Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Divisão de Gastroenterologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Arch Endocrinol Metab. 2022 Nov 17;66(6):823-830. doi: 10.20945/2359-3997000000514. Epub 2022 Sep 20.
Describe the clinical profile of patients with biopsy-proven non-alcoholic fatty liver disease (NAFLD) and analyze the risk predictors of hepatic fibrosis in outpatient follow-up at a university hospital.
Demographic, clinical and laboratory data of a cohort of 143 patients with biopsy-proven NAFLD were retrospectively analysed under univariate analyses. Diagnostic accuracy, determined by AUROC, was evaluated for variables that showed a significant difference in univariate comparison analysis and diagnostic performances were determined by sensitivity and specificity.
The mean age of studied patients were 48 years, 66.4% of them were women. Age, presence of diabetes mellitus, hypertension, metabolic syndrome and laboratory variables such as AST/ALT ratio, GGT, platelet count and fasting glucose were significantly associated with advanced fibrosis. FIB-4 and NAFLD fibrosis score (AUROC 0.82 and 0.89, respectively) outperformed APRI (AUROC 0.73) for advanced liver fibrosis and cirrhosis ( of 0.04).
In our study, metabolic syndrome, diabetes, hypertension, AST/ALT ratio, GGT, platelet count and fasting glucose were associated with hepatic fibrosis in patients with NAFLD. The non-invasive tests FIB-4 and NAFLD fibrosis score showed the best accuracy to stratify disease severity.
描述经肝活检证实的非酒精性脂肪性肝病(NAFLD)患者的临床特征,并分析大学附属医院门诊随访中肝纤维化的风险预测因子。
对 143 例经肝活检证实的 NAFLD 患者的回顾性分析了人口统计学、临床和实验室数据。在单因素比较分析中显示出显著差异的变量进行了单因素分析,并通过 AUROC 评估了其诊断准确性,通过灵敏度和特异性确定了诊断性能。
研究患者的平均年龄为 48 岁,其中 66.4%为女性。年龄、糖尿病、高血压、代谢综合征以及 AST/ALT 比值、GGT、血小板计数和空腹血糖等实验室变量与晚期纤维化显著相关。FIB-4 和 NAFLD 纤维化评分(AUROC 分别为 0.82 和 0.89)在预测晚期肝纤维化和肝硬化(差异为 0.04)方面优于 APRI(AUROC 为 0.73)。
在我们的研究中,代谢综合征、糖尿病、高血压、AST/ALT 比值、GGT、血小板计数和空腹血糖与 NAFLD 患者的肝纤维化相关。非侵入性检测 FIB-4 和 NAFLD 纤维化评分显示了最佳的疾病严重程度分层准确性。