RT info:eu-repo/semantics/article
T1 Development and Validation of Hepamet Fibrosis Scoring System–A Simple, Noninvasive Test to Identify Patients With Nonalcoholic Fatty Liver Disease With Advanced Fibrosis
A1 Ampuero, Javier
A1 Pais, Raluca
A1 Aller de la Fuente, Rocío
A1 Gallego-Durán, Rocío
A1 Crespo, Javier
A1 García-Monzón, Carmelo
A1 Boursier, Jerome
A1 Vilar, Eduardo
A1 Petta, Salvatore
A1 Zheng, Ming-Hua
A1 Escudero, Desamparados
A1 Calleja, Jose Luis
A1 Aspichueta, Patricia
A1 Diago, Moisés
A1 Rosales, Jose Miguel
A1 Caballería, Joan
A1 Gómez-Camarero, Judith
A1 Lo Iacono, Oreste
A1 Benlloch, Salvador
A1 Albillos, Agustín
A1 Turnes, Juan
A1 Banales, Jesus M.
A1 Ratziu, Vlad
A1 Romero-Gómez, Manuel
AB Fibrosis affects prognoses for patients with nonalcoholic fatty liver disease (NAFLD). Severalnon-invasive scoring systems have aimed to identify patients at risk for advanced fibrosis, butinconclusive results and variations in features of patients (diabetes, obesity and older age)reduce their diagnostic accuracy. We sought to develop a scoring system based on serummarkers to identify patients with NAFLD at risk for advanced fibrosis.METHODS: We collected data from 2452 patients with NAFLD at medical centers in Italy, France, Cuba, andChina. We developed the Hepamet fibrosis scoring system using demographic, anthropometric,and laboratory test data, collected at time of liver biopsy, from a training cohort of patientsfrom Spain (n [ 768) and validated the system using patients from Cuba (n [ 344), Italy(n [ 288), France (n [ 830), and China (n [ 232). Hepamet fibrosis score (HFS) werecompared with those of previously developed fibrosis scoring systems (the NAFLD fibrosisscore [NFS] and FIB-4). The diagnostic accuracy of the Hepamet fibrosis scoring system wasassessed based on area under the receiver operating characteristic (AUROC) curve, sensitivity,specificity, diagnostic odds ratio, and positive and negative predictive values and likelihoodratiosVariables used to determine HFS were patient sex, age, homeostatic model assessment score,presence of diabetes, levels of aspartate aminotransferase, and albumin, and platelet counts;these were independently associated with advanced fibrosis. HFS discriminated between patientswith and without advanced fibrosis with an AUROC curve value of 0.85 whereas NFS orFIB-4 did so with AUROC values of 0.80 (P[.0001). In the validation set, cut-off HFS of 0.12 and0.47 identified patients with and without advanced fibrosis with 97.2% specificity, 74%sensitivity, a 92% negative predictive value, a 76.3% positive predictive value, a 13.22 positivelikelihood ratio, and a 0.31 negative likelihood ratio. HFS were not affected by patient age, bodymass index, hypertransaminasemia, or diabetes. The Hepamet fibrosis scoring system had thegreatest net benefit in identifying patients who should undergo liver biopsy analysis and led tosignificant improvements in reclassification, reducing the number of patients with undeterminedresults to 20% from 30% for the FIB-4 and NFS systems (P < .05).CONCLUSIONS: Using clinical and laboratory data from patients with NAFLD, we developed and validated theHepamet fibrosis scoring system, which identified patients with advanced fibrosis with greateraccuracy than the FIB-4 and NFS systems. the Hepamet system provides a greater net benefit forthe decision-making process to identify patients who should undergo liver biopsy analysis.
SN 1542-3565
YR 2020
FD 2020
LK https://uvadoc.uva.es/handle/10324/64733
UL https://uvadoc.uva.es/handle/10324/64733
LA eng
NO Revista: Clinical Gastroenterology and Hepatology Capítulo: ISSN/ISBN:  1542-3565	Volumen: 18	Número:  Páginas.:  	Fecha: 2020
DS UVaDOC
RD 24-nov-2024