Mare Ruxandra, Sporea Ioan, Tomescu Mirela, Pop Gheorghe Nicușor, Vitel Andrei, Popescu Alina, Nistorescu Silviu, Sirli Roxana
Department of Internal Medicine II, Gastroenterology and Hepatology Unit, Advanced Research Center in Gastroenterology and Hepatology "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
Regional Center of Research in Advanced Hepatology, Academy of Medical Science, Timisoara, Romania.
Diabetes Metab Syndr Obes. 2022 Jun 7;15:1703-1713. doi: 10.2147/DMSO.S358744. eCollection 2022.
Many of the patients presenting with metabolic syndrome (MetS) also have liver steatosis (NAFLD) and some of them could develop liver fibrosis.
To develop a simple score that could rule out fibrosis, especially significant fibrosis (F≥2) and could be used in daily practice in patients with MetS, in order to identify patients at risk.
A total of 204 patients with MetS were prospectively enrolled. Evaluation of liver fibrosis was made using Vibration Controlled Transient Elastography while evaluation of steatosis was achieved using ultrasound (US).
Out of 204 patients with MetS, 179 patients (87.7%) had reliable liver stiffness measurements and 22.9% (41/179) had F ≥2. To formulate the fibrosis predicting score, all clinical variables associated with F ≥2 in the univariate analysis were considered in a multivariate regression model. According to the power of correlation, by consensus, we attributed 1 point for BMI >31.4 kg/m, 1 point for female gender, 1 point for HDLc <47mg/dL, 1 point for mild steatosis at US, 1.5 point for moderate and 2 points for severe steatosis.
At an optimal cut-off value of <3.5, our score could be used to rule-out the risk for developing at least significant fibrosis with a high negative predictive value (NPV 89.2%) in patients with MetS.
许多患有代谢综合征（MetS）的患者也有肝脂肪变性（非酒精性脂肪性肝病，NAFLD），其中一些人可能会发展为肝纤维化。
制定一个简单的评分系统，以排除纤维化，尤其是显著纤维化（F≥2），并可用于MetS患者的日常临床实践，以便识别有风险的患者。
前瞻性纳入了204例MetS患者。使用振动控制瞬时弹性成像评估肝纤维化，同时使用超声（US）评估脂肪变性。
在204例MetS患者中，179例（87.7%）获得了可靠的肝脏硬度测量值，22.9%（41/179）的患者F≥2。为了制定纤维化预测评分，在多变量回归模型中考虑了单变量分析中与F≥2相关的所有临床变量。根据相关性强度，经共识，我们对BMI>31.4kg/m²赋予1分，女性赋予1分，高密度脂蛋白胆固醇（HDLc）<47mg/dL赋予1分，超声检查显示轻度脂肪变性赋予1分，中度脂肪变性赋予1.5分，重度脂肪变性赋予2分。
在最佳临界值<3.5时，我们的评分可用于排除MetS患者发生至少显著纤维化的风险，具有较高的阴性预测值（NPV 89.2%）。
