Predictors of advanced liver fibrosis and the performance of fibrosis scores: lean compared to non-lean metabolic dysfunction-associated steatotic liver disease (MASLD) patients

被引：4
作者：
Dabbah, Shoham [1 ,2 ,4 ]
Ben Yakov, Gil [1 ]
Kaufmann, Monika-Inda [3 ]
Cohen-Ezra, Oranit [1 ]
Likhter, Maria [1 ]
Davidov, Yana [1 ]
Ben Ari, Ziv [1 ,2 ]
机构：
[1] Sheba Med Ctr, Liver Dis Ctr, Ramat Gan, Israel
[2] Tel Aviv Univ, Sackler Fac Med, Tel Aviv, Israel
[3] Inst Pathol, Sheba Med Ctr, Ramat Gan, Israel
[4] Sheba Med Ctr, Liver Dis Ctr, Sheba Rd 2, IL-52621 Tel Aviv, Israel
来源：
MINERVA GASTROENTEROLOGY | 2024年 / 70卷 / 03期
关键词：
Cardiometabolic risk factors; Liver cirrhosis; Liver diseases; Non-alcoholic fatty liver disease; NAFLD; MORTALITY; OUTCOMES; SYSTEM;
D O I：
10.23736/S2724-5985.23.03518-0
中图分类号：
R57 [消化系及腹部疾病];
学科分类号：
摘要：
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) in lean patients differs from that of NAFLD in non-lean patients. However, current data regarding predictors of advanced fibrosis and the performance of fibrosis-4 index (FIB-4) and NAFLD fibrosis score (NFS) in lean compared to non-lean metabolic dysfunction-associated steatotic liver disease (MASLD) patients is insufficient. METHODS: This was a cross-sectional study. Lean was defined as Body Mass Index <25 kg/m2. Advanced fibrosis (F3 F4) was detected by liver biopsy or two-dimension shear wave elastography (2D-SWE). Predictors of advanced fibrosis were identified using logistic regression and area under ROC curves (AUROC) were derived for FIB-4 and NFS.RESULTS: Lean patients (N.=153) comprised 19.2% of the MASLD cohort. Advanced fibrosis was associated with the number of cardiometabolic risk factors (CMRF) in lean (OR=2.06, P=0.011) and non-lean (OR=1.58, P<0.001) patients, however, hypertension and diabetes or impaired fasting glucose were significant only among non-lean. Age was associated with advanced fibrosis in both subgroups with age >65 showing higher odds in lean compared to non-lean patients (P=0.016). Non-lean patients had higher odds for advanced fibrosis relative to lean patients (OR=4.8, P=0.048). FIB-4 and NFS predicted advanced fibrosis among lean (AUROC=0.79 and AUROC=0.85, respectively) and non-lean (AUROC=0.79 and AUROC=0.76, respectively) patients. NFS >-1.445 showed higher specificity among lean compared to non-lean (P<0.001) and compared to that of FIB-4 >1.3 in lean patients (P<0.001). CONCLUSIONS: The number of CMRF was predictive of advanced fibrosis in both subgroups while age >65 showed higher odds among lean patients. NFS >-1.445 is more specific than FIB-4 >1.3 for advanced fibrosis prediction in lean patients. These findings may help identify high-risk lean MASLD patients for further liver fibrosis stage assessment.
引用
收藏
页码：322 / 331
页数：10
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