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Enhanced liver Fibrosis® test predicts liver-related outcomes in the general population

BACKGROUND & AIMS: The Enhanced Liver Fibrosis® (ELF) test exhibits good discriminative performance in detecting advanced liver fibrosis and in predicting liver-related outcomes in patients with specific liver diseases, but large population-based studies are missing. We analysed the predictive p...

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Autores principales: Saarinen, Kustaa, Färkkilä, Martti, Jula, Antti, Erlund, Iris, Vihervaara, Terhi, Lundqvist, Annamari, Åberg, Fredrik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10276292/
https://www.ncbi.nlm.nih.gov/pubmed/37333973
http://dx.doi.org/10.1016/j.jhepr.2023.100765
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author Saarinen, Kustaa
Färkkilä, Martti
Jula, Antti
Erlund, Iris
Vihervaara, Terhi
Lundqvist, Annamari
Åberg, Fredrik
author_facet Saarinen, Kustaa
Färkkilä, Martti
Jula, Antti
Erlund, Iris
Vihervaara, Terhi
Lundqvist, Annamari
Åberg, Fredrik
author_sort Saarinen, Kustaa
collection PubMed
description BACKGROUND & AIMS: The Enhanced Liver Fibrosis® (ELF) test exhibits good discriminative performance in detecting advanced liver fibrosis and in predicting liver-related outcomes in patients with specific liver diseases, but large population-based studies are missing. We analysed the predictive performance of the ELF test in a general population cohort. METHODS: Data were sourced from the Health 2000 study, a Finnish population-based health examination survey conducted in 2000–2001. Subjects with baseline liver disease were excluded. The ELF test was performed on blood samples collected at baseline. Data were linked with national healthcare registers for liver-related outcomes (hospitalisation, cancer, and death). RESULTS: The cohort comprised 6,040 individuals (mean age 52.7. 45.6% men) with 67 liver-related outcomes during a median 13.1-year follow-up. ELF predicted liver outcomes (unadjusted hazards ratio 2.70, 95% CI 2.16–3.38). with 5- and 10-year AUCs of 0.81 (95% CI 0.71–0.91) and 0.71 (95% CI 0.63–0.79) by competing-risk methodology. The 10-year risks for liver outcomes increased from 0.5% at ELF <9.8 to 7.1% at ELF ≥11.3, being higher among men than women at any given ELF level. Among individuals with body mass index ≥30 kg/m(2), diabetes, or alanine aminotransferase >40 U/L. Five-year AUCs for ELF were 0.85, 0.87, and 0.88, respectively. The predictive ability of the ELF test decreased with time: the 10-year AUCs were 0.78, 0.69, and 0.82, respectively. CONCLUSIONS: The ELF test shows good discriminative performance in predicting liver-related outcomes in a large general population cohort and appears particularly useful for predicting 5-year outcomes in persons with risk factors. IMPACT AND IMPLICATIONS: The Enhanced Liver Fibrosis test exhibits good performance for predicting liver-related outcomes (hospitalisation, liver cancer, or liver-related death) in the general population, especially in those with risk factors.
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spelling pubmed-102762922023-06-18 Enhanced liver Fibrosis® test predicts liver-related outcomes in the general population Saarinen, Kustaa Färkkilä, Martti Jula, Antti Erlund, Iris Vihervaara, Terhi Lundqvist, Annamari Åberg, Fredrik JHEP Rep Research Article BACKGROUND & AIMS: The Enhanced Liver Fibrosis® (ELF) test exhibits good discriminative performance in detecting advanced liver fibrosis and in predicting liver-related outcomes in patients with specific liver diseases, but large population-based studies are missing. We analysed the predictive performance of the ELF test in a general population cohort. METHODS: Data were sourced from the Health 2000 study, a Finnish population-based health examination survey conducted in 2000–2001. Subjects with baseline liver disease were excluded. The ELF test was performed on blood samples collected at baseline. Data were linked with national healthcare registers for liver-related outcomes (hospitalisation, cancer, and death). RESULTS: The cohort comprised 6,040 individuals (mean age 52.7. 45.6% men) with 67 liver-related outcomes during a median 13.1-year follow-up. ELF predicted liver outcomes (unadjusted hazards ratio 2.70, 95% CI 2.16–3.38). with 5- and 10-year AUCs of 0.81 (95% CI 0.71–0.91) and 0.71 (95% CI 0.63–0.79) by competing-risk methodology. The 10-year risks for liver outcomes increased from 0.5% at ELF <9.8 to 7.1% at ELF ≥11.3, being higher among men than women at any given ELF level. Among individuals with body mass index ≥30 kg/m(2), diabetes, or alanine aminotransferase >40 U/L. Five-year AUCs for ELF were 0.85, 0.87, and 0.88, respectively. The predictive ability of the ELF test decreased with time: the 10-year AUCs were 0.78, 0.69, and 0.82, respectively. CONCLUSIONS: The ELF test shows good discriminative performance in predicting liver-related outcomes in a large general population cohort and appears particularly useful for predicting 5-year outcomes in persons with risk factors. IMPACT AND IMPLICATIONS: The Enhanced Liver Fibrosis test exhibits good performance for predicting liver-related outcomes (hospitalisation, liver cancer, or liver-related death) in the general population, especially in those with risk factors. Elsevier 2023-04-21 /pmc/articles/PMC10276292/ /pubmed/37333973 http://dx.doi.org/10.1016/j.jhepr.2023.100765 Text en © 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Research Article
Saarinen, Kustaa
Färkkilä, Martti
Jula, Antti
Erlund, Iris
Vihervaara, Terhi
Lundqvist, Annamari
Åberg, Fredrik
Enhanced liver Fibrosis® test predicts liver-related outcomes in the general population
title Enhanced liver Fibrosis® test predicts liver-related outcomes in the general population
title_full Enhanced liver Fibrosis® test predicts liver-related outcomes in the general population
title_fullStr Enhanced liver Fibrosis® test predicts liver-related outcomes in the general population
title_full_unstemmed Enhanced liver Fibrosis® test predicts liver-related outcomes in the general population
title_short Enhanced liver Fibrosis® test predicts liver-related outcomes in the general population
title_sort enhanced liver fibrosis® test predicts liver-related outcomes in the general population
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10276292/
https://www.ncbi.nlm.nih.gov/pubmed/37333973
http://dx.doi.org/10.1016/j.jhepr.2023.100765
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