Analysis of non- invasive fibrosis markers in non-alcoholic fatty liver disease patients
Introduction: The diagnosis of non-alcoholic fatty liver disease (NAFLD) is performed by the liver biopsy that directs its treatment.The disadvantages of the biopsy are costs,the possibility of sample error and morbidity of the procedure.In order to minimize and/or direct indication of the liver bio...
| Autores: | , , , |
|---|---|
| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2020 |
| País: | Brasil |
| Institución: | Faculdade de Medicina de São José do Rio Preto (FAMERP) |
| Repositorio: | Archives of Health Sciences (Online) |
| Idioma: | portugués |
| OAI Identifier: | oai:ojs2.ahs.famerp.br:article/62 |
| Acceso en línea: | https://ahs.famerp.br/index.php/ahs/article/view/62 |
| Access Level: | acceso abierto |
| Palabra clave: | Hepatopatia Gordurosa não Alcoólica; Cirrose Hepática; Fígado Gorduroso Non-alcoholic Fatty Liver Disease; Liver Cirrhosis; Fatty liver |
| Sumario: | Introduction: The diagnosis of non-alcoholic fatty liver disease (NAFLD) is performed by the liver biopsy that directs its treatment.The disadvantages of the biopsy are costs,the possibility of sample error and morbidity of the procedure.In order to minimize and/or direct indication of the liver biopsy,noninvasive markers have been proposed to evaluate fibrosis in patients with NAFLD.Objectives: Analyze the efficacy of non-invasive fibrosis scores APRI and FIB-4 in evaluating patients with NAFLD and verify their benefit in clinical practice.Methods: It was carried out a cross-sectional study,including patients with NAFLD undergoing liver biopsy.The stage of fibrosis equal or greater than two were defined as significant taking the biopsy as gold standard.ROC curves were used to evaluate the diagnostic performance of the scores in predicting the presence or absence of significant fibrosis.Results: The study sample was composed of 33 adult patients with mean age of 46.4 ± 11.05 years.It was considered as cut-off points for non-significant fibrosis values equal to or less than 0.33 and 1.3 for APRI and FIB-4, respectively.The AUROCs were 0.68 for the APRI and 0.63 for the FIB-4. The presence of cirrhosis was considered at the cutoff points 1 and 2.67 for APRI and FIB-4, respectively.The VPP and NPV for significant fibrosis exclusion were for the APRI 90% and 46.15% and for the FIB-4 85.18% and 66.66%, respectively. If we restrict the indication of liver biopsy to individuals with intermediate values of each score, this procedure could have been correctly avoided for a considerable number of patients reaching 54.5% with APRI and 66.7% with FIB-4. Conclusion: Although the APRI and FIB-4 models presented sub-optimal sensitivity and specificity to differentiate significant fibrosis, the biopsy could have been avoided for most of the patients with the application of the non-invasive scores APRI and FIB-4, which corroborates their use in clinical practice. |
|---|