Department of Gastrointestinal Surgery, Laboratory of Bariatric and Metabolic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, China.
Department of General Surgery, The Second Clinical Medical College, The Fifth People's Hospital affiliated to Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Obes Surg. 2022 Nov;32(11):3619-3626. doi: 10.1007/s11695-022-06251-1. Epub 2022 Sep 7.
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the world, and liver fibrosis has been proven to be associated with liver disease related events and total mortality. Several noninvasive methods have been developed, but whether those methods are suitable for the detection of fibrosis in Chinese patients with obesity and NAFLD has not been completely elucidated. This study aimed to compare the efficacy of fibrosis-4 (FIB-4), aspartate transaminase to platelet ratio index (APRI), modified aspartate transaminase to platelet ratio index (m-APRI), BARD (BARD (BMI (body mass index) > 28 = 1 point, AAR (aspartate aminotransferase/alanine aminotransferase) > 0.8 = 2 points, DM (diabetes mellitus) = 1 point)), NAFLD fibrosis score (NFS), and shear wave elastography (SWE) in the evaluation of the degree of liver fibrosis in Chinese patients with obesity and NAFLD.
A retrospective study consisted of 100 patients. The accuracy of FIB-4, APRI, m-APRI, BARD, NFS, and SWE in the assessment of significant or advanced liver fibrosis in Chinese patients with obesity and NAFLD was compared.
Weight and alanine aminotransferase (ALT) were independent risk factors for liver fibrosis. SWE, APRI, and m-APRI had significant efficiency in the diagnosis of significant fibrosis in patients with obesity and NAFLD. APRI and SWE were superior to the other methods in the diagnosis of significant and advanced liver fibrosis in patients with obesity and NAFLD. APRI and SWE showed no statistically significant difference in diagnostic efficiency.
Weight and ALT are independent risk factors for liver fibrosis progression in NAFLD patients. SWE and APRI have predictive value for significant and advanced fibrosis of NAFLD in Chinese patients with obesity.
非酒精性脂肪性肝病（NAFLD）是世界上最常见的慢性肝病，肝纤维化已被证明与肝病相关事件和全因死亡率相关。已经开发了几种非侵入性方法，但这些方法是否适用于肥胖和 NAFLD 中国患者的纤维化检测尚未完全阐明。本研究旨在比较纤维化-4（FIB-4）、天冬氨酸转氨酶与血小板比值指数（APRI）、改良天冬氨酸转氨酶与血小板比值指数（m-APRI）、BARD（BMI（体重指数）>28=1 分，AAR（天冬氨酸转氨酶/丙氨酸转氨酶）>0.8=2 分，DM（糖尿病）=1 分）、NAFLD 纤维化评分（NFS）和剪切波弹性成像（SWE）在评估肥胖和 NAFLD 中国患者肝纤维化程度的准确性。
回顾性研究包括 100 例患者。比较了 FIB-4、APRI、m-APRI、BARD、NFS 和 SWE 在评估肥胖和 NAFLD 中国患者显著或晚期肝纤维化程度中的准确性。
体重和丙氨酸转氨酶（ALT）是肝纤维化的独立危险因素。SWE、APRI 和 m-APRI 对肥胖和 NAFLD 患者显著纤维化的诊断具有显著效率。APRI 和 SWE 在肥胖和 NAFLD 患者中诊断显著和晚期肝纤维化方面优于其他方法。APRI 和 SWE 在诊断效率上无统计学差异。
体重和 ALT 是 NAFLD 患者肝纤维化进展的独立危险因素。SWE 和 APRI 对肥胖的中国 NAFLD 患者的显著和晚期纤维化具有预测价值。
