Simple non-invasive fibrosis scoring systems can reliably exclude advanced fibrosis in patients with non-alcoholic fatty liver disease

McPherson, Stuart; Stewart, Stephen; Henderson, Emily; Burt, Alastair D.; Day, Christopher P.

doi:10.1136/gut.2010.216077

Cited by 764 publications

(761 citation statements)

References 30 publications

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“…Risk factors for advanced fibrosis among NAFLD patients identified in the present study are similar to those reported by others [3,[12][13][14][15]. Even though DM is a recognized risk factor for advanced fibrosis in NAFLD we observed that certain prescribed medications affect the relation between fibrosis and diabetes mellitus [3,[12][13][14][15].…”

Section: Discussionsupporting

confidence: 77%

See 1 more Smart Citation

Diabetes Mellitus, Insulin, Sulfonylurea and Advanced Fibrosis in Non-Alcoholic Fatty Liver Disease

Goh¹,

Pagadala²,

Dasarathy

et al. 2014

J Diabetes Metab

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Section: Discussionsupporting

confidence: 77%

“…Even though DM is a recognized risk factor for advanced fibrosis in NAFLD we observed that certain prescribed medications affect the relation between fibrosis and diabetes mellitus [3,[12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Diabetes Mellitus, Insulin, Sulfonylurea and Advanced Fibrosis in Non-Alcoholic Fatty Liver Disease

Goh¹,

Pagadala²,

Dasarathy

et al. 2014

J Diabetes Metab

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“…In the last years, some clinical/laboratory scores have been created to assess the risk of NASH evolution and the need of biopsy in these patients [1]. Among all, NALFD fibrosis score seems to predict well the presence of significant fibrosis [4][5][6]. Although the traditional ultrasound (US) is an excellent diagnostic technique to reveal the presence of diffuse fatty liver disease, it is neither sensitive nor specific to reveal fibrosis, except in advanced stages where signs of cirrhosis are evident.…”

Section: Introductionmentioning

confidence: 99%

Hepatic artery resistive index (HARI) and non-alcoholic fatty liver disease (NAFLD) fibrosis score in NAFLD patients: cut-off suggestive of non-alcoholic steatohepatitis (NASH) evolution

Tana

Tana²,

Rossi

et al. 2016

J Ultrasound

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Purpose of the study Conventional ultrasound (US) is reliable to reveal the presence of non-alcoholic fatty liver disease (NAFLD), but it is neither sensitive nor specific to reveal fibrosis clues, except in advanced stages where signs of cirrhosis are evident. NALFD fibrosis score is a noninvasive parameter that predicts well the presence of significant fibrosis, but correlations with US parameters are lacking. The aim of this study was, therefore, to compare resistive index of hepatic artery (HARI) of NAFLD patients with different severity degrees of diffuse fatty liver disease vs HARI of controls, and to compare HARI of NAFLD patients with different NAFLD fibrosis scores vs HARI of controls. Methods This was a spontaneous, no-profit observational study conducted in our US department between December 2013 and July 2014. Patients with NAFLD with different severity of disease and healthy controls were included. Echogenicity and size of liver and spleen, maximum portal vein velocity, RI, peak systolic velocity (PSV), and end diastolic velocity (EDV) of splenic artery, PSV, EDV, and RI of hepatic artery, and NAFLD fibrosis score were acquired and compared between groups.Results HARI was significantly lower in NAFLD patients than controls (p \ 0.0001). A significant difference was also found between the groups of NAFLD severity (p \ 0.0001). There was also a difference between HARI of NAFLD patients with different NAFLD fibrosis scores vs HARI of controls (p \ 0.0001) with a positive correlation between HARI and NAFLD fibrosis score. Conclusion and discussion Conventional Doppler US can be helpful to detect NAFLD patients with the risk of fibrous tissue accumulation. HARI tends to exceed the range of controls for patients with NAFLD fibrosis score greater than 0.675. The detection of HARI greater than 0.9 in NAFLD patients, regardless of the US degree of severity of steatosis, might suggest the execution of biopsy to predict the risk of progression to steatohepatitis and fibrous tissue accumulation. Low values of HARI may be expression of lower risk, which does not necessitate any biopsy.Keywords Hepatic artery resistive index Á Non-alcoholic fatty liver disease Á NAFLD fibrosis score Á Non-alcoholic steatohepatitis Á Ultrasound Á Color Doppler Sommario Scopo dello studio L'ecografia convenzionale è risultata affidabile nel rilevare la presenza di steatosi epatica, tra cui la forma non alcolica (NAFLD), ma non è né sensibile né specifica nel rivelare indizi suggestivi di fibrosi, tranne che in fase avanzata dove sono presenti segni conclamati di cirrosi. Il NALFD fibrosis score è un parametro non invasivo che predice bene la presenza di fibrosi significativa, ma non ci sono dati in letteratura riguardanti una possibile correlazione con i parametri ecografici. Lo scopo di questo studio è stato quindi quello di confrontare HARI dei pazienti con NAFLD a differente grado di severità di steatosi epatica vs l'HARI dei controlli, e di confrontare HARI dei pazienti affetti da NAFLD a differente NAFLD fibrosis score...

