Clinically Significant Fibrosis Is Associated With Longitudinal Increases in Fibrosis-4 and Nonalcoholic Fatty Liver Disease Fibrosis Scores

Patel, Preya; Cheng, Johnson; Banh, Xuan; Gracen, Lucy; Radford-Smith, Daniel E.; Hossain, Fabrina; Horsfall, Leigh; Hayward, Kelly L.; Williams, Suzanne; Johnson, Tracey; Brown, Nigel N.; Saad, Nivene; Stuart, Katherine; Russell, Anthony; Valery, Patricia C.; Clouston, Andrew D.; Irvine, Katharine M.; Bernard, Anne; Powell, Elizabeth E.

doi:10.1016/j.cgh.2019.07.036

Cited by 9 publications

(8 citation statements)

References 30 publications

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“…Furthermore, 15% of NASH patients develop hepatic fibrosis ultimately leading to cirrhosis. Pathologically, fibrosis staging using Brunt classification [15] but not the NAFLD scoring system has been shown to be an important factor in event occurrence [16] . Clinically, imaging modalities and liver fibrosis scoring systems such as the FIB-4 index are available [9] and are useful to some extent for assessing hepatic fibrosis [17,18] .…”

Section: Discussionmentioning

confidence: 99%

“…Pathologically, fibrosis staging using Brunt classification [15] but not the NAFLD scoring system has been shown to be an important factor in event occurrence. [16] Clinically, imaging modalities and liver fibrosis scoring systems such as the FIB-4 index are available [9] and are useful to some extent for assessing hepatic fibrosis. [17,18] However, they are not sufficiently accurate for assessing the development of liver fibrosis.…”

Section: Discussionmentioning

confidence: 99%

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Decline in serum albumin concentration is a predictor of serious events in nonalcoholic fatty liver disease

et al. 2021

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Decline in serum albumin concentration is a predictor of serious events in nonalcoholic fatty liver disease

et al. 2021

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“…The most known techniques approved by the European Association for the Study of Diabetes (EASD) [ 122 ] include NAFLD liver fat score (NLFS) and the fatty liver index (FLI) for NAFLD diagnosis [ 123 ], and fibrosis-4 index (FIB-4) and NAFLD fibrosis score (NFS) for fibrosis assessment [ 124 ]. Also, known the SteatoTest, NashTest, ActiTest, FibroTest, and FibroScan are handy tools in quantifying liver impairment [ 125 ].…”

Section: Screening and Assessmentmentioning

confidence: 99%

The Intricate Relationship between Type 2 Diabetes Mellitus (T2DM), Insulin Resistance (IR), and Nonalcoholic Fatty Liver Disease (NAFLD)

Tănase

Gosav

Costea

et al. 2020

Journal of Diabetes Research

281

180

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Nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) remain as one of the most global problematic metabolic diseases with rapidly increasing prevalence and incidence. Epidemiological studies noted that T2DM patients have by two-fold increase to develop NAFLD, and vice versa. This complex and intricate association is supported and mediated by insulin resistance (IR). In this review, we discuss the NAFLD immunopathogenesis, connection with IR and T2DM, the role of screening and noninvasive tools, and mostly the impact of the current antidiabetic drugs on steatosis liver and new potential therapeutic targets.

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“…In particular, no patient with low‐risk NFS developed liver decompensation or liver‐related mortality. Following repeat NFS at the end of follow‐up, all patients with a liver‐related complication were in the high‐risk NFS category, suggesting that longitudinal changes in the NFS score ( 21 ) may have a role in predicting adverse liver outcomes.…”

Section: Discussionmentioning

confidence: 99%

Predicting Liver‐Related Outcomes in People With Nonalcoholic Fatty Liver Disease: The Prognostic Value of Noninvasive Fibrosis Tests

et al. 2021

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It remains unclear whether screening for advanced fibrosis in the community can identify the subgroup of people with nonalcoholic fatty liver disease (NAFLD) at higher risk for development of liver‐related complications. We aimed to determine the prognostic value of baseline noninvasive fibrosis tests for predicting liver‐related outcomes and mortality in patients with NAFLD from type 2 diabetes (T2D) clinics or primary care. Patients (n = 243) who were screened for NAFLD with advanced fibrosis by using NAFLD fibrosis score (NFS), fibrosis 4 score (FIB‐4), enhanced liver fibrosis (ELF) test, and liver stiffness measurements (LSMs) were followed up for clinical outcomes by review of electronic medical records. During a median follow‐up of 50 months, decompensated liver disease or primary liver cancer occurred in 6 of 35 (17.1%) patients with baseline LSM > 13 kPa, 1 of 17 (5.9%) patients with LSM 9.5‐13 kPa, and in no patients with LSM < 9.5 kPa. No patient with low‐risk NFS developed liver decompensation or liver‐related mortality. Following repeat NFSs at the end of follow‐up, all patients with a liver‐related complication were in the high‐risk NFS category. Patients who developed liver‐related complications were also more likely to have baseline high‐risk FIB‐4 scores or ELF test ≥9.8 compared to patients who did not develop liver outcomes. Conclusion: Liver fibrosis risk stratification in non‐hepatology settings can identify the subset of patients at risk of liver‐related complications. Although the rate of development of a decompensation event or hepatocellular carcinoma was low (2.1% per year) in our patients with compensated cirrhosis (LSM > 13 kPa), these events are projected to lead to a substantial increase in NAFLD‐related disease burden over the next decade due to the high prevalence of NAFLD in people with obesity and T2D.

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Clinically Significant Fibrosis Is Associated With Longitudinal Increases in Fibrosis-4 and Nonalcoholic Fatty Liver Disease Fibrosis Scores

Abstract: Conclusions: Non-invasively measured fibrosis scores increase progressively in patients with NAFLD and CSF. Further studies are needed to determine whether repeated measurements can identify patients at risk for CSF.

Cited by 9 publications

References 30 publications

Decline in serum albumin concentration is a predictor of serious events in nonalcoholic fatty liver disease

Decline in serum albumin concentration is a predictor of serious events in nonalcoholic fatty liver disease

The Intricate Relationship between Type 2 Diabetes Mellitus (T2DM), Insulin Resistance (IR), and Nonalcoholic Fatty Liver Disease (NAFLD)

Predicting Liver‐Related Outcomes in People With Nonalcoholic Fatty Liver Disease: The Prognostic Value of Noninvasive Fibrosis Tests

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