Validation of the FIB4 Index in a Japanese Nonalcoholic Fatty Liver Disease Population

Sumida, Yoshio; Yoneda, Masato; Hyogo, Hideyuki; Itoh, Yoshito; Ono, Masafumi; Fujii, Hideki; Eguchi, Yuichiro; Suzuki, Yôichi; Aoki, Noriaki; Kanemasa, Kazuyuki; Fujita, Koji; Chayama, Kazuaki; Saibara, Toshiji; Kawada, Norifumi; Fujimoto, Kazuma; Kohgo, Yutaka; Yoshikawa, Toshikazu; Okanoue, Takeshi

doi:10.1016/s0016-5085(11)64097-3

Cited by 89 publications

(136 citation statements)

References 28 publications

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“…Several liver functional parameters may reflect hepatic fibrosis and related liver stiffness. Surrogate indexes for hepatic fibrosis such as FIB‐4 and APRI were also high in such patients and comparison between Vs and these indexes was necessary in the present study. The Vs in the liver was well correlated with the degree of hepatic fibrosis or serum HA levels, and measuring liver stiffness by an ARFI image is useful for examining the degree of fibrosis in chronic liver injuries, particularly cirrhosis.…”

Section: Discussionmentioning

confidence: 94%

“…FIB‐4 index, age (years) * aspartate aminotransferase (IU/L) / platelet count (10 9 /L) * alanine aminotransferase (IU/L) 1/2 .…”

Section: Resultsmentioning

confidence: 99%

“…The value of the Vs was compared with the patient demographics, laboratory data, histological findings, surgical records, histological findings and postoperative complications. To evaluate liver stiffness or cirrhosis, serum hyaluronic acid (HA) level, FIB‐4 index, and aspartate aminotransferase (AST; upper limit of normal range at our institute, 33 IU/L) to platelet ratio index (APRI) were compared with the Vs of ARFI . The hardness of the resected liver specimens (Neutone) was measured using a muscle durometer (TDM‐Z1[RB]; TRY‐ALL, Chiba, Japan).…”

Section: Methodsmentioning

confidence: 99%

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Usefulness of evaluating hepatic elasticity using artificial acoustic radiation force ultrasonography before hepatectomy

Nanashima

Sakamoto

et al. 2014

Hepatology Research

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Section: Discussionmentioning

confidence: 94%

“…FIB‐4 index, age (years) * aspartate aminotransferase (IU/L) / platelet count (10 9 /L) * alanine aminotransferase (IU/L) 1/2 .…”

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Usefulness of evaluating hepatic elasticity using artificial acoustic radiation force ultrasonography before hepatectomy

Nanashima

Sakamoto

et al. 2014

Hepatology Research

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“…Severity of liver disease was evaluated using the Fib‐4 index. All patients were classified into either a chronic hepatitis or liver cirrhosis group according to the Fib‐4 index (cut‐off value 3.25) …”

Section: Methodsmentioning

confidence: 99%

Effects of in‐hospital exercise on sarcopenia in hepatoma patients who underwent transcatheter arterial chemoembolization

