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SHR Neuro Cancer Cardio Lipid Metab Microb

Mózes, FE; Lee, JA; Selvaraj, EA; Jayaswal, ANA; Trauner, M; Boursier, J; Fournier, C; Staufer, K; Stauber, RE; Bugianesi, E; Younes, R; Gaia, S; Lupșor-Platon, M; Petta, S; Shima, T; Okanoue, T; Mahadeva, S; Chan, WK; Eddowes, PJ; Hirschfield, GM; Newsome, PN; Wong, VW; de, Ledinghen, V; Fan, J; Shen, F; Cobbold, JF; Sumida, Y; Okajima, A; Schattenberg, JM; Labenz, C; Kim, W; Lee, MS; Wiegand, J; Karlas, T; Yılmaz, Y; Aithal, GP; Palaniyappan, N; Cassinotto, C; Aggarwal, S; Garg, H; Ooi, GJ; Nakajima, A; Yoneda, M; Ziol, M; Barget, N; Geier, A; Tuthill, T; Brosnan, MJ; Anstee, QM; Neubauer, S; Harrison, SA; Bossuyt, PM; Pavlides, M, , LITMUS, Investigators.
Diagnostic accuracy of non-invasive tests for advanced fibrosis in patients with NAFLD: an individual patient data meta-analysis.
Gut. 2022; 71(5):1006-1019 Doi: 10.1136/gutjnl-2021-324243 [OPEN ACCESS]
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Co-authors Med Uni Graz: Stauber Rudolf; Trauner Michael
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Abstract:: OBJECTIVE: Liver biopsy is still needed for fibrosis staging in many patients with non-alcoholic fatty liver disease. The aims of this study were to evaluate the individual diagnostic performance of liver stiffness measurement by vibration controlled transient elastography (LSM-VCTE), Fibrosis-4 Index (FIB-4) and NAFLD (non-alcoholic fatty liver disease) Fibrosis Score (NFS) and to derive diagnostic strategies that could reduce the need for liver biopsies. DESIGN: Individual patient data meta-analysis of studies evaluating LSM-VCTE against liver histology was conducted. FIB-4 and NFS were computed where possible. Sensitivity, specificity and area under the receiver operating curve (AUROC) were calculated. Biomarkers were assessed individually and in sequential combinations. RESULTS: Data were included from 37 primary studies (n=5735; 45% women; median age: 54 years; median body mass index: 30 kg/m²; 33% had type 2 diabetes; 30% had advanced fibrosis). AUROCs of individual LSM-VCTE, FIB-4 and NFS for advanced fibrosis were 0.85, 0.76 and 0.73. Sequential combination of FIB-4 cut-offs (<1.3; ≥2.67) followed by LSM-VCTE cut-offs (<8.0; ≥10.0 kPa) to rule-in or rule-out advanced fibrosis had sensitivity and specificity (95% CI) of 66% (63-68) and 86% (84-87) with 33% needing a biopsy to establish a final diagnosis. FIB-4 cut-offs (<1.3; ≥3.48) followed by LSM cut-offs (<8.0; ≥20.0 kPa) to rule out advanced fibrosis or rule in cirrhosis had a sensitivity of 38% (37-39) and specificity of 90% (89-91) with 19% needing biopsy. CONCLUSION: Sequential combinations of markers with a lower cut-off to rule-out advanced fibrosis and a higher cut-off to rule-in cirrhosis can reduce the need for liver biopsies.
Find related publications in this database (using NLM MeSH Indexing): Biomarkers - administration & dosage; Biopsy - administration & dosage; Diabetes Mellitus, Type 2 - administration & dosage; Elasticity Imaging Techniques - administration & dosage; Female - administration & dosage; Fibrosis - administration & dosage; Humans - administration & dosage; Liver - diagnostic imaging, pathology; Liver Cirrhosis - diagnosis, pathology; Male - administration & dosage; Middle Aged - administration & dosage; Non-alcoholic Fatty Liver Disease - complications, diagnosis, pathology
Find related publications in this database (Keywords): hepatic fibrosis; fatty liver; clinical decision making; biostatistics