Development and validation of a simple NAFLD clinical scoring system for identifying patients without advanced disease

Harrison, Stephen A.; Oliver, Dana; Arnold, Hays; Gogia, Sudhanshu; Neuschwander‐Tetri, Brent A.

doi:10.1136/gut.2007.146019

Cited by 739 publications

(588 citation statements)

References 46 publications

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“…18,19 Although there are some clinical scoring systems for NAFLD, they are mostly used to identify different stages of disease. [20][21][22][23] Our study shows that a simple clinical risk score originally developed to identify undiagnosed type 2 diabetes in the population may help to identify individuals at high risk of NAFLD. We have shown that the IDRS also helps to identify metabolic syndrome and cardiovascular disease in our population, 9 and it costs virtually nothing, as it requires only three questions and a waist measurement.…”

Section: Discussionmentioning

confidence: 99%

A Simple Indian Diabetes Risk Score Could Help Identify Nondiabetic Individuals at High Risk of Non-Alcoholic Fatty Liver Disease (CURES-117)

Anbalagan

Venkataraman

Vamsi

et al. 2012

J Diabetes Sci Technol

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Abbreviations: (ALT) alanine aminotransferase, (AST) aspartate aminotransferase, (BMI) body mass index, (CURES) Chennai Urban Rural Epidemiology Study, (HbA1c) glycated hemoglobin, (HDL) high-density lipoprotein, (HOMA-IR) homeostasis assessment model for insulin resistance, (IDRS) Indian diabetes risk score, (LDL) low-density lipoprotein, (NAFLD) non-alcoholic fatty liver disease, (NASH) non-alcoholic steatohepatitis, (NCD) noncommunicable disease, (OR) odds ratio

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Section: Discussionmentioning

confidence: 99%

A Simple Indian Diabetes Risk Score Could Help Identify Nondiabetic Individuals at High Risk of Non-Alcoholic Fatty Liver Disease (CURES-117)

Anbalagan

Venkataraman

Vamsi

et al. 2012

J Diabetes Sci Technol

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“…NAFLD fibrosis score,26 BMI, AST/ALT ratio, diabetes (BARD) score,27 Göteborg University cirrhosis index (GUCI) score,28 fibrosis‐4 (FIB‐4) score,29 and AST to platelet ratio index (APRI) score30 were calculated using biochemical and clinical data.…”

Section: Methodsmentioning

confidence: 99%

Natural history of nonalcoholic fatty liver disease: A prospective follow‐up study with serial biopsies

Nasr

Ignatova

Kechagias

et al. 2017

Hepatology Communications

128

104

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Nonalcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease in the world. The complete natural history of NAFLD is unknown because few high‐quality follow‐up studies have been conducted. Our aim was to find variables predicting disease severity through an extended follow‐up with serial biopsies. In a prospective cohort study, 129 patients who enrolled between 1988 and 1993 were asked to participate in a follow‐up study on two occasions; biochemical, clinical, and histologic data were documented. The mean time between biopsies was 13.7 (±1.7) and 9.3 (±1.0) years, respectively. At the end of the study period, 12 patients (9.3%) had developed end‐stage liver disease and 34% had advanced fibrosis. Out of the 113 patients with baseline low fibrosis (<3), 16% developed advanced fibrosis. Fibrosis progression did not differ among the different stages of baseline fibrosis (P = 0.374). Fifty‐six patients (43%) had isolated steatosis, of whom 9% developed advanced fibrosis (3 patients with biopsy‐proven fibrosis stage F3‐F4 and 2 patients with end‐stage liver disease). Fibrosis stage, ballooning, and diabetes were more common in patients who developed end‐stage liver disease; however, there were no baseline clinical, histologic, or biochemical variables that predicted clinical significant disease progression. Conclusion: NAFLD is a highly heterogeneous disease, and it is surprisingly hard to predict fibrosis progression. Given enough time, NAFLD seems to have a more dismal prognosis then previously reported, with 16% of patients with fibrosis stage <3 developing advanced fibrosis and 9.3% showing signs of end‐stage liver disease. (Hepatology Communications 2018;2:199–210)

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“…The spectrum of disease encompasses bland steatosis without inflammation to nonalcoholic steatohepatitis (NASH), the latter being associated with a relatively greater risk of cirrhosis, occurring in up to 15% of patients (4). Although insulin resistance and its sequelae, i.e.…”

Section: Nonalcoholic Fatty Liver Disease (Nafld)mentioning

confidence: 99%

Bile Acid Receptor Activation Modulates Hepatic Monocyte Activity and Improves Nonalcoholic Fatty Liver Disease

McMahan

Wang

Cheng

et al. 2013

Journal of Biological Chemistry

200

146

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Background:The bile acid receptors FXR and TGR5 have pleiotropic functions, including immune modulation. Results: Treatment of a murine model of nonalcoholic fatty liver disease (NAFLD) with a dual FXR/TGR5 agonist decreased intrahepatic inflammation and altered the immune phenotype of monocytes. Conclusion: Bile acid receptor activation improves NAFLD. Significance: These results identify potential targeting strategies for treatment of NAFLD.

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Development and validation of a simple NAFLD clinical scoring system for identifying patients without advanced disease

Abstract: Insulin resistance and its co-morbidities are often present in patients with NAFLD. An easily calculated score based on readily available clinical data can reliably exclude the presence of advanced fibrosis in these patients, particularly among non-diabetics.

Cited by 739 publications

References 46 publications

A Simple Indian Diabetes Risk Score Could Help Identify Nondiabetic Individuals at High Risk of Non-Alcoholic Fatty Liver Disease (CURES-117)

A Simple Indian Diabetes Risk Score Could Help Identify Nondiabetic Individuals at High Risk of Non-Alcoholic Fatty Liver Disease (CURES-117)

Natural history of nonalcoholic fatty liver disease: A prospective follow‐up study with serial biopsies

Bile Acid Receptor Activation Modulates Hepatic Monocyte Activity and Improves Nonalcoholic Fatty Liver Disease

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