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Cross-Sectional and Longitudinal Performance of Non-Invasive Tests of Liver Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease

Background and aims: Non-invasive tests (NITs) are needed in clinical practice to replace histology for the identification of liver fibrosis and prognostication in Non-Alcoholic Fatty Liver Disease (NAFLD). Novel collagen-derived fibrogenesis markers including N-terminal type III collagen pro-peptid...

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Autores principales: Armandi, Angelo, Rosso, Chiara, Younes, Ramy, Leeming, Diana Julie, Karsdal, Morten A., Caviglia, Gian Paolo, Pérez-Diaz-del-Campo, Nuria, D’Amato, Daphne, Abdulle, Amina, Nicolosi, Aurora, Castelnuovo, Gabriele, Saracco, Giorgio Maria, Ribaldone, Davide Giuseppe, Bugianesi, Elisabetta
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9862059/
https://www.ncbi.nlm.nih.gov/pubmed/36675579
http://dx.doi.org/10.3390/jcm12020650
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author Armandi, Angelo
Rosso, Chiara
Younes, Ramy
Leeming, Diana Julie
Karsdal, Morten A.
Caviglia, Gian Paolo
Pérez-Diaz-del-Campo, Nuria
D’Amato, Daphne
Abdulle, Amina
Nicolosi, Aurora
Castelnuovo, Gabriele
Saracco, Giorgio Maria
Ribaldone, Davide Giuseppe
Bugianesi, Elisabetta
author_facet Armandi, Angelo
Rosso, Chiara
Younes, Ramy
Leeming, Diana Julie
Karsdal, Morten A.
Caviglia, Gian Paolo
Pérez-Diaz-del-Campo, Nuria
D’Amato, Daphne
Abdulle, Amina
Nicolosi, Aurora
Castelnuovo, Gabriele
Saracco, Giorgio Maria
Ribaldone, Davide Giuseppe
Bugianesi, Elisabetta
author_sort Armandi, Angelo
collection PubMed
description Background and aims: Non-invasive tests (NITs) are needed in clinical practice to replace histology for the identification of liver fibrosis and prognostication in Non-Alcoholic Fatty Liver Disease (NAFLD). Novel collagen-derived fibrogenesis markers including N-terminal type III collagen pro-peptide (PRO-C3) are among the most promising tools in this field. The aim of this study was to assess the diagnostic accuracy of PRO-C3, the derivative ADAPT score, and other NITs for the identification of advanced fibrosis (stages 3–4) and changes over 12 months of follow-up. Methods: In this longitudinal study, 96 patients with biopsy-proven NAFLD were evaluated at baseline, of which 50 underwent a follow-up visit after 12 months. Clinical-biochemical parameters, liver stiffness (LS) by transient elastography, PRO-C3, and other NITs (ADAPT, FIB-4, NFS, APRI) were collected at baseline and follow-up. Results: LS showed the best accuracy for the identification of advanced fibrosis, with Area under the Receiving Operator Curve (AUROC) 0.82 (0.73–0.89) for a cut-off value of 9.4 kPa. Among the other NITs, the ADAPT score showed the best accuracy, with AUROC 0.80 (0.71–0.88) for a cut-off of 5.02 (Se 62%, Sp 89%, PPV 74%, NPV 83%). The comparison between the AUROC of LS with that of ADAPT was not statistically different (DeLong test p value 0.348). At follow-up, LS was slightly reduced, whilst PRO-C3 displayed a significant increase from baseline median 11.2 ng/mL to 13.9 ng/mL at follow-up (p = 0.017). Accordingly, ADAPT score increased from median 5.3 to 6.1 (p = 0.019). The other NITs did not significantly change over 12 months. Conclusions: The ADAPT score shows the best performance among non-invasive scores for the identification of advanced fibrosis, not different from LS. Collagen-derived biomarker PRO-C3 and the derivative score ADAPT display significant changes over time, and may be useful tools for monitoring the progression of liver disease or assessing responses to treatments.
