Faculdade de Medicina da Pontíficia Universidade Católica de Campinas, Campinas, SP, Brasil.
Universidade Estadual de Campinas, Departamento de Cirurgia, Campinas, SP, Brasil.
Arq Gastroenterol. 2024 Jun 17;61:e23050. doi: 10.1590/S0004-2803.24612023-050. eCollection 2024.
Non-invasive markers have been developed to assess the presence and severity of liver abnormalities related to non-alcoholic fatty liver disease (NAFLD).
To analyze the diagnostic accuracy of non-invasive NAFLD markers (NAFLD liver fat score [NLFS], non-invasive non-alcoholic steatohepatitis detection score [NI-NASH-DS] and fibrosis score based on four variables [FIB-4]) in individuals with obesity undergoing bariatric surgery.
A descriptive retrospective cross-sectional study was carried out enrolling 91 individuals who underwent bariatric surgery at a tertiary-level public university hospital. Non-invasive NAFLD markers were calculated using laboratory tests, clinical and anthropometric variables and diagnostic accuracy tests were calculated comparing them in relation to the gold-standard test for this analysis (histopathological evaluation).
A total of 85.7% of the participants were female and mean age was 39.1±9.8 years. The average body mass index was 38.4±3.6 kg/m2. At histopathological examination, 84 (92.3%) patients presented with steatosis, 82 (90.1%) with some type of fibrosis; 21 (23.1%) patients were diagnosed with NASH according to the NAFLD activity score criteria. The overall accuracy of NLFS score was 58.2% for general hepatic steatosis and 61.5% for moderate to severe steatosis. The overall accuracy of FIB-4 was 95.4% for advanced fibrosis. NI-NASH-DS had a 74.7% overall accuracy for NASH.
In a population of individuals with obesity, the FIB-4 score had high overall accuracy in assessing the presence of advanced liver fibrosis, whereas the NFLS and NI-NASH-DS had moderate accuracies for the assessment of steatosis and NASH, respectively.
已经开发出非侵入性标志物来评估与非酒精性脂肪性肝病（NAFLD）相关的肝脏异常的存在和严重程度。
分析非侵入性 NAFLD 标志物（NAFLD 肝脂肪评分[NLFS]、非侵入性非酒精性脂肪性肝炎检测评分[NI-NASH-DS]和基于四个变量的纤维化评分[FIB-4]）在接受减肥手术的肥胖个体中的诊断准确性。
进行了一项描述性回顾性横断面研究，共纳入 91 名在三级公立大学医院接受减肥手术的个体。使用实验室检查、临床和人体测量学变量计算非侵入性 NAFLD 标志物，并计算比较这些标志物与该分析的金标准测试（组织病理学评估）的诊断准确性测试。
共有 85.7%的参与者为女性，平均年龄为 39.1±9.8 岁。平均体重指数为 38.4±3.6 kg/m2。在组织病理学检查中，84 名（92.3%）患者存在脂肪变性，82 名（90.1%）患者存在某种类型的纤维化；根据 NAFLD 活动评分标准，21 名（23.1%）患者被诊断为 NASH。NLFS 评分对一般肝脂肪变性的总体准确性为 58.2%，对中重度脂肪变性的总体准确性为 61.5%。FIB-4 的总体准确性为 95.4%，用于评估晚期纤维化。NI-NASH-DS 对 NASH 的总体准确性为 74.7%。
在肥胖人群中，FIB-4 评分对评估晚期肝纤维化的存在具有较高的总体准确性，而 NLFS 和 NI-NASH-DS 对评估脂肪变性和 NASH 的准确性分别为中等。
