Stine Jonathan G, Rinella Mary E
Division of Gastroenterology & Hepatology, University of Virginia, Charlottesville, Virginia, USA.
Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Am J Gastroenterol. 2017 May;112(5):752-754. doi: 10.1038/ajg.2017.60.
Despite the widespread prevalence of nonalcoholic fatty liver disease, diagnostic uncertainty of noninvasive tests to detect those with more advanced disease remains an important unmet need. Numerous predictive models have been developed, many of which incorporate age as a covariate. Index derivation studies typically have not included young adults or the elderly and the predictive utility of these models may not be equivalent across the age spectrum. New cutoffs for advanced fibrosis in those >65 have been proposed and validated in a recent study but will require external validation.
尽管非酒精性脂肪性肝病普遍流行，但检测病情更严重患者的非侵入性检查在诊断上仍存在不确定性，这仍是一个重要的未满足需求。已经开发了许多预测模型，其中许多将年龄作为协变量纳入。指数推导研究通常未纳入年轻人或老年人，这些模型在整个年龄范围内的预测效用可能并不相同。最近的一项研究提出并验证了65岁以上人群晚期纤维化的新临界值，但仍需要外部验证。
