Department of Infectious Disease and Liver Disease, The Second Hospital of Nanjing, Nanjing, Jiangsu, China.
Department of Internal Medicine, Shandong Rehabilitation Hospital, Jinan, Shandong, China.
Medicine (Baltimore). 2024 Oct 25;103(43):e40214. doi: 10.1097/MD.0000000000040214.
Nonalcoholic fatty liver disease (NAFLD) is characterized by liver fibrosis, which serves as a crucial indicator of its progression and prognosis. Owing to the limitations of biopsy, which is the gold standard for measuring liver fibrosis, a reliable and noninvasive marker is required. We evaluated the diagnostic role of the fibrosis-4 (FIB-4) index and nonalcoholic fatty liver disease fibrosis score (NFS) in patients with NAFLD with varying severities of liver fibrosis. The FIB-4 index and NFS were calculated using laboratory data from 121 patients who underwent liver biopsies between January 2022 and December 2023. The results were compared with those of the Scheuer scoring system for liver biopsies (F0, F1 + F2, and F3 + F4) to determine the sensitivity and specificity of the FIB-4 index and the liver disease fibrosis score in detecting and staging liver fibrosis. Twenty-one patients had advanced fibrosis (F3-F4), and 100 had minimal or mild fibrosis (F0-F2). The degree of liver fibrosis increased with decreased albumin, alanine aminotransferase and platelet count levels, and increasing age. Receiver operating characteristic curve analysis for the FIB-4 index and NFS revealed that the areas under the curve for the FIB-4 index and NFS were 0.895 (95% confidence interval: 0.836-0.954) and 0.882 (95% confidence interval: 0.813-0.952), respectively. The FIB-4 indices showed 95.24% sensitivity at a cutoff point of 1.30, and 85% specificity at a cutoff point of 2.67, while the NFS indices showed 95.24% sensitivity at -1.455 cutoff point and 95% specificity at a cutoff point of 0.676. The FIB-4 index and NFS may replace biopsy for the detection of fibrosis in patients with NAFLD.
非酒精性脂肪性肝病 (NAFLD) 的特征是肝纤维化，这是其进展和预后的重要指标。由于肝活检是测量肝纤维化的金标准，因此需要一种可靠的非侵入性标志物。我们评估了纤维化-4 (FIB-4) 指数和非酒精性脂肪性肝病纤维化评分 (NFS) 在不同严重程度肝纤维化的 NAFLD 患者中的诊断作用。FIB-4 指数和 NFS 是使用 2022 年 1 月至 2023 年 12 月期间接受肝活检的 121 名患者的实验室数据计算得出的。将结果与 Scheuer 肝活检评分系统 (F0、F1+F2 和 F3+F4) 进行比较，以确定 FIB-4 指数和肝脏疾病纤维化评分在检测和分期肝纤维化方面的敏感性和特异性。21 名患者患有晚期纤维化 (F3-F4)，100 名患者患有轻微或轻度纤维化 (F0-F2)。肝纤维化程度随白蛋白、丙氨酸转氨酶和血小板计数水平降低以及年龄增长而增加。FIB-4 指数和 NFS 的受试者工作特征曲线分析显示，FIB-4 指数和 NFS 的曲线下面积分别为 0.895(95%置信区间：0.836-0.954)和 0.882(95%置信区间：0.813-0.952)。FIB-4 指数在截断值为 1.30 时具有 95.24%的敏感性，在截断值为 2.67 时具有 85%的特异性，而 NFS 指数在截断值为-1.455 时具有 95.24%的敏感性，在截断值为 0.676 时具有 95%的特异性。FIB-4 指数和 NFS 可能取代肝活检用于检测 NAFLD 患者的纤维化。
