Non-alcoholic fatty liver disease Noninvasive scores: Difference between revisions
(Fibrotic NASH Index (FNI)) |
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APRI [https://www.mdcalc.com/calc/3094/ast-platelet-ratio-index-apri MedCalc] | APRI [https://www.mdcalc.com/calc/3094/ast-platelet-ratio-index-apri MedCalc] | ||
The LiverRisk score *https://www.liverriskscore.com/) may be more accurate than the FIB-4 or aspartate transferase to platelet ratio index ([https://www.mdcalc.com/calc/3094/ast-platelet-ratio-index-apri APRI]) at | The NAFLD-MESA Index uses "eight predictors: age, sex, race/ethnicity, type 2 diabetes, smoking history, body mass index, gamma-glutamyltransferase (GGT), and triglycerides (TG)"<ref name="pmid33501527">{{cite journal| author=Rodriguez LA, Shiboski SC, Bradshaw PT, Fernandez A, Herrington D, Ding J | display-authors=etal| title=Predicting Non-Alcoholic Fatty Liver Disease for Adults Using Practical Clinical Measures: Evidence from the Multi-ethnic Study of Atherosclerosis. | journal=J Gen Intern Med | year= 2021 | volume= 36 | issue= 9 | pages= 2648-2655 | pmid=33501527 | doi=10.1007/s11606-020-06426-5 | pmc=8390627 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33501527 }} </ref> The score predicted NAFLD by liver computed tomography (≤ 40 Hounsfield units indicating > 30% hepatic steatosis) with AUC = 0.8 | ||
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The LiverRisk score *https://www.liverriskscore.com/) may be more accurate than the FIB-4 or aspartate transferase to platelet ratio index ([https://www.mdcalc.com/calc/3094/ast-platelet-ratio-index-apri APRI]) at predicting liver stiffness measurements of 6 kPa or more, 10 kPa or more, and 15 kPa<ref name="pmid37572680">{{cite journal| author=Serra-Burriel M, Juanola A, Serra-Burriel F, Thiele M, Graupera I, Pose E | display-authors=etal| title=Development, validation, and prognostic evaluation of a risk score for long-term liver-related outcomes in the general population: a multicohort study. | journal=Lancet | year= 2023 | volume= | issue= | pages= | pmid=37572680 | doi=10.1016/S0140-6736(23)01174-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=37572680 }} </ref>. These kPa thresholds correspond to: | |||
* 6 kPa: no fibrosis | * 6 kPa: no fibrosis | ||
* 10 kPa: between F3 and F4 fibrosis | * 10 kPa: between F3 and F4 fibrosis | ||
* 15 kPa: above F4 fibrosis | * 15 kPa: above F4 fibrosis | ||
"LS of 8 and 12.5 kPa represent generally accepted cut-off values for F3 and F4 fibrosis. LS highly correlates with portal pressure, and esophageal varices are likely at values >20 kPa."<ref name="pmid24367208">{{cite journal| author=Mueller S, Sandrin L| title=Liver stiffness: a novel parameter for the diagnosis of liver disease. | journal=Hepat Med | year= 2010 | volume= 2 | issue= | pages= 49-67 | pmid=24367208 | doi=10.2147/hmer.s7394 | pmc=3846375 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24367208 }} </ref> | ==Imaging== | ||
Liver stiffness measurements: "LS of 8 and 12.5 kPa represent generally accepted cut-off values for F3 and F4 fibrosis. LS highly correlates with portal pressure, and esophageal varices are likely at values >20 kPa."<ref name="pmid24367208">{{cite journal| author=Mueller S, Sandrin L| title=Liver stiffness: a novel parameter for the diagnosis of liver disease. | journal=Hepat Med | year= 2010 | volume= 2 | issue= | pages= 49-67 | pmid=24367208 | doi=10.2147/hmer.s7394 | pmc=3846375 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24367208 }} </ref> | |||
* LS of 8 suggests F3 fibrosis | |||
* LS of 12.5 kPa suggests F4 fibrosis | |||
CT scan: "≤ 40 Hounsfield units indicating > 30% hepatic steatosis"<ref name="pmid33501527"/>. | |||
==References== | ==References== | ||
Revision as of 02:06, 23 August 2023
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
FIB-4 index at MedCalc and https://www.hepatitisc.uw.edu/page/clinical-calculators/fib-4 . For assessing need for biopsy in hepatitis B and hepatitis C.
NAFLD fibrosis score MedCalc
Fibrotic NASH Index (FNI) which contains the AST, HDL, HbA1c[1].
APRI MedCalc
The NAFLD-MESA Index uses "eight predictors: age, sex, race/ethnicity, type 2 diabetes, smoking history, body mass index, gamma-glutamyltransferase (GGT), and triglycerides (TG)"[2] The score predicted NAFLD by liver computed tomography (≤ 40 Hounsfield units indicating > 30% hepatic steatosis) with AUC = 0.8 0. The LiverRisk score *https://www.liverriskscore.com/) may be more accurate than the FIB-4 or aspartate transferase to platelet ratio index (APRI) at predicting liver stiffness measurements of 6 kPa or more, 10 kPa or more, and 15 kPa[3]. These kPa thresholds correspond to:
- 6 kPa: no fibrosis
- 10 kPa: between F3 and F4 fibrosis
- 15 kPa: above F4 fibrosis
Imaging
Liver stiffness measurements: "LS of 8 and 12.5 kPa represent generally accepted cut-off values for F3 and F4 fibrosis. LS highly correlates with portal pressure, and esophageal varices are likely at values >20 kPa."[4]
- LS of 8 suggests F3 fibrosis
- LS of 12.5 kPa suggests F4 fibrosis
CT scan: "≤ 40 Hounsfield units indicating > 30% hepatic steatosis"[2].
References
- ↑ Tavaglione F, Jamialahmadi O, De Vincentis A, Qadri S, Mowlaei ME, Mancina RM; et al. (2023). "Development and Validation of a Score for Fibrotic Nonalcoholic Steatohepatitis". Clin Gastroenterol Hepatol. 21 (6): 1523–1532.e1. doi:10.1016/j.cgh.2022.03.044. PMID 35421583 Check
|pmid=value (help). - ↑ 2.0 2.1 Rodriguez LA, Shiboski SC, Bradshaw PT, Fernandez A, Herrington D, Ding J; et al. (2021). "Predicting Non-Alcoholic Fatty Liver Disease for Adults Using Practical Clinical Measures: Evidence from the Multi-ethnic Study of Atherosclerosis". J Gen Intern Med. 36 (9): 2648–2655. doi:10.1007/s11606-020-06426-5. PMC 8390627 Check
|pmc=value (help). PMID 33501527 Check|pmid=value (help). - ↑ Serra-Burriel M, Juanola A, Serra-Burriel F, Thiele M, Graupera I, Pose E; et al. (2023). "Development, validation, and prognostic evaluation of a risk score for long-term liver-related outcomes in the general population: a multicohort study". Lancet. doi:10.1016/S0140-6736(23)01174-1. PMID 37572680 Check
|pmid=value (help). - ↑ Mueller S, Sandrin L (2010). "Liver stiffness: a novel parameter for the diagnosis of liver disease". Hepat Med. 2: 49–67. doi:10.2147/hmer.s7394. PMC 3846375. PMID 24367208.