超重/肥胖人群中间接纤维化和脂肪变性指标及其预测因子的一致性。
Concordance between indirect fibrosis and steatosis indices and their predictors in subjects with overweight/obesity.
机构信息
Institute of Clinical Physiology, CNR, Pisa, Italy.
Occupational Health Unit, Center of Obesity and Work EASO Collaborating Centers for Obesity Management, Fondazione Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
出版信息
Eat Weight Disord. 2022 Oct;27(7):2617-2627. doi: 10.1007/s40519-022-01400-y. Epub 2022 May 9.
BACKGROUND
The non-invasive assessment of steatosis/fibrosis tried to overcome some of peri-procedural risk of liver biopsy; for this, several indices of steatosis and fibrosis in liver have been proposed.
AIM
To evaluate concordance of non-invasive fibrosis and steatosis indices in a large population of adult subjects at risk of NAFLD, and how obesity and its physio-pathological features may interact with steatosis/fibrosis indexes and related biomarkers of cardio-metabolic risk.
METHODS
Indices of steatosis (fatty liver index-FLI), NAFLD liver fat score-NLFS)) and fibrosis (Fibrosis 4 (FIB-4), BARD, BAAT and FORN) were calculated in 1145 outpatients with overweight or obesity at risk for T2D and NAFLD. Indices were correlated with clinical variables.
RESULTS
Concordance between tests occurred in 81% of the overall values between FLI and NLFS, but was lower when comparing the other fibrosis scores (FIB-4 vs FORN 72%, FIB-4 vs BARD 36%, BARD vs FORN 46%, BARD vs BAAT 58%, FIB-4 vs BAAT 46%, BAAT vs FORN 62%). Each index was differently correlated with anthropometric, clinical and laboratory variables.
CONCLUSION
Indices evaluated retain low concordance, clinicians should be aware of these differences between steatosis/fibrosis scores when expressing a differential liver disease diagnosis or assessing the progression of a known liver disease.
LEVEL OF EVIDENCE
Level V, descriptive research.
背景
非侵入性评估脂肪变性/纤维化试图克服肝活检的一些围手术期风险；为此，已经提出了几种肝脂肪变性和纤维化的指数。
目的
评估非侵入性纤维化和脂肪变性指数在患有非酒精性脂肪性肝病（NAFLD）风险的大量成年人群中的一致性，以及肥胖及其生理病理特征如何与脂肪变性/纤维化指数以及相关的心血管代谢风险生物标志物相互作用。
方法
在 1145 名超重或肥胖且有 2 型糖尿病和 NAFLD 风险的门诊患者中计算了脂肪变性指数（脂肪肝指数-FLI）、NAFLD 肝脂肪评分-NLFS）和纤维化指数（FIB-4、BARD、BAAT 和 FORN）。指数与临床变量相关。
结果
FLI 和 NLFS 之间的总体值之间的测试一致性为 81%，但当比较其他纤维化评分时，一致性较低（FIB-4 与 FORN 为 72%，FIB-4 与 BARD 为 36%，BARD 与 FORN 为 46%，BARD 与 BAAT 为 58%，FIB-4 与 BAAT 为 46%，BAAT 与 FORN 为 62%）。每个指数与人体测量、临床和实验室变量的相关性不同。
结论
评估的指数一致性低，临床医生在表达不同的肝脏疾病诊断或评估已知肝脏疾病的进展时，应注意这些脂肪变性/纤维化评分之间的差异。
证据水平
V 级，描述性研究。
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