MEFIB-Index 和 MAST-Score 在代谢相关脂肪性肝病肝失代偿评估中的应用：个体参与者数据荟萃分析。
MEFIB-Index and MAST-Score in the assessment of hepatic decompensation in metabolic dysfunction-associated steatosis liver disease-Individual participant data meta-analyses.
机构信息
MASLD Research Center, Division of Gastroenterology, University of California at San Diego, La Jolla, California, USA.
Division of Gastroenterology, University of California at San Diego, La Jolla, California, USA.
出版信息
Aliment Pharmacol Ther. 2023 Nov;58(9):856-865. doi: 10.1111/apt.17707. Epub 2023 Sep 11.
BACKGROUND
There are limited data regarding the longitudinal association between MEFIB-Index (MRE combined with FIB-4) versus MAST-Score (MRI-aspartate aminotransferase) and hepatic decompensation.
AIM
To examine the longitudinal association between MEFIB-Index versus MAST-Score in predicting hepatic decompensation in patients with metabolic dysfunction-associated steatotic liver disease (MASLD).
METHODS
This was a longitudinal, retrospective analysis of subjects from United States, Japan, and Turkey who underwent a baseline MRE and MRI-PDFF and were followed for hepatic decompensation. Cox-proportional hazard analyses were used to assess the association between MEFIB-Index versus MAST-Score with a composite primary outcome (hepatic decompensation) defined as ascites, hepatic encephalopathy, and varices needing treatment.
RESULTS
This meta-analysis of individual participants (IPDMA) included 454 patients (58% women) with a mean (±SD) age of 56.0 (±13.5) years. The MEFIB-Index (MRE ≥3.3 kPa + FIB 4 ≥1.6) and MAST-Score (>0.242) were positive for 34% and 9% of the sample, respectively. At baseline, 23 patients met criteria for hepatic decompensation. Among 297 patients with available longitudinal data with a median (IQR) of 4.2 (5.0) years of follow-up, 25 incident cases met criteria for hepatic decompensation. A positive MEFIB-Index [HR = 49.22 (95% CI: 6.23-388.64, p < 0.001)] and a positive MAST-Score [HR = 3.86 (95% CI: 1.46-10.17, p < 0.001)] were statistically significant predictors of the incident hepatic decompensation. MEFIB-Index (c-statistic: 0.89, standard error (SE) = 0.02) was statistically superior to the MAST-Score (c-statistic: 0.81, SE = 0.03) (p < 0.0001) in predicting hepatic decompensation.
CONCLUSION
A combination of MRI-based biomarker and blood tests, MEFIB-Index and MAST-Score can predict the risk of hepatic decompensation in patients with MASLD.
背景
关于 MEFIB-Index（磁共振弹性成像结合 FIB-4）与 MAST-Score（磁共振肝纤维化与脂肪定量技术-天门冬氨酸氨基转移酶）在预测肝失代偿方面的纵向关联，目前数据有限。
目的
研究 MEFIB-Index 与 MAST-Score 在预测代谢相关脂肪性肝病合并肝纤维化（MAFLD）患者肝失代偿方面的纵向关联。
方法
这是一项在美国、日本和土耳其进行的纵向、回顾性分析，纳入了接受基线磁共振弹性成像和磁共振质子密度脂肪分数测定并随访肝失代偿的受试者。采用 Cox 比例风险分析评估 MEFIB-Index 与 MAST-Score 与复合主要结局（腹水、肝性脑病和需要治疗的静脉曲张）之间的关联。
结果
本项个体参与者荟萃分析（IPDMA）纳入了 454 名（58%为女性）平均（±标准差）年龄为 56.0（±13.5）岁的患者。MEFIB-Index（磁共振弹性成像≥3.3kPa+FIB-4≥1.6）和 MAST-Score（>0.242）的阳性率分别为 34%和 9%。基线时，23 例患者符合肝失代偿标准。在 297 例具有中位（IQR）4.2（5.0）年随访时间的纵向数据可用的患者中，有 25 例发生肝失代偿事件。MEFIB-Index 阳性[风险比（HR）=49.22（95%可信区间：6.23-388.64，p<0.001)]和 MAST-Score 阳性[HR=3.86（95%可信区间：1.46-10.17，p<0.001)]是肝失代偿发生的统计学显著预测因素。MEFIB-Index（C 统计量：0.89，标准误（SE）=0.02）在预测肝失代偿方面统计学上优于 MAST-Score（C 统计量：0.81，SE=0.03）（p<0.0001）。
结论
基于 MRI 的生物标志物和血液检测的联合应用，MEFIB-Index 和 MAST-Score 可预测 MAFLD 患者肝失代偿的风险。
Zotero 插件