Long-term outcomes and predictive ability of non-invasive scoring systems in patients with non-alcoholic fatty liver disease

Younes, Ramy; Caviglia, Gian Paolo; Govaere, Olivier; Rosso, Chiara; Armandi, Angelo; Sanavia, Tiziana; Pennisi, Grazia; Liguori, Antonio; Francione, Paolo; Gallego‐Durán, Rocío; Ampuero, Javier; Blanco, Marı́a José; Aller, R.; Tiniakos, Dina; Burt, Alastair D.; David, Ezio; Vecchio, Fabio Maria; Maggioni, Marco; Cabibi, Daniela; Pareja, María Jesús; Zaki, Marco Y.W.; Grieco, Antonio; Fracanzani, Anna Ludovica; Valenti, Luca; Miele, Luca; Fariselli, Piero; Petta, Salvatore; Romero–Gómez, Manuel; Anstee, Quentin M.; Bugianesi, Elisabetta

doi:10.1016/j.jhep.2021.05.008

Cited by 134 publications

(115 citation statements)

References 29 publications

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“…Among the different biomarkers proposed to be used for this purpose [2], in recent years, an increasing interest has been addressed regarding the aspartate transaminase to platelet ratio index (APRI), which has been investigated mainly in adult NAFLD and other chronic liver diseases, such as viral hepatitis [14][15][16][17][18]. When compared with liver biopsy and other non-invasive methods, APRI appeared to be a promising biomarker for assessing liver fibrosis/steatosis, with the advantages of being at low cost and repeatable [19].…”

Section: Introductionmentioning

confidence: 99%

The Role of Aspartate Transaminase to Platelet Ratio Index (APRI) for the Prediction of Non-Alcoholic Fatty Liver Disease (NAFLD) in Severely Obese Children and Adolescents

et al. 2022

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The aspartate transaminase to platelet ratio index (APRI) has been proposed as an easy-to-use biochemical marker in obese adults with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatotic hepatitis (NASH). The objective of the present study was to evaluate the clinical and predictive value of APRI in a paediatric obese population. Seven hundred fifty-seven obese children and adolescents (BMI standard deviation score, SDS: >2.0; age range: 10–18.5 years), not consuming alcohol and without hepatitis B or C, were recruited after having been screened for NAFLD by ultrasonography. A series of demographic, biochemical and clinical parameters was compared between the two subgroups (with or without NAFLD); the same parameters were correlated with APRI; and finally, univariable and multivariable logistic regression was used to evaluate the predictors of NAFLD. NAFLD was diagnosed in about 39% of the entire paediatric population, predominantly in males and in subjects suffering from metabolic syndrome. APRI was correlated with the waist circumference (WC), high-density lipoprotein cholesterol (HDL-C), uric acid, total bilirubin, C reactive protein (CRP) and systolic blood pressure (SBP). Furthermore, APRI was higher in males than females, but independent from steatosis severity and metabolic syndrome. With the univariable analysis, the BMI SDS, triglycerides (TG), insulin, homeostatic model assessment for insulin resistance (HOMA-IR), APRI, uric acid and metabolic syndrome were positive predictors of NAFLD, with female sex being negative predictor. At multivariable analysis; however, only BMI SDS, TG, HOMA-IR and APRI were positive predictors of NAFLD, with female sex being a negative predictor. The accuracy of APRI as a biochemical marker of NAFLD was about 60%.In conclusion, in a large (Italian) paediatric obese population, parameters, such as BMI SDS, TG, HOMA-IR and APRI, were positive predictors of NAFLD, with female sex being a negative predictor and most of the prediction explained by APRI. Nevertheless, APRI appears to be a simple biochemical marker of liver injury rather than of NAFLD/NASH and, moreover, is endowed with a limited accuracy for the prediction/diagnosis of NAFLD.

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Section: Introductionmentioning

confidence: 99%

The Role of Aspartate Transaminase to Platelet Ratio Index (APRI) for the Prediction of Non-Alcoholic Fatty Liver Disease (NAFLD) in Severely Obese Children and Adolescents

et al. 2022

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“…Those who are already better established and have been externally validated are included in the Fibrosis-4 (FIB-4) and the NAFLD fibrosis score (NFS). However, only a few scores such as HEPAMET [ 41 ] have comparable accuracy to our score in predicting significant fibrosis (including also F2, beyond F3 and F4). Recently, a Latin American group validated all three scores (HEPAMET, FIB-4 and NFS) in a Latin America population, including Brazilians, also demonstrating good accuracy in terms of predicting significant fibrosis [ 14 ].…”

