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Accuracy of FIB-4 to Detect Elevated Liver Stiffness Measurements in Patients with Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study in Referral Centers

The identification of advanced fibrosis by applying noninvasive tests is still a key component of the diagnostic algorithm of NAFLD. The aim of this study is to assess the concordance between the FIB-4 and liver stiffness measurement (LSM) in patients referred to two liver centers for the ultrasound...

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Autores principales: Viganò, Mauro, Pugliese, Nicola, Cerini, Federica, Turati, Federica, Cimino, Vincenzo, Ridolfo, Sofia, Rocchetto, Simone, Foglio, Francesca, Terrin, Maria, La Vecchia, Carlo, Rumi, Maria Grazia, Aghemo, Alessio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604259/
https://www.ncbi.nlm.nih.gov/pubmed/36293345
http://dx.doi.org/10.3390/ijms232012489
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author Viganò, Mauro
Pugliese, Nicola
Cerini, Federica
Turati, Federica
Cimino, Vincenzo
Ridolfo, Sofia
Rocchetto, Simone
Foglio, Francesca
Terrin, Maria
La Vecchia, Carlo
Rumi, Maria Grazia
Aghemo, Alessio
author_facet Viganò, Mauro
Pugliese, Nicola
Cerini, Federica
Turati, Federica
Cimino, Vincenzo
Ridolfo, Sofia
Rocchetto, Simone
Foglio, Francesca
Terrin, Maria
La Vecchia, Carlo
Rumi, Maria Grazia
Aghemo, Alessio
author_sort Viganò, Mauro
collection PubMed
description The identification of advanced fibrosis by applying noninvasive tests is still a key component of the diagnostic algorithm of NAFLD. The aim of this study is to assess the concordance between the FIB-4 and liver stiffness measurement (LSM) in patients referred to two liver centers for the ultrasound-based diagnosis of NAFLD. Fibrosis 4 Index for Liver Fibrosis (FIB-4) and LSM were assessed in 1338 patients. A total of 428 (32%) had an LSM ≥ 8 kPa, whereas 699 (52%) and 113 (9%) patients had an FIB-4 < 1.3 and >3.25, respectively. Among 699 patients with an FIB-4 < 1.3, 118 (17%) had an LSM ≥ 8 kPa (false-negative FIB-4). This proportion was higher in patients ≥60 years, with diabetes mellitus (DM), arterial hypertension or a body mass index (BMI) ≥ 27 kg/m(2). In multiple adjusted models, age ≥ 60 years (odds ratio (OR) = 1.96, 95% confidence interval (CI) 1.19–3.23)), DM (OR = 2.59, 95% CI 1.63–4.13), body mass index (BMI) ≥ 27 kg/m(2) (OR = 2.17, 95% CI 1.33–3.56) and gamma-glutamyltransferase ≥ 25 UI/L (OR = 2.68, 95% CI 1.49–4.84) were associated with false-negative FIB-4. The proportion of false-negative FIB-4 was 6% in patients with none or one of these risk factors and increased to 16, 31 and 46% among those with two, three and four concomitant risk factors, respectively. FIB-4 is suboptimal to identify patients to refer to liver centers, because about one-fifth may be false negative at FIB-4, having instead an LSM ≥ 8 KPa.
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spelling pubmed-96042592022-10-27 Accuracy of FIB-4 to Detect Elevated Liver Stiffness Measurements in Patients with Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study in Referral Centers Viganò, Mauro Pugliese, Nicola Cerini, Federica Turati, Federica Cimino, Vincenzo Ridolfo, Sofia Rocchetto, Simone Foglio, Francesca Terrin, Maria La Vecchia, Carlo Rumi, Maria Grazia Aghemo, Alessio Int J Mol Sci Article The identification of advanced fibrosis by applying noninvasive tests is still a key component of the diagnostic algorithm of NAFLD. The aim of this study is to assess the concordance between the FIB-4 and liver stiffness measurement (LSM) in patients referred to two liver centers for the ultrasound-based diagnosis of NAFLD. Fibrosis 4 Index for Liver Fibrosis (FIB-4) and LSM were assessed in 1338 patients. A total of 428 (32%) had an LSM ≥ 8 kPa, whereas 699 (52%) and 113 (9%) patients had an FIB-4 < 1.3 and >3.25, respectively. Among 699 patients with an FIB-4 < 1.3, 118 (17%) had an LSM ≥ 8 kPa (false-negative FIB-4). This proportion was higher in patients ≥60 years, with diabetes mellitus (DM), arterial hypertension or a body mass index (BMI) ≥ 27 kg/m(2). In multiple adjusted models, age ≥ 60 years (odds ratio (OR) = 1.96, 95% confidence interval (CI) 1.19–3.23)), DM (OR = 2.59, 95% CI 1.63–4.13), body mass index (BMI) ≥ 27 kg/m(2) (OR = 2.17, 95% CI 1.33–3.56) and gamma-glutamyltransferase ≥ 25 UI/L (OR = 2.68, 95% CI 1.49–4.84) were associated with false-negative FIB-4. The proportion of false-negative FIB-4 was 6% in patients with none or one of these risk factors and increased to 16, 31 and 46% among those with two, three and four concomitant risk factors, respectively. FIB-4 is suboptimal to identify patients to refer to liver centers, because about one-fifth may be false negative at FIB-4, having instead an LSM ≥ 8 KPa. MDPI 2022-10-18 /pmc/articles/PMC9604259/ /pubmed/36293345 http://dx.doi.org/10.3390/ijms232012489 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Viganò, Mauro
Pugliese, Nicola
Cerini, Federica
Turati, Federica
Cimino, Vincenzo
Ridolfo, Sofia
Rocchetto, Simone
Foglio, Francesca
Terrin, Maria
La Vecchia, Carlo
Rumi, Maria Grazia
Aghemo, Alessio
Accuracy of FIB-4 to Detect Elevated Liver Stiffness Measurements in Patients with Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study in Referral Centers
title Accuracy of FIB-4 to Detect Elevated Liver Stiffness Measurements in Patients with Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study in Referral Centers
title_full Accuracy of FIB-4 to Detect Elevated Liver Stiffness Measurements in Patients with Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study in Referral Centers
title_fullStr Accuracy of FIB-4 to Detect Elevated Liver Stiffness Measurements in Patients with Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study in Referral Centers
title_full_unstemmed Accuracy of FIB-4 to Detect Elevated Liver Stiffness Measurements in Patients with Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study in Referral Centers
title_short Accuracy of FIB-4 to Detect Elevated Liver Stiffness Measurements in Patients with Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study in Referral Centers
title_sort accuracy of fib-4 to detect elevated liver stiffness measurements in patients with non-alcoholic fatty liver disease: a cross-sectional study in referral centers
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604259/
https://www.ncbi.nlm.nih.gov/pubmed/36293345
http://dx.doi.org/10.3390/ijms232012489
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