The BARD score and the NAFLD fibrosis score in the assessment of advanced liver fibrosis in nonalcoholic fatty liver disease

Cichoż‐Lach, Halina; Celiński, Krzysztof; Prozorow-Król, Beata; Swatek, Jarosław; Słomka, Maria; Lach, Tomasz

doi:10.12659/msm.883601

Cited by 59 publications

(33 citation statements)

References 38 publications

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“…The guideline was published in Hepatology in 2012 [44] . The broad categories of pharmacotherapy for the treatment of NAFLD include: (1) Antioxidants; (2) Table 3 Several noninvasive scoring systems based on indirect serologic markers of fibrosis are available to predict the presence or absence of advanced hepatic fibrosis BARD (BMI > 28, AST/ALT ≥ 0.8 and diabetes mellitus) score [29] : Score ranges from 0 to 4. BMI > 28 (yes = 1, no = 0) + AST/ALT (> 0.8 = 2, ≤ 0.8 = 0) + diabetes mellitus (yes = 1, no = 0) Score 0 to 1 means low probability of advanced hepatic fibrosis (negative predictive value 96%) and score 2 to 4 means high probability of hepatic fibrosis (positive predictive value 43%)…”

Section: Pharmacotherapymentioning

confidence: 99%

Non-alcoholic fatty liver disease in 2015

Ahmed¹

2015

WJH

169

134

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There is worldwide epidemic of non-alcoholic fatty liver disease (NAFLD). NAFLD is a clinical entity related to metabolic syndrome. Majority of the patients are obese but the disease can affect non-obese individuals as well. Metabolic factors and genetics play important roles in the pathogenesis of this disorder. The spectrum of disorders included in NAFLD are benign macrovesicular hepatic steatosis, non-alcoholic steatohepatitis, hepatic fibrosis, cirrhosis of liver and hepatocellular carcinoma. Although the disease remains asymptomatic most of the time, it can slowly progress to end stage liver disease. It will be the most common indication of liver transplantation in the future. It is diagnosed by abnormal liver chemistry, imaging studies and liver biopsy. As there are risks of potential complications during liver biopsy, many patients do not opt for liver biopsy. There are some noninvasive scoring systems to find out whether patients have advanced hepatic fibrosis. At the present time, there are limited treatment options which include lifestyle modification to loose weight, vitamin E and thioglitazones. Different therapeutic agents are being investigated for optimal management of this entity. There are some studies done on incretin based therapies in patients with NAFLD. Other potential agents will be silent information regulator protein Sirtuin and antifibrotic monoclonal antibody Simtuzumab against lysyl oxidase like molecule 2. But they are still in the investigational phase.

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Section: Pharmacotherapymentioning

confidence: 99%

Non-alcoholic fatty liver disease in 2015

Ahmed¹

2015

WJH

169

134

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“…The BARD score compares favourably to the NFS, and is both easier to calculate and does not produce intermediary results of indeterminate significance. However, its utility is hampered by the significant proportion of patients who, despite mild disease severity, are allocated high total scores due to obesity [113,114] . Although the NFS and BARD score accurately predict the onset of cirrhotic complications and liver-related mortality, their clinical application towards these goals is undermined by the inclusion of DM Ⅱ as independent predictor of adverse clinical outcome [115,116] .…”

Section: Cardio-metabolic Risk Traits and Liver Enzyme Levelsmentioning

confidence: 99%

Composite prognostic models across the non-alcoholic fatty liver disease spectrum: Clinical application in developing countries

