Kaya Eda, Bakir Alev, Eren Fatih, Yilmaz Yusuf
Department of Internal Medicine, Helios Hospital Schleswig, Academical Educational Hospital of Luebeck and Kiel Universities, Schleswig, Germany.
Department of Biostatics and Medical Informatics, Halic University Faculty of Medicine, Istanbul, Turkey.
Hepatol Forum. 2020 Jan 20;1(1):8-13. doi: 10.14744/hf.2020.0006. eCollection 2020 Jan.
Noninvasive scores are developed for the estimation of advanced fibrosis, including parameters in addition to transaminases in non-alcoholic fatty liver disease (NAFLD). In this study, we aimed to investigate the diagnostic performances of Fibrosis-4 (FIB-4) and NAFLD Fibrosis Score (NFS) in the estimation of advanced fibrosis comparing patients with normal and elevated transaminases.
We retrospectively analyzed the prospectively collected data of a total of 407 consecutive patients with biopsy-proven NAFLD. FIB-4 scores of <1.3 and >2.67 or <1.45 and >3.25 indicated a low and high risk for advanced fibrosis, respectively. NFS scores of <-1.455 and >0.676 were used to assess low and high risk for advanced fibrosis, respectiv.
FIB-4 cutoffs of <1.3 and <1.45 for low risk of advanced fibrosis had a sensitivity of 70% and 54% in patients with elevated transaminases and 70% and 52% in patients with normal transaminases, respectively. The specificities for the cutoffs of >2.67 and >3.25 were 97% and 98% in patients with elevated transaminases and 99% and 100% in patients with normal transaminases, respectively. Concerning NFS, we found similar results.
FIB-4 and NFS showed acceptable diagnostic performance in the exclusion of advanced fibrosis in both populations with normal and elevated transaminases.
非侵入性评分用于评估晚期肝纤维化，非酒精性脂肪性肝病（NAFLD）中除转氨酶外还包括其他参数。在本研究中，我们旨在比较转氨酶正常和升高的患者，研究纤维化-4（FIB-4）和NAFLD纤维化评分（NFS）在评估晚期肝纤维化中的诊断性能。
我们回顾性分析了前瞻性收集的共407例经活检证实的NAFLD患者的数据。FIB-4评分<1.3和>2.67或<1.45和>3.25分别表示晚期肝纤维化的低风险和高风险。NFS评分<-1.455和>0.676分别用于评估晚期肝纤维化的低风险和高风险。
FIB-4用于评估晚期肝纤维化低风险的临界值<1.3和<1.45，在转氨酶升高的患者中敏感性分别为70%和54%，在转氨酶正常的患者中敏感性分别为70%和52%。临界值>2.67和>3.25的特异性，在转氨酶升高的患者中分别为97%和98%，在转氨酶正常的患者中分别为99%和100%。关于NFS，我们得到了类似的结果。
FIB-4和NFS在排除转氨酶正常和升高人群的晚期肝纤维化方面均表现出可接受的诊断性能。
