) when compared to other variables. Conclusion This investigation showed that Forns and S-index may be helpful strategies for detecting advanced fibrosis in HBV patients admitted to community hospitals.

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Accuracy of a sequential algorithm based on FIB-4 and ELF to identify high-risk advanced liver fibrosis at the primary care level

Gabriel-Medina,

Ferrer-Costa,

Ciudin

et al. 2023

Intern Emerg Med

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Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease, and liver fibrosis is the strongest predictor of morbimortality. We aimed to assess the performance of a sequential algorithm encompassing the Fibrosis 4 (FIB-4) and Enhanced Liver Fibrosis (ELF) scores for identifying patients at risk of advanced fibrosis. This cross-sectional study included one hospital-based cohort with biopsy-proven NAFLD (n = 140) and two primary care cohorts from different clinical settings: Type 2 Diabetes (T2D) follow-up (n = 141) and chronic liver disease (CLD) initial study (n = 138). Logistic regression analysis was performed to assess liver fibrosis diagnosis models based on FIB-4 and ELF biomarkers. The sequential algorithm retrieved the following accuracy parameters in predicting stages F3–4 in the biopsy-confirmed cohort: sensitivity (85%), specificity (73%), negative predictive value (79%) and positive predictive value (81%). In both T2D and CLD cohorts, a total of 28% of patients were classified as stages F3–4. Furthermore, of all F3–4 classified patients in the T2D cohort, 80% had a diagnosis of liver disease and 44% were referred to secondary care. Likewise, of all F3–4 classified patients in the CLD cohort, 71% had a diagnosis of liver disease and 44% were referred to secondary care. These results suggest the potential utility of this algorithm as a liver fibrosis stratifying tool in primary care, where updating referral protocols to detect high-risk F3–4 is needed. FIB-4 and ELF sequential measurement is an efficient strategy to prioritize patients with high risk of F3–4 in populations with metabolic risk factors.

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Acoustic radiation force impulse elastography and liver fibrosis risk scores in severe obesity

Cited by 3 publications

References 33 publications

Improvement of Type 2 Diabetes Mellitus and Attenuation of NAFLD Are Associated with the Success of Obesity Therapy

Improvement of Type 2 Diabetes Mellitus and Attenuation of NAFLD Are Associated with the Success of Obesity Therapy

Retrospective Evaluation of Non-Invasive Assessment Based on Routine Laboratory Markers for Assessing Advanced Liver Fibrosis in Chronic Hepatitis B Patients

Accuracy of a sequential algorithm based on FIB-4 and ELF to identify high-risk advanced liver fibrosis at the primary care level

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