Copyright
©The Author(s) 2021.
World J Gastroenterol. Sep 14, 2021; 27(34): 5753-5763
Published online Sep 14, 2021. doi: 10.3748/wjg.v27.i34.5753
Published online Sep 14, 2021. doi: 10.3748/wjg.v27.i34.5753
| Formula | Equation | Lower cutoff | Higher cutoff |
| FIB-4 | [Age (yr) × AST (IU/L)]/{platelet count (109/L) × [ALT(IU/L)]1/2} | 1.3 | 2.67[11] |
| 1.45 | 3.25[22] | ||
| APRI | [(AST/ULN)/platelet count (109/L)] × 100 | 0.5 | 1.5[21] |
| NFS | -1.675 + 0.037 × age (yr) + 0.094 × BMI (kg/m2) + 1.13 × IFG/diabetes (yes = 1, no = 0) + 0.99 × AST/ALT-0.013 × platelet count (× 109/L) - 0.66 × albumin (g/dL) | -0.676 | 1.455[10] |
| BARD | Scale 0-4; BMI ≥ 28 kg/m2 = 1 point; AST/ALT ≥ 0.8 = 2 points; Diabetes = 1 point | 2[12] | |
Table 2 Baseline characteristics of the patients
| Overall, n = 417 | No/mild fibrosis, n = 261 | Advanced fibrosis, n = 156 | P value | |
| Age (yr) | 40.54 ± 10.95 | 39.42 ± 11.39 | 42.41 ± 9.94 | 0.007 |
| Male, n (%) | 354 (84.9) | 219 (83.9) | 135 (86.5) | 0.468 |
| BMI (kg/m2) | 25.48 ± 2.66 | 25.51 ± 2.56 | 25.42 ± 2.83 | 0.757 |
| Diabetes mellitus, n (%) | 82 (19.7) | 46 (17.6) | 36 (23.1) | 0.175 |
| Hypertension, n (%) | 42 (10.1) | 30 (11.5) | 12 (7.7) | 0.212 |
| ALB (g/L) | 42.53 ± 4.96 | 43.65 ± 5.14 | 40.65 ± 3.98 | < 0.001 |
| GLO (g/L) | 29.88 ± 14.11 | 29.11 ± 6.00 | 31.13 ± 21.53 | 0.160 |
| ALT (U/L) | 133.07 ± 199.05 | 126.93 ± 151.37 | 143.33 ± 260.27 | 0.416 |
| AST (U/L) | 70.69 ± 85.14 | 63.24 ± 62.19 | 83.17 ± 112.77 | 0.021 |
| GGT (U/L) | 89.64 ± 109.58 | 88.75 ± 117.46 | 91.11 ± 95.28 | 0.832 |
| FPG (mmol/L) | 5.34 ± 1.42 | 5.28 ± 1.20 | 5.45 ± 1.73 | 0.251 |
| Cr (μmol/L) | 73.41 ± 13.71 | 74.00 ± 13.50 | 72.41 ± 14.07 | 0.273 |
| UA (μmol/L) | 368.49 ± 82.08 | 377.02 ± 83.87 | 353.77 ± 76.98 | 0.007 |
| TG (mmol/L) | 1.67 ± 1.12 | 1.78 ± 1.45 | 1.48 ± 0.71 | 0.016 |
| HDL-C (mmol/L) | 1.12 ± 0.30 | 1.12 ± 0.29 | 1.12 ± 0.33 | 0.959 |
| PLT (× 109/L) | 204.00 ± 64.22 | 221.00 ± 62.76 | 175.52 ± 56.22 | < 0.001 |
| FIB-4 | 1.48 ± 1.64 | 1.19 ± 1.65 | 1.97 ± 1.49 | < 0.001 |
| APRI | 1.03 ± 1.72 | 0.84 ± 1.33 | 1.34 ± 2.19 | 0.003 |
| NFS | -2.16 ± 1.38 | -2.56 ± 1.24 | -1.50 ± 1.33 | < 0.001 |
| BARD (%) | < 0.001 | |||
| 0 | 209 (50.1) | 145 (55.6) | 64 (41.0) | |
| 1 | 86 (20.6) | 59 (22.6) | 27 (17.3) | |
| 2 | 92 (22.1) | 48 (18.4) | 44 (28.2) | |
| 3 | 25 (6.0) | 8 (3.1) | 17 (10.9 ) | |
| 4 | 5 (1.2) | 1 (0.4) | 4 (2.6) |
Table 3 Comparison of the diagnostic value among fibrosis-4 index, nonalcoholic fatty liver disease fibrosis score, aspartate aminotransferase to platelet ratio index, and body mass index, aspartate aminotransferase/alanine aminotransferase ratio, diabetes score in metabolic associated fatty liver disease
| Cutoffs | AUROC | Accuracy, % | Advanced fibrosis being missed, %1 | Sensitivity, % | Specificity, % | PPV, % | NPV, % | Youden index | |
