The Utility of the “NAFLD Fibrosis Score” in Morbidly Obese Subjects with NAFLD

Qureshi, Kamran; Clements, Ronald H.; Abrams, Gary A.

doi:10.1007/s11695-007-9295-8

Cited by 58 publications

(33 citation statements)

References 14 publications

(15 reference statements)

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“…Of these, the NAFLD fibrosis score is the most widely known nowadays. [24][25][26][27] This study showed that T2DM was significantly associated with the presence of NAFLD in a morbidly obese population.…”

Section: Discussionmentioning

confidence: 59%

Influence of type 2 diabetes mellitus on liver histology among morbidly obese individuals. A cross-sectional study

et al. 2016

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CONTEXT AND OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) has become a public health concern. It encompasses a wide spectrum of histological abnormalities and has close relationships with insulin resistance and type 2 diabetes mellitus (T2DM). This study sought to compare the histological alterations observed in morbidly obese individuals with and without T2DM who underwent Roux-en-Y gastric bypass. DESIGN AND SETTING: Cross-sectional study in a tertiary-level public hospital.METHODS: This was a cross-sectional study on 197 individuals who underwent gastric bypass surgery between 2011 and 2013. NAFLD was assessed through liver biopsies. T2DM was diagnosed through the International Diabetes Federation criteria. RESULTS: Non-diabetics presented significantly more biopsies without any histological abnormalities, regarding steatosis (42.6% versus 25.5%; P = 0.0400), fibrosis (60.6% versus 36.2%; P = 0.0042) and steatohepatitis (27.3% versus 12.8%; P = 0.0495), while diabetics presented significantly higher frequency of moderate forms of steatosis (36.2% versus 20%; P = 0.0307) and fibrosis (23.4% versus 4%; P = 0.0002). DISCUSSION: T2DM was associated with more advanced forms of NAFLD within the population studied. NAFLD has previously been correlated with severe forms of heart disease. CONCLUSION: Screening for and early detecting of NAFLD in high-risk populations are important for avoiding further development of severe forms and the need for liver transplantation. RESUMO CONTEXTO E OBJETIVO:A doença gordurosa não alcoólica do fígado se tornou um problema de saúde pública. Ela compreende um amplo espectro de alterações histológicas e se relaciona intimamente com a resistência insulínica e o diabetes mellitus tipo 2. Este estudo tem por objetivo comparar as alterações histológicas observadas em obesos mórbidos com e sem diabetes submetidos ao bypass gástrico em Y de Roux. TIPO DE ESTUDO E LOCAL: Estudo transversal em um hospital terciário público. MÉTODOS: Este é um estudo transversal que envolveu 197 indivíduos submetidos ao bypass gástrico entre 2011 e 2013. A doença gordurosa do fígado foi avaliada através de biópsia hepática. O diabetes mellitus tipo 2 foi diagnosticado através dos critérios da Federação Internacional de Diabetes. RESULTADOS: Indivíduos não diabéticos apresentaram significativamente mais biópsias sem anormalidades histológicas, em relação a esteatose (42,6% versus 25,5%; P = 0.04), fibrose (60,6% versus 36,2%; P = 0.0042) e esteato-hepatite (27,3% versus 12,8%; P = 0.0495); os diabéticos apresentaram uma frequên-cia significativamente mais alta de formas moderadas de esteatose (36,2% versus 20%; P = 0.0307) e fibrose (23,4% versus 4%; P = 0.0002). DISCUSSÃO: O DM-2 associou-se a formas mais avançadas de doença gordurosa do fígado dentro da população estudada. A doença gordurosa não alcoólica do fígado foi associada previamente com formas graves de doença cardíaca. CONCLUSÃO: A busca e detecção precoce da doença gordurosa em populações de alto risco são importantes para evitar o fut...

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Section: Discussionmentioning

confidence: 59%

Influence of type 2 diabetes mellitus on liver histology among morbidly obese individuals. A cross-sectional study

et al. 2016

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“…The NAFLD fibrosis score (NFS) has proven useful in accurately predicting as well as excluding advanced hepatic fibrosis using high and low cut-off values, respectively. Although the NFS has been extensively investigated and validated in different population groups, it has limited utility in intermediate stages of non-severe fibrosis [110][111][112] . The BARD score compares favourably to the NFS, and is both easier to calculate and does not produce intermediary results of indeterminate significance.…”

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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“…Algorithms specifically derived from NAFLD cohorts include the BAAT score (consisting of BMI, ALT, age and TG levels) [225], the BARD score (BMI, AST/ALT ratio, diabetes) [202,226] and the NAFLD fibrosis score (incorporating age, glucose, AST, ALT, BMI, platelets and albumin) [201,222,223,227,228]. In a recent meta-analysis the AUROC for the NAFLD fibrosis score was found to be 0.85 with a pooled sensitivity of 90 % and specificity of 97 % [143].…”

Section: Noninvasive Markers Of Fibrosis In Nafldmentioning

confidence: 99%

Nonalcoholic Fatty Liver Disease

Fitzpatrick

2015

Textbook of Pediatric Gastroenterology, Hepatology and Nutrition

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The Utility of the “NAFLD Fibrosis Score” in Morbidly Obese Subjects with NAFLD

Abstract: The NAFLD fibrosis score may be a useful noninvasive approach for excluding significant and advanced fibrosis and in morbidly obese patients.

Cited by 58 publications

References 14 publications

Influence of type 2 diabetes mellitus on liver histology among morbidly obese individuals. A cross-sectional study

Influence of type 2 diabetes mellitus on liver histology among morbidly obese individuals. A cross-sectional study

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

Nonalcoholic Fatty Liver Disease

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