Koya

Kawaguchi

Hashida

et al. 2018

J of Gastro and Hepatol

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Background and Aim Sarcopenia is a prognostic factor in hepatocellular carcinoma (HCC) patients. HCC patients who underwent transcatheter arterial chemoembolization (TACE) are at a risk of muscle atrophy. We aimed to investigate the effects of in‐hospital exercise on muscle mass and factors associated with muscle hypertrophy in HCC patients who underwent TACE. Methods We enrolled 209 HCC patients who underwent TACE. Patients were classified into either an exercise (n = 102) or control (n = 107) group. In the exercise group, patients were treated with in‐hospital exercise (median 2.5 metabolic equivalents/20–40 min/day). The effects of exercise on muscle mass were evaluated by changes in skeletal muscle index (ΔSMI) between before and after TACE. Factors associated with an increase in SMI were analyzed by logistic regression and decision‐tree analyses. Results There was no significant difference in serum albumin and bilirubin levels between the two groups. ΔSMI was significantly higher in the exercise group than in the control group (0.28 cm2/m2 vs −1.11 cm2/m2, P = 0.0029). In the logistic regression analysis, exercise was an independent factor for an increase in SMI (hazard ratio 2.13; 95% confidence interval 1.215–3.846; P = 0.0085). Moreover, the decision‐tree analysis showed that exercise was the initial divergence variable for an increase in SMI (the ratio of increased SMI: 53% in the exercise group vs 36% in the control group). Conclusions In‐hospital exercises increased muscle mass in HCC patients who underwent TACE. In addition, exercise was an independent factor for muscle hypertrophy. Thus, in‐hospital exercise may prevent sarcopenia in HCC patients who underwent TACE.

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“…The fibrosis‐4 index (FIB‐4 index) was first proposed as a parameter to follow the progression of liver fibrosis in patients with human immunodeficiency virus and hepatitis C virus co‐infection, and subsequently, its applicability to NAFLD has also been investigated. The FIB‐4 index, among other scoring systems, including the NFS, has been demonstrated to be the most useful for predicting advanced fibrosis in NAFLD patients, not only in the USA but also in Japanese patients . Especially, in a validation study conducted in Japanese patients with NAFLD, an FIB‐4 index of less than 1.45 was reported to have a 98% negative predictive value for NAFLD with advanced fibrosis (fibrosis stage 3–4) .…”

Section: Introductionmentioning

confidence: 99%

Distribution of liver stiffness in non‐alcoholic fatty liver disease with higher fibrosis‐4 index than low cut‐off index

Tomeno

Imajo

Kuwada³

et al. 2019

J of Gastro and Hepatol

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Background and Aim In the condition of high prevalence of non‐alcoholic fatty liver disease (NAFLD), a new diagnostic algorithm to efficiently identify NAFLD patients with significant fibrosis is urgently required. We evaluated the predictive ability of the fibrosis‐4 index (FIB‐4 index) for significant liver fibrosis (F ≥ 2) in a cohort of Japanese patients with NAFLD. Methods We prospectively calculated the FIB‐4 index in patients who were incidentally diagnosed as fatty liver in medical checkups and then conducted liver stiffness measurement by vibration‐controlled transient elastography (VCTE) only in patients in whom the FIB‐4 index was more than the low cut‐off index (> 1.45). Results Of the 5929 people who underwent medical checkups, a total of 1374 people were identified as having fatty liver. Among these, we performed VCTE in 106 patients in whom the FIB‐4 index was higher than 1.45. The distribution of the fibrosis stage as estimated by VCTE in the patients was as follows: F0, 52.8%; F1, 10.3%; F2, 21.6%; F3, 11.3%; and F4, 3.7%. The positive predictive value of the FIB‐4 index for detecting NAFLD with significant fibrosis was 36.6%. The minimum value of the FIB‐4 index was constant for each estimated fibrosis stage. Conclusions This is the first prospective study to evaluate the usefulness of the FIB‐4 index as the first step to screen NAFLD patients with significant fibrosis. In Japan, addition of one further step that combined with the FIB‐4 index is necessary to meaningfully reduce the number of patients needing liver stiffness measurement or liver biopsy.

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Validation of the FIB4 Index in a Japanese Nonalcoholic Fatty Liver Disease Population

Cited by 89 publications

References 28 publications

Usefulness of evaluating hepatic elasticity using artificial acoustic radiation force ultrasonography before hepatectomy

Usefulness of evaluating hepatic elasticity using artificial acoustic radiation force ultrasonography before hepatectomy

Effects of in‐hospital exercise on sarcopenia in hepatoma patients who underwent transcatheter arterial chemoembolization

Distribution of liver stiffness in non‐alcoholic fatty liver disease with higher fibrosis‐4 index than low cut‐off index

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