Section: Discussionmentioning

confidence: 89%

Ability of a Combined FIB4/miRNA181a Score to Predict Significant Liver Fibrosis in NAFLD Patients

et al. 2021

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Liver biopsy is the gold standard for assessing fibrosis, but there is a need to seek non-invasive biomarkers for this purpose. The aim of this study was to evaluate the correlation between the serum levels of the microRNAs miR-21, miR-29a, miR-122, miR-155 and miR-181a and the phenotypic expression of NAFLD. A cross-sectional study was carried out on 108 NAFLD patients diagnosed by liver biopsy. FIB-4 and NAFLD fibrosis scores were calculated. The comparison between the distributions of microRNA values according to the presence or absence of histological fibrosis (F2–F4) was performed. A multivariate logistic regression analysis was performed to build a score for predicting fibrosis using FIB-4 and Ln (miR-181a) as independent variables. Only miR-181a showed a statistical difference between patients with significant liver fibrosis (>F2) and those without (F0–F1) (p = 0.017). FIB-4 revealed an AUC on the ROC curve of 0.667 to predict clinically significant fibrosis (F2–F4). When assessed using the score in association with Ln (miR-181a), there was an improvement in the ROC curve, with an AUC of 0.71. miR-181a can be used as a non-invasive method of predicting fibrosis in NAFLD, and an association with FIB-4 has the potential to increase the accuracy of each method alone.

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“…Larger, more diverse studies that include patients with different types of clinical liver diseases and a direct comparison to other non-invasive tests for cirrhosis required (3,11,(70)(71)(72)(73) In conclusion, this study establishes a clinical rationale for integrating direct analysis of IgG glycans for the active management of people with liver disease. The diagnostic performance of this method was dramatically greater than other non-invasive tests for liver fibrosis (Supplementary Table S8), such as FIB4, APRI and even tests that look at IgG glycans (11,16,74). One reason for this is the ability to not just look at total IgG but also the specific IgG sub-classes, which has not been performed before, as such studies were not technically feasible for large patient cohorts.…”

Section: Discussionmentioning

confidence: 99%

GlycoFibroTyper: A Novel Method for the Glycan Analysis of IgG and the Development of a Biomarker Signature of Liver Fibrosis

Scott¹,

Wang

Grauzam

et al. 2022

Front. Immunol.

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Our group has recently developed the GlycoTyper assay which is a streamlined antibody capture slide array approach to directly profile N-glycans of captured serum glycoproteins including immunoglobulin G (IgG). This method needs only a few microliters of serum and utilizes a simplified processing protocol that requires no purification or sugar modifications prior to analysis. In this method, antibody captured glycoproteins are treated with peptide N-glycosidase F (PNGase F) to release N-glycans for detection by MALDI imaging mass spectrometry (IMS). As alterations in N-linked glycans have been reported for IgG from large patient cohorts with fibrosis and cirrhosis, we utilized this novel method to examine the glycosylation of total IgG, as well as IgG1, IgG2, IgG3 and IgG4, which have never been examined before, in a cohort of 106 patients with biopsy confirmed liver fibrosis. Patients were classified as either having no evidence of fibrosis (41 patients with no liver disease or stage 0 fibrosis), early stage fibrosis (10 METAVIR stage 1 and 18 METAVIR stage 2) or late stage fibrosis (6 patients with METAVIR stage 3 fibrosis and 37 patients with METAVIR stage 4 fibrosis (cirrhosis)). Several major alterations in glycosylation were observed that classify patients as having no fibrosis (sensitivity of 92% and a specificity of 90%), early fibrosis (sensitivity of 84% with 90% specificity) or significant fibrosis (sensitivity of 94% with 90% specificity).

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Long-term outcomes and predictive ability of non-invasive scoring systems in patients with non-alcoholic fatty liver disease

Cited by 134 publications

References 29 publications

The Role of Aspartate Transaminase to Platelet Ratio Index (APRI) for the Prediction of Non-Alcoholic Fatty Liver Disease (NAFLD) in Severely Obese Children and Adolescents

The Role of Aspartate Transaminase to Platelet Ratio Index (APRI) for the Prediction of Non-Alcoholic Fatty Liver Disease (NAFLD) in Severely Obese Children and Adolescents

Ability of a Combined FIB4/miRNA181a Score to Predict Significant Liver Fibrosis in NAFLD Patients

GlycoFibroTyper: A Novel Method for the Glycan Analysis of IgG and the Development of a Biomarker Signature of Liver Fibrosis

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