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spelling pubmed-98620592023-01-22 Cross-Sectional and Longitudinal Performance of Non-Invasive Tests of Liver Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease Armandi, Angelo Rosso, Chiara Younes, Ramy Leeming, Diana Julie Karsdal, Morten A. Caviglia, Gian Paolo Pérez-Diaz-del-Campo, Nuria D’Amato, Daphne Abdulle, Amina Nicolosi, Aurora Castelnuovo, Gabriele Saracco, Giorgio Maria Ribaldone, Davide Giuseppe Bugianesi, Elisabetta J Clin Med Article Background and aims: Non-invasive tests (NITs) are needed in clinical practice to replace histology for the identification of liver fibrosis and prognostication in Non-Alcoholic Fatty Liver Disease (NAFLD). Novel collagen-derived fibrogenesis markers including N-terminal type III collagen pro-peptide (PRO-C3) are among the most promising tools in this field. The aim of this study was to assess the diagnostic accuracy of PRO-C3, the derivative ADAPT score, and other NITs for the identification of advanced fibrosis (stages 3–4) and changes over 12 months of follow-up. Methods: In this longitudinal study, 96 patients with biopsy-proven NAFLD were evaluated at baseline, of which 50 underwent a follow-up visit after 12 months. Clinical-biochemical parameters, liver stiffness (LS) by transient elastography, PRO-C3, and other NITs (ADAPT, FIB-4, NFS, APRI) were collected at baseline and follow-up. Results: LS showed the best accuracy for the identification of advanced fibrosis, with Area under the Receiving Operator Curve (AUROC) 0.82 (0.73–0.89) for a cut-off value of 9.4 kPa. Among the other NITs, the ADAPT score showed the best accuracy, with AUROC 0.80 (0.71–0.88) for a cut-off of 5.02 (Se 62%, Sp 89%, PPV 74%, NPV 83%). The comparison between the AUROC of LS with that of ADAPT was not statistically different (DeLong test p value 0.348). At follow-up, LS was slightly reduced, whilst PRO-C3 displayed a significant increase from baseline median 11.2 ng/mL to 13.9 ng/mL at follow-up (p = 0.017). Accordingly, ADAPT score increased from median 5.3 to 6.1 (p = 0.019). The other NITs did not significantly change over 12 months. Conclusions: The ADAPT score shows the best performance among non-invasive scores for the identification of advanced fibrosis, not different from LS. Collagen-derived biomarker PRO-C3 and the derivative score ADAPT display significant changes over time, and may be useful tools for monitoring the progression of liver disease or assessing responses to treatments. MDPI 2023-01-13 /pmc/articles/PMC9862059/ /pubmed/36675579 http://dx.doi.org/10.3390/jcm12020650 Text en © 2023 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
Armandi, Angelo
Rosso, Chiara
Younes, Ramy
Leeming, Diana Julie
Karsdal, Morten A.
Caviglia, Gian Paolo
Pérez-Diaz-del-Campo, Nuria
D’Amato, Daphne
Abdulle, Amina
Nicolosi, Aurora
Castelnuovo, Gabriele
Saracco, Giorgio Maria
Ribaldone, Davide Giuseppe
Bugianesi, Elisabetta
Cross-Sectional and Longitudinal Performance of Non-Invasive Tests of Liver Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease
title Cross-Sectional and Longitudinal Performance of Non-Invasive Tests of Liver Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease
title_full Cross-Sectional and Longitudinal Performance of Non-Invasive Tests of Liver Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease
title_fullStr Cross-Sectional and Longitudinal Performance of Non-Invasive Tests of Liver Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease
title_full_unstemmed Cross-Sectional and Longitudinal Performance of Non-Invasive Tests of Liver Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease
title_short Cross-Sectional and Longitudinal Performance of Non-Invasive Tests of Liver Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease
title_sort cross-sectional and longitudinal performance of non-invasive tests of liver fibrosis in patients with non-alcoholic fatty liver disease
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9862059/
https://www.ncbi.nlm.nih.gov/pubmed/36675579
http://dx.doi.org/10.3390/jcm12020650
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