Circulating Fibroblast Activation Protein activity as a liver fibrosis biomarker in NAFLD

Zhang, Hui Emma; Brewer, Kate; Jeffrey, G.; Twigg, Stephen M.; McCaughan, G.W.; Williams, Kathryn; Adams, Leon A.; Gorrell, Mark D.

doi:10.1016/s0168-8278(17)31802-0

Cited by 1 publication

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“…The cFAP activity was assigned to the score calculation according to its respective ordinal level. The score was derived from age, diabetes status, ALT, and cFAP level, as described previously [ 30 ] and as shown in Table 1 .…”

Section: Methodsmentioning

confidence: 99%

“…The commonly used liver fibrosis scoring systems include the Fibrosis-4 (FIB-4) index [ 27 ], aspartate aminotransferase (AST)-to-platelet ratio index (APRI) [ 28 ], and NAFLD fibrosis score (NFS) [ 29 ]. We have also previously demonstrated the potential for the use of circulating fibroblast activation protein alpha (cFAP) as a diagnostic biomarker for liver fibrosis, based on which the fibroblast activation protein (FAP) index can be calculated [ 30 , 31 ]. In prior studies, cFAP has been found to be elevated in cirrhosis, as well as in moderate-to-severe fibrosis among individuals with type 2 diabetes or those undergoing bariatric surgery, further demonstrating its potential clinical utility as a liver fibrosis biomarker [ 32 , 33 ].…”

Section: Introductionmentioning

confidence: 99%

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Application and Diagnostic Performance of Two-Dimensional Shear Wave Elastography and Liver Fibrosis Scores in Adults with Class 3 Obesity

Chimoriya,

Ho,

Wang

et al. 2023

Nutrients

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There are no ideal non-invasive tests for assessing the severity of liver fibrosis in people with metabolic dysfunction-associated steatotic liver disease (MASLD) and class 3 obesity, where body habitus often makes imaging technically challenging. This study aimed to assess the applicability and diagnostic performance of two-dimensional shear wave elastography (2D-SWE), alongside several serum-based liver fibrosis scoring methods, in individuals with class 3 obesity. A cross-sectional study was conducted in patients aged ≥18 years and with a body mass index (BMI) ≥ 40 kg/m2 who were participants in a publicly funded multidisciplinary weight management program in South Western Sydney. The 2D-SWE was performed using the ElastQ Imaging (EQI) procedure with the Phillips EPIQ Elite series ultrasound. An EQI Median value of ≥6.43 kPa was taken as a cutoff score for significant fibrosis, and the scan was considered valid when the liver EQI IQR/Med value was <30%. The Fibrosis-4 (FIB-4) index, AST-to-platelet ratio index (APRI), NAFLD fibrosis score (NFS), and circulating fibroblast activation protein index (FAP index) were calculated from fasting blood samples. The participants (n = 116; 67.2% female) were aged 47.2 ± 12.9 years, with BMI 54.5 ± 11.0 kg/m2. EQI Median values were obtained for 97.4% (113/116) of the 2D-SWE scans, and 91.4% (106/116) of the scans were considered valid. The EQI Median values exhibited a moderately positive correlation with the FIB-4 index (r = 0.438; p < 0.001) and a weakly positive correlation with the APRI (r = 0.388; p < 0.001), NFS (r = 0.210; p = 0.036) and FAP index (r = 0.226; p = 0.020). All liver fibrosis scores were positively correlated with one another. Among those referred for a liver biopsy based on the 2D-SWE and serum scores, half (11/22) underwent liver biopsy, and their 2D-SWE scores exhibited 72.7% accuracy (sensitivity: 71.4%; specificity: 75%) in detecting significant fibrosis. Our results show that 2D-SWE is a feasible, non-invasive test to assess liver fibrosis among people with class 3 obesity. Further research is needed to assess how 2D-SWE can be used alongside existing serum-based risk scores to reliably detect significant fibrosis, which would potentially reduce the need for invasive liver biopsy.

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Section: Methodsmentioning

confidence: 99%