Poor performance of existing non-invasive tests for assessing advanced fibrosis in Non-alcoholic fatty liver disease (NAFLD) and development of a novel screening score.

Arora, Umang; Biswas, Sagnik; Vaishnav, Manas; Swaroop, Shekhar; Pathak, Piyush; Bharadiya, Vishwesh; Gamangatti, Shivanand; Yadav, Rajni; Das, Prasenjit; Aggarwal, Sandeep; Shalimar, S.

doi:10.1016/j.jceh.2022.07.186

Cited by 3 publications

(3 citation statements)

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“…It is worth mentioning that LSM is the most reliable NIT for patients with CHB & NAFLD, CHB & MASLD, and CHB & MAFLD compared with FIB‐4, APRI, and GPRI ( p < 0.05) in our study, which was consistent with previous studies 29 . LSM has a diagnostic efficacy of 0.83 (0.79–0.86) for advanced fibrosis in patients with NAFLD in Asian populations, which is superior to FIB‐4 and APRI (all < 0.7) when using certain cutoff values suggested in the literature 30 . In addition, in Indian patients with MASLD, LSM (AUC = 0.82 [0.79–0.86]) performed best compared with APRI (AUC = 0.58 [0.53–0.64]) and FIB‐4 (AUC = 0.67 [0.62–0.72]) ( p < 0.01) 31 .…”

Section: Discussionsupporting

confidence: 92%

Noninvasive tests maintain high accuracy for advanced fibrosis in chronic hepatitis B patients with different nomenclatures of steatotic liver disease

Chen,

Tao,

Zeng

et al. 2024

Journal of Medical Virology

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Metabolic dysfunction‐associated steatotic liver disease (MASLD) is a new nomenclature proposed in 2023. We aimed to compare the diagnostic efficacy of noninvasive tests (NITs) for advanced fibrosis under different nomenclatures in patients with chronic hepatitis B (CHB). A total of 844 patients diagnosed with CHB and concurrent steatotic liver disease (SLD) by liver biopsy were retrospectively enrolled and divided into four groups. The performances of fibrosis‐4 (FIB‐4), gamma‐glutamyl transpeptidase to platelet ratio index (GPRI), aspartate aminotransferase to platelet ratio index (APRI), and liver stiffness measurement (LSM) were compared among the four groups. The four NITs showed similar diagnostic efficacy for nonalcoholic fatty liver disease (NAFLD), MASLD, and metabolic dysfunction‐associated fatty liver disease (MAFLD) in patients with CHB with advanced fibrosis. LSM showed the most stable accuracy for NAFLD (AUC = 0.842), MASLD (AUC = 0.846), and MAFLD (AUC = 0.863) compared with other NITs (p < 0.05). Among the four NITs, APRI (AUC = 0.841) and GPRI (AUC = 0.844) performed best in patients with CHB & MetALD (p < 0.05). The cutoff value for GPRI in patients with CHB & MetALD was higher than that in the other three groups, while further comparisons of NITs at different fibrosis stages showed that the median GPRI of CHB & MetALD (1.113) at F3‐4 was higher than that in the CHB & MASLD group (0.508) (p < 0.05). Current NITs perform adequately in patients with CHB and SLD; however, alterations in cutoff values for CHB & MetALD need to be noted.

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Section: Discussionsupporting

confidence: 92%

Noninvasive tests maintain high accuracy for advanced fibrosis in chronic hepatitis B patients with different nomenclatures of steatotic liver disease

Chen,

Tao,

Zeng

et al. 2024

Journal of Medical Virology

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“…Moreover, an Indian study on 685 patients showed that noninvasive fibrosis tests had same accuracy on MASLD than NAFLD. 12…”

Section: Implication In Clinical Practicementioning

confidence: 99%

New Nomenclature for Nonalcoholic Fatty Liver Disease: Understanding Metabolic Dysfunction-Associated Steatotic Liver Disease, Metabolic Dysfunction- and Alcohol-Associated Liver Disease, and Their Implications in Clinical Practice

