Modified AST to platelet ratio index improves APRI and better predicts advanced fibrosis and liver cirrhosis in patients with non-alcoholic fatty liver disease.
Clin Res Hepatol Gastroenterol
; 45(4): 101528, 2021 Jul.
Article
em En
| MEDLINE
| ID: mdl-33268036
ABSTRACT
AIMS:
Advanced fibrosis (AF) and liver cirrhosis (LC) are important milestones in non-alcoholic fatty liver disease (NAFLD). FIB-4, NFS and BARD are validated scores with good accuracy in detecting AF and LC. APRI does not have similar predictive accuracy. While a modification (m-APRI) improves its use in viral hepatitis, this has yet to be evaluated in NAFLD. This study compares diagnostic performance of aforementioned scores in predicting AF and LC in NAFLD.METHODS:
Consecutive NAFLD patients undergoing Transient Elastography (TE) using Echosens® Fibroscan® for fibrosis staging were included. Cut-off liver stiffness measurements for AF and LC were 7.9â¯kPa and 11.5â¯kPa respectively. Anthropometric and laboratory tests done within 3 months were used. Diagnostic performances of scores were analyzed by standard statistical tests.RESULTS:
161 patients qualified for the study. Mean age was 60.2⯱â¯14 years, BMI 26.8⯱â¯4.6â¯kg/m2. M-probe was used in 113, XL in 48. Optimal cut-offs of m-APRI for AF and LC were 5.84 and 9 respectively. Area under receiver operator characteristic curves (AUROC) for prediction of AF at optimal cut-off points were m-APRI 0.84, APRI 0.80, FIB-4 0.77, NFS 0.77 and BARD 0.65. For prediction of LC, AUROC were m-APRI 0.83, APRI 0.76, FIB-4 0.81, NFS 0.77 and BARD 0.66. m-APRI was significantly superior to all scores compared in detecting AF (pâ¯<â¯0.05 for all) and superior to APRI (pâ¯=â¯0.008) and BARD (pâ¯=â¯0.007) in predicting LC. There was no significant difference between m-APRI and FIB-4 or NFS in prediction of LC.CONCLUSIONS:
For prediction of AF in NAFLD, m-APRI outperforms BARD, APRI, NFS and FIB-4, while for the prediction of cirrhosis, m-APRI is superior to APRI and BARD but comparable to NFS and FIB-4.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Hepatopatia Gordurosa não Alcoólica
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Humans
/
Middle aged
Idioma:
En
Revista:
Clin Res Hepatol Gastroenterol
Ano de publicação:
2021
Tipo de documento:
Article