| Title: | Development and Validation of a Score for Fibrotic Nonalcoholic Steatohepatitis |
| Journal: | Clinical Gastroenterology and Hepatology |
| Published: | 11 Apr 2022 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/35421583/ |
| DOI: | https://doi.org/10.1016/j.cgh.2022.03.044 |
| URL: | http://www.cghjournal.org/article/S1542356522003858/pdf |
| Citations: | 42 (34 in last 2 years) as of 8 Aug 2024 |
Publication 12417
WARNING: the interactive features of this website use CSS3, which your browser does not support. To use the full features of this website, please update your browser.
Abstract
BACKGROUND & AIMS: Noninvasive assessment of histological features of nonalcoholic fatty liver disease (NAFLD) has been an intensive research area over the last decade. Herein, we aimed to develop a simple noninvasive score using routine laboratory tests to identify, among individuals at high risk for NAFLD, those with fibrotic nonalcoholic steatohepatitis (NASH) defined as NASH, NAFLD activity score ≥4, and fibrosis stage ≥2.</p>
METHODS: The derivation cohort included 264 morbidly obese individuals undergoing intraoperative liver biopsy in Rome, Italy. The best predictive model was developed and internally validated using a bootstrapping stepwise logistic regression analysis (2000 bootstrap samples). Performance was estimated by the area under the receiver operating characteristic curve (AUROC). External validation was assessed in 3 independent European cohorts (Finland, n = 370; Italy, n = 947; England, n = 5368) of individuals at high risk for NAFLD.</p>
RESULTS: The final predictive model, designated as Fibrotic NASH Index (FNI), combined aspartate aminotransferase, high-density lipoprotein cholesterol, and hemoglobin A1c. The performance of FNI for fibrotic NASH was satisfactory in both derivation and external validation cohorts (AUROC = 0.78 and AUROC = 0.80-0.95, respectively). In the derivation cohort, rule-out and rule-in cutoffs were 0.10 for sensitivity ≥0.89 (negative predictive value, 0.93) and 0.33 for specificity ≥0.90 (positive predictive value, 0.57), respectively. In the external validation cohorts, sensitivity ranged from 0.87 to 1 (negative predictive value, 0.99-1) and specificity from 0.73 to 0.94 (positive predictive value, 0.12-0.49) for rule-out and rule-in cutoff, respectively.</p>
CONCLUSION: FNI is an accurate, simple, and affordable noninvasive score which can be used to screen for fibrotic NASH in individuals with dysmetabolism in primary health care.</p>
8 Keywords
- Biopsy
- Fibrosis
- Humans
- Liver
- Liver Cirrhosis
- Non-alcoholic Fatty Liver Disease
- Obesity, Morbid
- Predictive Value of Tests
22 Authors
- Federica Tavaglione
- Oveis Jamialahmadi
- Antonio De Vincentis
- Sami Qadri
- Mohammad Erfan Mowlaei
- Rosellina Margherita Mancina
- Ester Ciociola
- Simone Carotti
- Giuseppe Perrone
- Vincenzo Bruni
- Ida Francesca Gallo
- Dario Tuccinardi
- Cristiana Bianco
- Daniele Prati
- Silvia Manfrini
- Paolo Pozzilli
- Antonio Picardi
- Marco Caricato
- Hannele Yki-Järvinen
- Luca Valenti
- Umberto Vespasiani-Gentilucci
- Stefano Romeo
1 Application
| Application ID | Title |
|---|---|
| 37142 | UNDERSTANDING THE GENETIC ARCHITECTURE OF CHRONIC LIVER DISEASE |
Enabling scientific discoveries that improve human health