Canivet,

Boursier,

Loomba

2024

Semin Liver Dis

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In June 2023, under the patronage of the American Association for Study of Liver Disease, the European Association for Study of the Liver, and the Asociación Latinoamericana para el Estudio del Hígado with the involvement of 236 participants from around the world, a new nomenclature and definition for nonalcoholic fatty liver disease (NAFLD) has been proposed. Metabolic dysfunction-associated steatotic liver disease (MASLD) was defined as presence of hepatic steatosis and at least one of the cardiometabolic risk factors with alcohol intake less than 140 g/wk for women and 210 g/wk for men and no other causes of steatosis. A new entity called combined metabolic dysfunction- and alcohol-associated liver disease (MetALD) was created outside of pure MASLD for patients with metabolic dysfunction and alcohol intake greater than that allowed for MASLD (i.e., 140–350 g/wk for women and 210–420 g/wk for men). Recent studies have confirmed a 95% overlap between NAFLD and the new MASLD diagnostic criteria. Natural history, biomarkers, and thresholds of alcohol intake in MetALD group remains to be studied and validated.

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“…In this study, VCTE was most accurate compared with serum or combination serum and imaging biomarkers (i.e., FAST). 89 Imaging biomarker performance has been further evaluated by our group in our cohort of patients with biopsy-proven MASH. We found that the diagnostic accuracy of VCTE and MRE to detect significant fibrosis was significantly lower in Hispanic compared with non-Hispanic participants (AUROC 0.78 vs. 0.92, p ¼ 0.02 for VCTE; AUROC 0.87 vs. 0.98, p ¼ 0.01 for MRE).…”

Section: Clinical Outcomes Assessment Using Combination Of Serologic ...mentioning

confidence: 99%

Noninvasive Tests to Assess Fibrosis and Disease Severity in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic-Dysfunction-Associated Steatohepatitis

Tincopa,

Loomba

2024

Semin Liver Dis

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Risk of disease progression and clinical outcomes in metabolic dysfunction-associated steatotic liver disease (MASLD) is associated with fibrosis stage and presence of “at-risk metabolic dysfunction-associated steatohepatitis (MASH).” Although liver biopsy is considered the gold standard to diagnose MASH and stage of fibrosis, biopsy is infrequently performed in clinical practice and has associated sampling error, lack of interrater reliability, and risk for procedural complications. Noninvasive tests (NITs) are routinely used in clinical practice for risk stratification of patients with MASLD. Several NITs are being developed for detecting “at-risk MASH” and cirrhosis. Clinical care guidelines apply NITs to identify patients needing subspecialty referral. With recently approved Food and Drug Administration treatment for MASH and additional emerging pharmacotherapy, NITs will identify patients who will most benefit from treatment, monitor treatment response, and assess risk for long-term clinical outcomes. In this review, we examine the performance of NITs to detect “at-risk MASH,” fibrosis stage, response to treatment, and risk of clinical outcomes in MASLD and MASH.

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Poor performance of existing non-invasive tests for assessing advanced fibrosis in Non-alcoholic fatty liver disease (NAFLD) and development of a novel screening score.

Cited by 3 publications

References 0 publications

Noninvasive tests maintain high accuracy for advanced fibrosis in chronic hepatitis B patients with different nomenclatures of steatotic liver disease

Noninvasive tests maintain high accuracy for advanced fibrosis in chronic hepatitis B patients with different nomenclatures of steatotic liver disease

New Nomenclature for Nonalcoholic Fatty Liver Disease: Understanding Metabolic Dysfunction-Associated Steatotic Liver Disease, Metabolic Dysfunction- and Alcohol-Associated Liver Disease, and Their Implications in Clinical Practice

Noninvasive Tests to Assess Fibrosis and Disease Severity in Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic-Dysfunction-Associated Steatohepatitis

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