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“…The FIB-4 index was initially developed for chronic hepatitis C virus (HCV)/HIV co-infection and has been subsequently validated for other liver diseases (36,37). The variables entered in the FIB-4 are readily available and include aspartate aminotransferase (AST), alanine aminotransferase (ALT), and platelet (PLT) count.…”

Section: Fib-4 Indexmentioning

confidence: 99%

Fibrosis assessment in patients with chronic hepatitis B virus (HBV) infection

Parikh¹,

Ryan²,

Tsochatzis³

2017

Ann. Transl. Med.

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Chronic hepatitis B virus (HBV) infection is a major cause of liver morbidity and mortality worldwide.While a proportion of the 250 million individuals chronically infected with HBV will not come to significant harm or require therapy, many others risk developing complications of the end-stage liver disease such as decompensated cirrhosis and hepatocellular carcinoma (HCC), without intervention. Due to the complex natural history of HBV infection, patients require an expert assessment to interpret biochemistry, viral serology and appropriately stage the disease, and to initiate monitoring and/or therapy where indicated. The detection and quantification of liver fibrosis is a key factor for disease management and prognostication for an individual with HBV. The reliance on invasive liver biopsy to stage disease is diminishing with the advent of robust non-invasive blood-and imagingbased algorithms which can reliably stage disease in many cases. These tests are now incorporated into International guidelines for HBV management and relied upon daily to inform clinical judgement. Both blood-and imagingbased approaches have advantages over liver biopsy, including minimal risks, lower cost, better patient acceptance and speed of results, while disadvantages include lower diagnostic accuracy in intermediate disease stages and variability with co-existing hepatic inflammation or steatosis. This review outlines the methods of fibrosis assessment in chronic HBV infection and focuses on the most commonly used blood-and imaging-based noninvasive tests, reviewing their diagnostic performance and applicability to patient care.

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Simple non-invasive fibrosis scoring systems can reliably exclude advanced fibrosis in patients with non-alcoholic fatty liver disease

Cited by 764 publications

References 30 publications

Diabetes Mellitus, Insulin, Sulfonylurea and Advanced Fibrosis in Non-Alcoholic Fatty Liver Disease

Diabetes Mellitus, Insulin, Sulfonylurea and Advanced Fibrosis in Non-Alcoholic Fatty Liver Disease

Hepatic artery resistive index (HARI) and non-alcoholic fatty liver disease (NAFLD) fibrosis score in NAFLD patients: cut-off suggestive of non-alcoholic steatohepatitis (NASH) evolution

Fibrosis assessment in patients with chronic hepatitis B virus (HBV) infection

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