The utility of noninvasive scores in non-alcoholic fatty liver disease patients with normal and elevated serum transaminases

Kaya, Eda; Bakır, Alev; Eren, Fatih; Yılmaz, Yusuf

doi:10.14744/hf.2020.0006

Cited by 33 publications

(41 citation statements)

References 33 publications

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“…18 A recent study found that the optimal FIB-4 cut-off value in NASH patients for the identification of advanced fibrosis was >1.3 in the literature. 29 However, for identifying HCC risk, we showed that a cut-off value of 2 would be more appropriate.…”

Section: Discussionmentioning

confidence: 90%

Screening and follow‐up of chronic liver diseases with understanding their etiology in clinics and hospitals

et al. 2020

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Section: Discussionmentioning

confidence: 90%

Screening and follow‐up of chronic liver diseases with understanding their etiology in clinics and hospitals

et al. 2020

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“…As recommended in the major guidelines, non-invasive fibrosis scores as FIB-4 and NFS are useful diagnostic modalities in estimation of advanced fibrosis [ 2 , 24 ]. They show acceptable diagnostic performance both in patients with elevated and normal transaminase levels [ 52 ]. Using FIB-4 for our sample, we found respectively 89.4%, 10.0% and 0.5% (0.1% missing) respondents with eALT to have low, indeterminate or high risk of advanced fibrosis using < 1.45 and > 3.25 as cut-off values.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with elevated alanine aminotransferase in employees of a German chemical company: results of a large cross-sectional study

2021

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Background We aimed to determine the prevalence of elevated alanine aminotransferase (eALT) in employees of a German chemical company, and analyze its association with sociodemographic, work- and lifestyle-related factors. Methods The cross-sectional study is based on data surveyed from occupational health check-ups between 2013 and 2018 at the site clinic of a chemical company based in Ludwigshafen, Germany. We used logistic regression analyses to assess the association between sociodemographic, work- and lifestyle-related characteristics and eALT. Quantile regression technique was applied to investigate if associations vary across different quantiles of the ALT distribution. Results Participants (n = 15,348) were predominantly male (78.3%) with a mean age of 42.2 years (SD 10.7). The prevalence of eALT was 18.5% (21.6% in men/7.2% in women) with a geometric mean of 28.9 U/L (32.8 U/L in men/18.5 U/L in women). In the multivariable logistic regression model, odds of eALT were significantly higher for males (OR 2.61; 95%-CI 2.24–3.05), manual workers (OR 1.23; 95%-CI 1.06–1.43), overweight (OR 2.66; 95%-CI 2.36–3.00) or obese respondents (e.g. OR 7.88; 95%-CI 5.75–10.80 for obesity class III), employees who consume any number of alcoholic drinks/week (e.g. OR 1.32; 95%-CI 1.16–1.49 for ≥ 3 drinks per week) and diabetics (OR 1.47; 95%-CI 1.22–1.78). Additionally, season of participation was significantly associated with eALT, with odds being higher for participation in spring, fall or winter, as compared to summer. A significant interaction between age and gender (pInteraction < 0.001) was found, showing approximately a u-shaped age/ALT relationship in women and an inversely u-shaped relationship in men. Quantile regression showed an increasing positive effect of male gender, overweight/obesity, and for diabetics on ALT level when moving from the lowest (q0.1) to the highest (q0.9) considered quantile. Additionally, from the lowest to the highest quantile an increasing negative effect on ALT for older age was observed. Conclusions Prevalence of eALT in our sample of employees can be considered as high, with almost one in five participants affected. Identification of risk groups allows the implementation of targeted preventive measures in order to avoid transition to severe morbidity.

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“…Fibrosis-4 score (FIB-4; based on patient age, platelet count, AST, and ALT [ 10 ]) and NAFLD fibrosis score (NFS; based on patient age, BMI, platelet count, AST to ALT ratio, albumin, and the presence of diabetes/impaired glucose tolerance [ 11 ]) were calculated. Kaya et al [ 12 ] have previously advised that FIB-4 and NFS scores have an acceptable diagnostic performance in the exclusion of advanced fibrosis in patients with normal or elevated transaminases. FIB-4 scores of < 1.3 and > 2.67 indicate a low and high risk for advanced fibrosis, respectively [ 13 , 14 ]; NFS < –1.455 indicates that advanced fibrosis is unlikely, but a score ≥ 0.67 indicates a high probability of fibrosis [ 11 ].…”

Section: Methodsmentioning

confidence: 99%

Clinical Characteristics of a Non-Alcoholic Fatty Liver Disease Population Across the Fibrosis Spectrum Measured by Magnetic Resonance Elastography: Analysis of Screening Data

et al. 2020

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Introduction: Non-alcoholic fatty liver disease (NAFLD), one of the most common liver diseases, is associated with liver-related complications and metabolic comorbidities. The phenotype is wide, ranging from simple steatosis to non-alcoholic steatohepatitis with advanced fibrosis. In this analysis of a phase 1 trial, clinical characteristics of screened subjects with NAFLD were studied according to the extent of fibrosis assessed using magnetic resonance elastography (MRE). Methods: One hundred ninety-four subjects with body mass index (BMI) of 25-40 kg/m 2 and suspected NAFLD were assessed by MRE and grouped by MRE thresholds as a proxy for fibrosis staging (groups 0-4). Data were summarized by group levels, and correlation analyses between MRE values and clinical parameters (including magnetic resonance imaging-proton density fat fraction) were performed. Results: Most subjects had MRE values in the lower range (groups 0-1; N = 148). Type 2 diabetes (T2D) and BMI [ 35 kg/m 2 were more frequent in groups with higher than lower MRE values. Subjects in the highest MRE groups also tended to be older and have higher liver enzyme concentrations compared with lower MRE groups. No, or weak, correlations were found between MRE values and clinical parameters (all r values B 0.45). Conclusions: There was considerable variation and overlap in clinical characteristics across the spectrum of liver stiffness. Although groups with high MRE values generally included more subjects with T2D and obesity, and had higher age and concentrations of liver enzymes, the clinical characteristics did not strongly correlate with MRE scores in this population. Trial Registration: Registered on Clinicaltrials.gov on November 29, 2017 (NCT03357380).

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The utility of noninvasive scores in non-alcoholic fatty liver disease patients with normal and elevated serum transaminases

Cited by 33 publications

References 33 publications

Screening and follow‐up of chronic liver diseases with understanding their etiology in clinics and hospitals

Screening and follow‐up of chronic liver diseases with understanding their etiology in clinics and hospitals

Factors associated with elevated alanine aminotransferase in employees of a German chemical company: results of a large cross-sectional study

Clinical Characteristics of a Non-Alcoholic Fatty Liver Disease Population Across the Fibrosis Spectrum Measured by Magnetic Resonance Elastography: Analysis of Screening Data

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