Enhanced liver fibrosis (ELF) score accurately detects advanced fibrosis in nonalcoholic fatty liver disease (NAFLD)

Stauber, R.E.; Staufer, Katharina; Stift, Judith; Marculescu, Rodrig; Obermayer-Pietsch, B.; Trauner, Michael; Lackner, K

doi:10.1016/s0168-8278(18)31383-7

Cited by 5 publications

(7 citation statements)

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“…We found 265 full-text reports from the electronic searches and 18 studies from other sources. In total, we were able to include 17 studies that had evaluated the accuracy of the ELF test in patients with NAFLD: 13 with full-text reports 17,[23][24][25][26][27][28][29][30]34,35,52,55 and 4 only reported in abstracts 22,[31][32][33] (Fig. 1).…”

Section: Search Resultsmentioning

confidence: 99%

“…59 ELF is now used with increasing confidence in many centers around the world, including in the US, 35 Japan, 25 South Korea, 60 the UK 24,34 and many other European countries. [26][27][28][29][30][31]33 However, the availability of the test in clinics varies from country to country, due to different regulatory requirements and insurance coverage. Moreover, the test is being used in clinical settings that differ in the prevalence of advanced fibrosis, ranging from 5-10% in the general population to more than 30% or 40% in secondary and tertiary referral centers.…”

Section: Discussionmentioning

confidence: 99%

“…The number of studies for each target condition is shown in Table S7. Accuracy in detecting advanced fibrosis (F > − 3) was reported by 11 studies 17,[22][23][24][28][29][30]33,34,52,55 ; in detecting significant fibrosis (F > − 2) by 5 17,24,26,35,55 studies. Only 1 study reported the performance of the test in detecting cirrhosis.…”

Section: Target Conditionsmentioning

confidence: 93%

“…20 Most other studies used manufacturer recommended thresholds for ruling advanced F3/4 fibrosis out (7.7) or in (9.8) respectively, and reported different levels of performance of this test. 17,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] The variability in reported results brings into question all recommendations regarding the ELF test as a diagnostic tool for NAFLD-related fibrosis, with consequences for clinical diagnoses, treatment decisions, and drug development. We aimed to perform a systematic review and meta-analysis of the published studies, to provide summary estimates of the accuracy of the ELF test for diagnosing liver fibrosis and NASH in patients with NAFLD, at the recommended thresholds, based on the currently available evidence.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Enhanced liver fibrosis test for the non-invasive diagnosis of fibrosis in patients with NAFLD: A systematic review and meta-analysis

Vali

Lee

Boursier

et al. 2020

Journal of Hepatology

190

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Section: Search Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Target Conditionsmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Enhanced liver fibrosis test for the non-invasive diagnosis of fibrosis in patients with NAFLD: A systematic review and meta-analysis

Vali

Lee

Boursier

et al. 2020

Journal of Hepatology

190

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“…Sono stati inoltre validati una serie di indicatori che prevedono l'impiego di biomarcatori più specifici per fibrosi e quindi scarsamente utilizzati nella pratica clinica, tra questi possiamo citare l'Enhanced Liver Fibrosis (ELF) (71), l'Hepascore (72) e il FibroTest (73).…”

