Sariyar Nisanur, Kani Haluk Tarik, Celikel Cigdem Ataizi, Yilmaz Yusuf
Department of Internal Medicine, Marmara University School of Medicine, Istanbul, Turkiye.
Department of Gastroenterology, Marmara University School of Medicine, Istanbul, Turkiye.
Hepatol Forum. 2024 Jan 16;5(1):33-36. doi: 10.14744/hf.2023.2023.0021. eCollection 2024.
This study aimed to investigate the predictive value of various non-invasive scores for identifying the progression of hepatic fibrosis over time in patients with Non-Alcoholic Fatty Liver Disease (NAFLD).
We examined 69 patients with NAFLD who had undergone two liver biopsies at an average interval of 21.3±9.7 months. Progression and regression of fibrosis were defined as an increase or decrease of at least one stage in fibrosis between the initial and follow-up biopsies, respectively. The Fibrosis-4 Index (FIB-4), NAFLD Fibrosis Score (NFS), Agile 3+, Agile 4, and FibroScan-AST (FAST) scores were calculated at the initial biopsy.
Comparison of paired biopsies revealed that 45% of participants (n=31) exhibited no change in fibrosis stages, 26% (n=18) experienced progression, and 29% (n=20) demonstrated regression. Multivariable logistic regression analysis identified the FAST score as the only independent predictor of progressive fibrosis, with the odds increasing by 19% (95% CI: 8-38%, p<0.05) for each unit increase in the FAST score at the initial biopsy. No independent predictors for fibrosis regression were identified.
Higher baseline FAST scores were associated with an increased likelihood of fibrosis progression, independent of other variables. Thus, the FAST score could serve as both a diagnostic and prognostic tool for fibrosis in patients with NAFLD.
本研究旨在探讨各种非侵入性评分对非酒精性脂肪性肝病（NAFLD）患者肝纤维化随时间进展的预测价值。
我们检查了69例NAFLD患者，这些患者平均间隔21.3±9.7个月接受了两次肝活检。纤维化的进展和消退分别定义为初始活检和随访活检之间纤维化至少增加或减少一个阶段。在初始活检时计算纤维化-4指数（FIB-4）、NAFLD纤维化评分（NFS）、Agile 3+、Agile 4和FibroScan-AST（FAST）评分。
配对活检比较显示，45%的参与者（n=31）纤维化阶段无变化，26%（n=18）病情进展，29%（n=20）病情消退。多变量逻辑回归分析确定FAST评分是进行性纤维化的唯一独立预测因子，初始活检时FAST评分每增加一个单位，进展几率增加19%（95%CI：8-38%，p<0.05）。未发现纤维化消退的独立预测因子。
较高的基线FAST评分与纤维化进展的可能性增加相关，独立于其他变量。因此，FAST评分可作为NAFLD患者纤维化的诊断和预后工具。
