Cost Saving or Cost Effective? Unanswered Questions in the Screening of Patients With Nonalcoholic Fatty Liver Disease

Jiang, Z. Gordon; Tapper, Elliot B.

doi:10.1002/hep4.1386

Cited by 3 publications

(1 citation statement)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Shima et al also showed that the diagnostic performance of FIB-4 for advanced fibrosis increased when combined with VCTE [20]. However, measuring VCTE requires special equipment that is not widely installed in primary care institutions [21]. Denir et al suggested that a combination of the FIB-4 index and non-invasive Koeln-Essen index (NIKEI) could reduce unnecessary referrals [9], but most of the NIKEI parameters overlap with those of the FIB-4 index, and it did not validate from average-risk population.…”

Section: Discussionmentioning

confidence: 99%

Sequential Combination of FIB-4 Followed by M2BPGi Enhanced Diagnostic Performance for Advanced Hepatic Fibrosis in an Average Risk Population

Kim

Jun

Park

et al. 2020

JCM

View full text Add to dashboard Cite

The fibrosis-4 (FIB-4) index is the most widely used estimated formula to screen for advanced hepatic fibrosis; however, it has a considerable intermediate zone. Here, we propose an algorithm to reduce the intermediate zone and improve the diagnostic performance of screening for advanced liver fibrosis by incorporating Mac-2-binding protein glycan isomer (M2BPGi) into a FIB-4 based screening strategy in an average risk group. Four-hundred eighty-eight healthy and chronic liver disease subjects were analyzed using a 1:1 propensity score matched for age and sex. Advanced liver fibrosis (≥F3) was defined by magnetic resonance elastography (MRE, ≥3.6 kPa). Classification tree analysis was employed to improve diagnostic performance using a combination of the FIB-4 index and M2BPGi. The median serum M2BPGi levels of healthy subjects, patients without advanced fibrosis, and those with the condition were 0.48, 0.94, and 2.93, respectively. The area under the receiver operating characteristic (AUROC) curve of M2BPGi (0.918) for advanced fibrosis was the highest compared to those of the FIB-4 index (0.887), APRI (0.873), and AST/ALT ratio (0.794). When M2BPGi was incorporated following the FIB-4 index, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 87.1%, 82.5%, 54.0%, and 96.4%, respectively. Moreover, 74.3% (133/179) of cases in the intermediate zone of the FIB-4 index avoided unnecessary referrals. Two-step pathway (FIB-4 followed by M2BPGi) could reduce unnecessary referrals and/or liver biopsies in an average-risk population.

show abstract

Section: Discussionmentioning

confidence: 99%

Sequential Combination of FIB-4 Followed by M2BPGi Enhanced Diagnostic Performance for Advanced Hepatic Fibrosis in an Average Risk Population

Kim

Jun

Park

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

Nonalcoholic Fatty Liver in the Pathogenesis of Diabetes

Nogueira

Leite

2023

The Diabetes Textbook

View full text Add to dashboard Cite

Nonalcoholic fatty liver disease and type 2 diabetes: where do Diabetologists stand?

Tomah

Alkhouri

Hamdy

2020

Clin Diabetes Endocrinol

View full text Add to dashboard Cite

Background Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide. The increasing prevalence of NAFLD mirrors that of obesity and type 2 diabetes over the last two decades. Main In a two-way pathophysiologic relationship, NAFLD increases the risk of developing type 2 diabetes, while the latter promotes the progression of simple fatty liver to a more advanced form called nonalcoholic steatohepatitis (NASH). NASH increases the risk of cirrhosis and hepatocellular carcinoma (HCC), which may require liver transplantation. With the absence of FDA-approved medications for NAFLD treatment, lifestyle intervention remains the only therapy. Lately, extensive research efforts have been aimed at modifying NASH fibrosis and developing noninvasive screening methods. Conclusion We highlight the pathophysiologic relationships between NAFLD and type 2 diabetes, discuss disease recognition, models of care, and current and emerging therapies for NASH treatment.

show abstract

Cost Saving or Cost Effective? Unanswered Questions in the Screening of Patients With Nonalcoholic Fatty Liver Disease

Cited by 3 publications

References 8 publications

Sequential Combination of FIB-4 Followed by M2BPGi Enhanced Diagnostic Performance for Advanced Hepatic Fibrosis in an Average Risk Population

Sequential Combination of FIB-4 Followed by M2BPGi Enhanced Diagnostic Performance for Advanced Hepatic Fibrosis in an Average Risk Population

Nonalcoholic Fatty Liver in the Pathogenesis of Diabetes

Nonalcoholic fatty liver disease and type 2 diabetes: where do Diabetologists stand?

Contact Info

Product

Resources

About