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Validation of a two‐step approach combining serum biomarkers and liver stiffness measurement to predict advanced fibrosis
BACKGROUND AND AIM: The Gut and Obesity in Asia Workgroup recently reported that a two‐step approach using fibrosis scores followed by liver stiffness measurement (LSM) could accurately detect patients with non‐alcoholic fatty liver disease (NAFLD) having advanced fibrosis in low‐risk fibrosis popul...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wiley Publishing Asia Pty Ltd
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8264241/ https://www.ncbi.nlm.nih.gov/pubmed/34263075 http://dx.doi.org/10.1002/jgh3.12590 |
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author | Fujii, Hideki Enomoto, Masaru Fukumoto, Shinya Kimura, Tatsuo Nadatani, Yuji Takashima, Shingo Hagihara, Atsushi Uchida‐Kobayashi, Sawako Tamori, Akihiro Nishimoto, Naoki Kawada, Norifumi |
author_facet | Fujii, Hideki Enomoto, Masaru Fukumoto, Shinya Kimura, Tatsuo Nadatani, Yuji Takashima, Shingo Hagihara, Atsushi Uchida‐Kobayashi, Sawako Tamori, Akihiro Nishimoto, Naoki Kawada, Norifumi |
author_sort | Fujii, Hideki |
collection | PubMed |
description | BACKGROUND AND AIM: The Gut and Obesity in Asia Workgroup recently reported that a two‐step approach using fibrosis scores followed by liver stiffness measurement (LSM) could accurately detect patients with non‐alcoholic fatty liver disease (NAFLD) having advanced fibrosis in low‐risk fibrosis populations. This study aimed to validate the utility of this approach using a Japanese health checkup registry. METHODS: This cross‐sectional study included subjects who underwent a health checkup from 2014 to 2019. Using estimated fibrosis stage measured by LSM as a standard, we calculated the percentage of misclassification from assessments made based on fibrosis scores (NAFLD fibrosis score [NFS] or Fibrosis‐4 score [FIB‐4]) and LSM, alone or in combination. RESULTS: Of 630 subjects with NAFLD, 4 (0.8%) had advanced fibrosis. In the first‐step evaluation, only 21.4–38.0% of subjects needed further testing. This approach was associated with a high specificity of approximately 100% and a negative predictive value of 99.7%. The percentage of misclassification based on NFS or FIB‐4 values followed by LSM in all subjects and using LSM after NFS or FIB‐4 determination only in subjects with indeterminate/high NFS or FIB‐4 values (two‐step approach) was 0% and 0.3% and 0.16% and 0.3%, respectively. In addition, very few false negatives occurred for both NFS and FIB‐4. CONCLUSION: The two‐step approach helps to identify the subjects with NAFLD who have advanced fibrosis during a routine health checkup and is associated with only a few false negatives. |
format | Online Article Text |
id | pubmed-8264241 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Wiley Publishing Asia Pty Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-82642412021-07-13 Validation of a two‐step approach combining serum biomarkers and liver stiffness measurement to predict advanced fibrosis Fujii, Hideki Enomoto, Masaru Fukumoto, Shinya Kimura, Tatsuo Nadatani, Yuji Takashima, Shingo Hagihara, Atsushi Uchida‐Kobayashi, Sawako Tamori, Akihiro Nishimoto, Naoki Kawada, Norifumi JGH Open Original Articles BACKGROUND AND AIM: The Gut and Obesity in Asia Workgroup recently reported that a two‐step approach using fibrosis scores followed by liver stiffness measurement (LSM) could accurately detect patients with non‐alcoholic fatty liver disease (NAFLD) having advanced fibrosis in low‐risk fibrosis populations. This study aimed to validate the utility of this approach using a Japanese health checkup registry. METHODS: This cross‐sectional study included subjects who underwent a health checkup from 2014 to 2019. Using estimated fibrosis stage measured by LSM as a standard, we calculated the percentage of misclassification from assessments made based on fibrosis scores (NAFLD fibrosis score [NFS] or Fibrosis‐4 score [FIB‐4]) and LSM, alone or in combination. RESULTS: Of 630 subjects with NAFLD, 4 (0.8%) had advanced fibrosis. In the first‐step evaluation, only 21.4–38.0% of subjects needed further testing. This approach was associated with a high specificity of approximately 100% and a negative predictive value of 99.7%. The percentage of misclassification based on NFS or FIB‐4 values followed by LSM in all subjects and using LSM after NFS or FIB‐4 determination only in subjects with indeterminate/high NFS or FIB‐4 values (two‐step approach) was 0% and 0.3% and 0.16% and 0.3%, respectively. In addition, very few false negatives occurred for both NFS and FIB‐4. CONCLUSION: The two‐step approach helps to identify the subjects with NAFLD who have advanced fibrosis during a routine health checkup and is associated with only a few false negatives. Wiley Publishing Asia Pty Ltd 2021-06-10 /pmc/articles/PMC8264241/ /pubmed/34263075 http://dx.doi.org/10.1002/jgh3.12590 Text en © 2021 The Authors. JGH Open published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Fujii, Hideki Enomoto, Masaru Fukumoto, Shinya Kimura, Tatsuo Nadatani, Yuji Takashima, Shingo Hagihara, Atsushi Uchida‐Kobayashi, Sawako Tamori, Akihiro Nishimoto, Naoki Kawada, Norifumi Validation of a two‐step approach combining serum biomarkers and liver stiffness measurement to predict advanced fibrosis |
title | Validation of a two‐step approach combining serum biomarkers and liver stiffness measurement to predict advanced fibrosis |
title_full | Validation of a two‐step approach combining serum biomarkers and liver stiffness measurement to predict advanced fibrosis |
title_fullStr | Validation of a two‐step approach combining serum biomarkers and liver stiffness measurement to predict advanced fibrosis |
title_full_unstemmed | Validation of a two‐step approach combining serum biomarkers and liver stiffness measurement to predict advanced fibrosis |
title_short | Validation of a two‐step approach combining serum biomarkers and liver stiffness measurement to predict advanced fibrosis |
title_sort | validation of a two‐step approach combining serum biomarkers and liver stiffness measurement to predict advanced fibrosis |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8264241/ https://www.ncbi.nlm.nih.gov/pubmed/34263075 http://dx.doi.org/10.1002/jgh3.12590 |
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