Department of Gastroenterology and Hepatology, Characteristic Medical Center of the Chinese People's Armed Police Force, Tianjin, China.
Tianjin Key Laboratory of Hepatopancreatic Fiberosis and Molecular Diagnosis & Treatment, Tianjin, China.
Medicine (Baltimore). 2023 Aug 25;102(34):e34957. doi: 10.1097/MD.0000000000034957.
To assess the relationship between clinical biochemical characteristics and steatosis or fibrosis by Fibroscan in non-alcoholic fatty liver disease (NAFLD) patients in order to seek the simple effective screening method closed to the results of the fibroScan measurement. A cross-sectional study was conducted on 188 patients with NAFLD who underwent FibroScan examinations. Demographic data and clinical biochemical characteristics were collected and analyzed. The result showed elevated serum uric acid (SUA) (P = .023, odds ratio [OR = 1.005, 95% CI (1.001-1.009) and metabolic syndrome (MetS) (P = .000, OR = 4.549, 95%CI (1.974-10.484) were associated with severe steatosis (controlled attenuation parameter, CAP ≥ 300 dB/m). The magnitude of liver stiffness measured using FibroScan was positively correlated with aspartate transaminase/alanine aminotransferase (AST/ALT) ratio (R = 0.419, P = .000), AST to platelet ratio index (APRI) score (R = 0.309, P = .000), and Fibrosis-4 score (FIB-4) (R = 0.507, P = .000). The areas under the receiver operating curve (ROC) of AST/ALT, APRI, and FIB-4 for mild or severe fibrosis were 0.563, 0.696, and 0.728, respectively, and those for advanced fibrosis were 0.648, 0.750, and 0.821, respectively. The FIB-4 index cutoff value was 1.65 with a sensitivity of 68.3% and specificity of 89.8% during the diagnosis of advanced fibrosis. MetS and elevated SUA are associated with severe steatosis according to the CAP value screen, whereas FIB-4, as the fibrosis score method, is closer to the liver stiffness measurement results from FibroScan, which may facilitate early warning of NAFLD in the community or in remote areas.
为了在非酒精性脂肪性肝病(NAFLD)患者中评估临床生化特征与脂肪变性或纤维化之间的关系,以便寻找与 FibroScan 测量结果接近的简单有效的筛查方法,我们进行了一项横断面研究。对 188 例接受 FibroScan 检查的 NAFLD 患者进行了回顾性分析。收集并分析了患者的人口统计学资料和临床生化特征。结果显示,血清尿酸(SUA)升高(P=0.023,比值比[OR]=1.005,95%置信区间[CI]:1.001-1.009)和代谢综合征(MetS)(P=0.000,OR=4.549,95%CI:1.974-10.484)与严重脂肪变性(受控衰减参数,CAP≥300 dB/m)有关。FibroScan 测量的肝硬度值与天冬氨酸转氨酶/丙氨酸转氨酶(AST/ALT)比值(R=0.419,P=0.000)、AST 与血小板比值指数(APRI)评分(R=0.309,P=0.000)和纤维化 4 指数(FIB-4)(R=0.507,P=0.000)呈正相关。AST/ALT、APRI 和 FIB-4 对轻度或重度纤维化的受试者工作特征曲线(ROC)下面积分别为 0.563、0.696 和 0.728,对进展性纤维化的面积分别为 0.648、0.750 和 0.821。FIB-4 指数截断值为 1.65,诊断进展性纤维化的敏感性为 68.3%,特异性为 89.8%。根据 CAP 值筛查,MetS 和 SUA 升高与严重脂肪变性相关,而 FIB-4 作为纤维化评分方法,与 FibroScan 测量的肝硬度结果更接近,这可能有助于社区或偏远地区的 NAFLD 早期预警。