Section: Metodiche Diagnostiche DI Nafld/nashunclassified

La gestione della pandemia di NAFLD: il ruolo del diabetologo

2021

ildia

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La steatosi epatica non alcolica (NAFLD) è la causa più comune di malattia epatica cronica in tutto il mondo, con una prevalenza globale stimata attorno al 25-30% nella popolazione generale (1), che raggiunge punte del 70% negli adulti con diabete di tipo 2 (DT2) (2-3). L'aumento costante della prevalenza di NAFLD, che si manifesta in parallelo con l'aumento della diffusione del diabete e delle patologie metaboliche legate all'obesità, non colpisce solo i paesi industrializzati ma anche quelli in via di sviluppo e le economie emergenti (3).La NAFLD è una condizione spesso asintomatica ed in molti casi non accompagnata da significative alterazioni ematochimiche; inoltre, l'opportunità di implementare misure di screening sulla popolazione generale piuttosto che su specifiche categorie a rischio è tuttora dibattuta, principalmente in relazione alla mancanza a tutt'oggi di una strategia terapeutica validata (3).A livello epidemiologico, a parità di fattori di rischio metabolici, il sesso femminile appare quello maggiormente colpito. Ad esserne maggiormente affetti sono gli individui di età avanzata e gli anziani, probabilmente per la prevalenza in queste popolazioni dei principali fattori di rischio per NAFLD (sovrappeso/obesità, DT2, dislipidemia, stile di vita sedentario) (1). La diffusione della NAFLD nei soggetti non obesi è influenzata da sesso, presenza di suscettibilità genetica ed etnia; la prevalenza di NAFLD nell'Asia meridionale è molto più alta negli uomini non obesi rispetto alle donne (4) ed è in genere maggiore negli ispanici e nelle popolazioni afro-americane (5). NAFLD e diabete: una relazione pericolosaLa NAFLD e il DT2 sono condizioni comunemente coesistenti nel paziente con sindrome metabolica. Più in generale, i pazienti con NAFLD sono identificabili tra coloro che presentano le componenti della sindrome metabolica (6-8). Il rischio e la severità di NAFLD e NASH, inoltre, aumentano all'aumentare del numero di componenti della sindrome metabolica (9). In ogni modo, il DT2 rappresenta il più importante fattore di rischio per lo sviluppo di NAFLD e il principale predittore di esiti sfavorevoli e rapida progressione della NAFLD verso stadi di fibrosi avanzata ed epatocarcinoma. La prevalenza di NAFLD tra i pazienti diabetici aumenta linearmente con il BMI (10-13).

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Relationship of ELF and PIIINP With Liver Histology and Response to Vitamin E or Pioglitazone in the PIVENS Trial

Gawrieh

Wilson²,

Yates³

et al. 2021

Hepatol Commun

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Enhanced liver fibrosis score (ELF) and one of its components, amino-terminal propeptide of type III procollagen (PIIINP) are promising noninvasive biomarkers of liver histology in patients with nonalcoholic steatohepatitis (NASH). We evaluated the association of ELF and PIIINP with fibrosis stages at baseline and end of treatment (EOT) with vitamin E or pioglitazone in the PIVENS trial (Pioglitazone vs. Vitamin E vs. Placebo for the Treatment of Nondiabetic Patients With NASH) and characterized ELF and PIIINP changes and their associations with changes in the histological endpoints. ELF and PIIINP were measured at baseline and weeks 16, 48, and 96 on sera from 243 PIVENS participants. Baseline and EOT ELF were significantly associated with fibrosis stage (P < 0.001). The area under the curve for ELF's detection of clinically significant and advanced fibrosis in baseline biopsies was 0.74 and 0.79, respectively (P < 0.001). There was a significant drop in ELF score at weeks 48 and 96 in patients who achieved the NAFLD activity score (NAS)-based primary end point (P = 0.007) but not in those who experienced NASH resolution (P = 0.24) or fibrosis improvement (P = 0.50). Change in PIIINP was significantly associated with NASH resolution and improvement in NAS-based histological endpoint and fibrosis (P < 0.05 for all). Over the study period, both ELF and PIIINP significantly decreased with vitamin E (P < 0.05), but only PIIINP decreased with pioglitazone (P < 0.001). Conclusion: ELF is significantly associated with clinically significant and advanced fibrosis in patients with NASH, but its longitudinal changes were not associated with improvement in fibrosis or NASH resolution. PIIINP, one of its components, appears promising for identifying longitudinal histologic changes in patients with NASH and is worthy of further investigation. (Hepatology Communications 2021;0:1-12).

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Enhanced liver fibrosis (ELF) score accurately detects advanced fibrosis in nonalcoholic fatty liver disease (NAFLD)

Cited by 5 publications

References 0 publications

Enhanced liver fibrosis test for the non-invasive diagnosis of fibrosis in patients with NAFLD: A systematic review and meta-analysis

Enhanced liver fibrosis test for the non-invasive diagnosis of fibrosis in patients with NAFLD: A systematic review and meta-analysis

La gestione della pandemia di NAFLD: il ruolo del diabetologo

Relationship of ELF and PIIINP With Liver Histology and Response to Vitamin E or Pioglitazone in the PIVENS Trial

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