| FIB-4 | 1.05 | 0.736 | 66.2 | 20.3 | 73.7 | 61.7 | 53.5 | 79.7 | 0.354 |
| 1.30 | 68.1 | 25.4 | 57.7 | 74.3 | 57.3 | 74.6 | 0.320 | ||
| 1.45 | 68.8 | 26.5 | 52.6 | 78.5 | 59.4 | 73.5 | 0.311 | ||
| 2.67 | 66.2 | 34.1 | 17.3 | 95.4 | 69.2 | 65.9 | 0.127 | ||
| 3.25 | 66.7 | 34.4 | 14.1 | 98.1 | 81.5 | 65.6 | 0.122 | ||
| NFS | -2.100 | 0.724 | 68.1 | 20.9 | 70.5 | 66.7 | 55.8 | 79.1 | 0.372 |
| -1.455 | 66.2 | 29.5 | 44.9 | 78.9 | 56.0 | 70.6 | 0.238 | ||
| 0.676 | 63.8 | 36.5 | 4.5 | 99.2 | 77.8 | 63.5 | 0.037 | ||
| APRI | 0.42 | 0.671 | 58.3 | 20.0 | 81.4 | 44.4 | 46.7 | 80.0 | 0.258 |
| 0.50 | 59.2 | 24.7 | 71.2 | 52.5 | 47.2 | 75.3 | 0.237 | ||
| 1.50 | 63.3 | 34.6 | 22.4 | 87.7 | 52.2 | 65.4 | 0.101 | ||
| BARD | 2 | 0.609 | 64.5 | 30.8 | 41.7 | 78.2 | 53.3 | 69.2 | 0.199 |
Table 4 Comparison of the diagnostic value among fibrosis-4 index, non-alcoholic fatty liver disease fibrosis score, aspartate aminotransferase to platelet ratio index, and body mass index, aspartate aminotransferase/alanine aminotransferase ratio, diabetes score in hepatitis B virus-metabolic associated fatty liver disease (group A) and pure metabolic associated fatty liver disease (group B) subgroups
| Cutoffs | AUROC | Accuracy, % | Sensitivity, % | Specificity, % | PPV, % | NPV, % | |||||||
| A | B | A | B | A | B | A | B | A | B | A | B | ||
| FIB-4 | 1.05 | 0.738 | 0.658 | 67.7 | 56.9 | 74.8 | 55.6 | 62.7 | 57.1 | 58.2 | 19.2 | 78.2 | 87.5 |
| 1.30 | 68.2 | 67.2 | 58.5 | 44.4 | 75.0 | 71.4 | 61.9 | 22.2 | 72.3 | 87.5 | |||
| 1.45 | 68.5 | 70.7 | 54.4 | 22.2 | 78.3 | 79.6 | 63.5 | 16.7 | 71.2 | 84.8 | |||
| 2.67 | 63.2 | 84.5 | 17.0 | 22.2 | 95.3 | 95.9 | 71.4 | 50.0 | 62.3 | 87.0 | |||
| 3.25 | 63.5 | 86.2 | 13.6 | 22.2 | 98.1 | 98.0 | 83.3 | 66.7 | 62.1 | 87.3 | |||
| NFS | -2.100 | 0.725 | 0.692 | 68.2 | 67.2 | 70.1 | 77.8 | 67.0 | 65.3 | 59.5 | 29.2 | 76.3 | 94.1 |
| -1.455 | 64.9 | 74.1 | 44.2 | 55.6 | 79.2 | 77.6 | 59.6 | 31.3 | 67.2 | 90.5 | |||
| 0.676 | 60.4 | 84.5 | 4.1 | 11.1 | 99.5 | 98.0 | 85.7 | 50.0 | 59.9 | 85.7 | |||
| APRI | 0.42 | 0.671 | 0.633 | 59.3 | 51.7 | 81.6 | 77.8 | 43.9 | 46.9 | 50.2 | 21.2 | 77.5 | 92.0 |
| 0.50 | 60.2 | 55.2 | 70.7 | 77.8 | 52.8 | 51.0 | 51.0 | 22.6 | 72.3 | 92.6 | |||
| 1.50 | 61.0 | 77.6 | 23.1 | 11.1 | 87.3 | 89.8 | 55.7 | 16.7 | 62.1 | 84.6 | |||
| BARD | 2 | 0.609 | 0.644 | 63.0 | 74.1 | 42.2 | 33.3 | 77.4 | 81.6 | 56.4 | 25.0 | 65.9 | 87.0 |
- Citation: Wu YL, Kumar R, Wang MF, Singh M, Huang JF, Zhu YY, Lin S. Validation of conventional non-invasive fibrosis scoring systems in patients with metabolic associated fatty liver disease. World J Gastroenterol 2021; 27(34): 5753-5763
- URL: https://www.wjgnet.com/1007-9327/full/v27/i34/5753.htm
- DOI: https://dx.doi.org/10.3748/wjg.v27.i34.5753