Luckhoff

Kruger

Kotze

2015

WJH

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Heterogeneity in clinical presentation, histological severity, prognosis and therapeutic outcomes charac teristic of nonalcoholic fatty liver disease (NAFLD) necessitates the development of scientifically sound classification schemes to assist clinicians in stratifying patients into meaningful prognostic subgroups. The need for replacement of invasive liver biopsies as the standard method whereby NAFLD is diagnosed, graded and staged with biomarkers of histological severity injury led to the development of composite prognostic models as potentially viable surrogate alternatives. In the present article, we review existing scoring systems used to (1) confirm the presence of undiagnosed hepatosteatosis; (2) distinguish between simple steatosis and NASH; and (3) predict advanced hepatic fibrosis, with particular emphasis on the role of NAFLD as an independent cardiometabolic risk factor. In addition, the incorporation of functional genomic markers and application of emerging imaging technologies are discussed as a means to improve the diagnostic accuracy and predictive performance of promising composite models found to be most appropriate for widespread clinical adoption. Composite prognostic models across the non-alcoholic fatty liver disease spectrum: Clinical application in developing countries have entered the clinical domain as potentially viable alternatives. Lifestylebased intervention remains the cornerstone of treatment in patients with NAFLD. The widespread clinical adoption of composite diagnostic and predictive models could however prove useful in informing clinical and therapeutic decision making with the goal of adding value to patient care across the NAFLD spectrum.Lückhoff HK, Kruger FC, Kotze MJ. Composite prognostic models across the non-alcoholic fatty liver disease spectrum:

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“…However, in NAFLD patients, AAR <0.8 had high predictive ability to exclude advanced fibrosis with AU-ROC of 0.83 [50]. respectively [54]. NAFLD fibrosis score is capable of excluding ad-NAFLD fibrosis score vanced liver fibrosis and significantly reducing the incidence of liver biopsies in NAFLD patients.…”

Section: Fatty Liver Index (Fli)mentioning

confidence: 90%

How Can Fatty Liver Lead to Liver Cancer and How Can We Simply Assess It?

Toman¹,

Vávra²,

Jelínek³

et al. 2019

Act Scie Gastro

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Background: In 2016, more than 1.9 billion adult populations were overweight, 650 million of them were obese, which represents around 13% of the world's adult population. Liver steatosis has become the most common chronic liver disease in developed countries. In most cases, non-alcoholic fatty liver disease (NAFLD) is a benign and reversible liver disorder. Under certain circumstances, the disease may result through the image of non-alcoholic steatohepatitis (NASH) and hepatic fibrosis to liver cirrhosis with all known negative consequences, until formation of hepatocellular carcinoma (HCC). Methods: We searched from the Pubmed, Google Scholar and Research gate database and looked for keywords NAFLD, steatohepatitis, steatohepatitic variant of HCC. Results: The pathogenesis of NAFLD and metabolic syndrome seems to have common pathophysiological mechanisms. Although liver biopsy remains the gold standard for NAFLD diagnosis, it seems that new diagnostic procedures and scoring systems are emerging that could non-invasively distinguish simple steatosis from NASH. Conclusion: A higher number of metabolic syndrome risk factors have been registered in patients with steatohepatitic HCC variant. HCC patients with clinical symptoms have a very poor prognosis (median 5-year overall survival is between 0-10%); on the other hand, patients with asymptomatic HCC detected by screening show a higher survival rate, with a total 5-year survival of more than 50 % due to radical treatment. Simple and unassuming diagnostic methods can be used in a wide range of patients, thus systematically preventing the development of diseases and related disorders. Early diagnosis and risk stratification are essential for effective treatment management. We searched from the Pubmed, Google Scholar and Research gate database and looked for keywords NAFLD, steatohepatitis, steatohepatitic variant of HCC. Search strategy and selection criteria The global prevalence of obesity nearly tripled between 1975 and 2016. As the incidence of obesity in the population increases, the number of patients with liver steatosis also increases.

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The BARD score and the NAFLD fibrosis score in the assessment of advanced liver fibrosis in nonalcoholic fatty liver disease

Cited by 59 publications

References 38 publications

Non-alcoholic fatty liver disease in 2015

Non-alcoholic fatty liver disease in 2015

Composite prognostic models across the non-alcoholic fatty liver disease spectrum: Clinical application in developing countries

How Can Fatty Liver Lead to Liver Cancer and How Can We Simply Assess It?

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