The novel cutoff points for the FIB4 index categorized by age increase the diagnostic accuracy in NAFLD: a multi-center study

Ishiba, Hiroshi; Sumida, Yoshio; Tanaka, Saiyu; Yoneda, Masato; Hyogo, Hideyuki; Ono, Masafumi; Fujii, Hideki; Eguchi, Yuichiro; Suzuki, Yôichi; Yoneda, Masashi; Takahashi, Hirokazu; Nakahara, Takashi; Seko, Yuya; Mori, Kumiko; Kanemasa, Kazuyuki; Shimada, Kaoru; Imai, Sunsuke; Imajo, Kento; Kawaguchi, Takumi; Nakajima, Atsushi; Chayama, Kazuaki; Saibara, Toshiji; Shima, Toshihide; Fujimoto, Kazuma; Okanoue, Takeshi; Itoh, Yoshito

doi:10.1007/s00535-018-1474-y

Cited by 95 publications

(93 citation statements)

References 20 publications

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“…The utility of FIB4 index was also confirmed in Japanese patients with NAFLD [12]. There was a possibility that the values of FIB4 index may be influenced by age because of its formula [23]. Indeed, in the current study, there was a significant difference in age among three groups, which were divided according to the baseline FIB4 index.…”

Section: Discussionsupporting

confidence: 63%

Effects of Sodium-Glucose Cotransporter 2 Inhibitors on Hepatic Fibrosis in Patients With Type 2 Diabetes: A Chart-Based Analysis

et al. 2020

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Background:The presence of nonalcoholic fatty liver diseases (NAFLDs) and type 2 diabetes was associated with elevated risks of cardiovascular events as well as the progression of NAFLD to fibrosis/cirrhosis and hepatocellular carcinoma. Sodium-glucose cotransporter 2 inhibitor (SGLT2i) is a widely used antidiabetic drug, which promotes urinary excretion of glucose. Recent animal and human studies demonstrated the beneficial effects of SGLT2is on lipid accumulation and fibrosis in the liver. The purpose of the current study was to elucidate the effects of SGLT2is on hepatic fibrosis in the realworld setting. Methods:We selected patients with type 2 diabetes who had been prescribed SGLT2is continuously for 12 months between April 1, 2014 and March 31, 2018 by a chart-based analysis. We compared the data before the SGLT2is treatment with the data at 6 and 12 months after the SGLT2is treatment started. Fibrosis in the liver was evaluated by fibrosis-4 (FIB4) index. Results:We enrolled 315 patients in this study. The body weight, body mass index (BMI), serum levels of aspartate aminotransferase, alanine aminotransferase and γ-glutamyl transferase were significantly decreased at 6 months and maintained at 12 months, whereas there was no significant change in FIB4 index. We divided the studied patients into three groups according to the baseline FIB4 index. Only in the group of high value of the baseline FIB4 index, FIB4 index was significantly decreased at 12 months. The correlations between the change of FIB4 index during 12-month SGLT2i treatment was correlated inversely with the baseline FIB4 index. Conclusion:Present study demonstrated that SGLT2i could ameliorate fibrosis in the liver in high-risk patients for hepatic fibrosis.

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Section: Discussionsupporting

confidence: 63%

Effects of Sodium-Glucose Cotransporter 2 Inhibitors on Hepatic Fibrosis in Patients With Type 2 Diabetes: A Chart-Based Analysis

et al. 2020

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“…Patients’ BMI was calculated as weight in kilograms/(height in meters) 2 , with obesity defined as a BMI >25 kg/m 2 . The Fibrosis‐4 (FIB4) index and NAFLD fibrosis score were calculated as the following formula: FIB4 index = age (years) × AST (IU/L) / (platelets PLT 10 9 /L × √ALT IU/L) . The NAFLD fibrosis score = −1.675 + 0.037 × age (years) + 0.094 × BMI (kg/m 2 ) + 1.13 × impaired fasting glucose/DM (with = 1, without = 0) + 0.99 × AST/ALT ratio – 0.013 × PLT (×10 9 /L) – 0.66 × Alb (g/dL) …”

Section: Methodsmentioning

confidence: 99%

Effect of luseogliflozin on hepatic fat content in type 2 diabetes patients with non‐alcoholic fatty liver disease: A prospective, single‐arm trial (LEAD trial)

Sumida

Murotani

Saito³

et al. 2018

Hepatology Research

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“…The FIB-4 index can be accurately used as the first step assuming the agreement of a primary care physician or health checkup facility. However, among hepatologists, the lowest cutoff value should be 1.45 [33,36], 1.3 [37], or 2.0 because the FIB-4 index can overpredict advanced fibrosis in the elderly [38,39]. That the FIB-4 index may show a false low value in diabetic patients [40] is not controversial, but this index remains sufficient for the first-step targeting of 2 billion NAFLD patients [31].…”

Section: Non-invasive Diagnostic Methods For Liver Fibrosismentioning

confidence: 99%

Surveillance of Hepatocellular Carcinoma in Nonalcoholic Fatty Liver Disease

et al. 2020

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Nonalcoholic fatty liver disease (NAFLD) is becoming the leading cause of hepatocellular carcinoma (HCC), liver-related mortality, and liver transplantation. There is sufficient epidemiological cohort data to recommend the surveillance of patients with NAFLD based upon the incidence of HCC. The American Gastroenterology Association (AGA) expert review published in 2020 recommends that NAFLD patients with cirrhosis or advanced fibrosis estimated by non-invasive tests (NITs) consider HCC surveillance. NITs include the fibrosis-4 (FIB-4) index, the enhanced liver fibrosis (ELF) test, FibroScan, and MR elastography. The recommended surveillance modality is abdominal ultrasound (US), which is cost effective and noninvasive with good sensitivity. However, US is limited in obese patients and those with NAFLD. In NAFLD patients with a high likelihood of having an inadequate US, or if an US is attempted but inadequate, CT or MRI may be utilized. The GALAD score, consisting of age, gender, AFP, the lens culinaris-agglutinin-reactive fraction of AFP (AFP-L3), and the protein induced by the absence of vitamin K or antagonist-II (PIVKA-II), can help identify a high risk of HCC in NAFLD patients. Innovative parameters, including a Mac-2 binding protein glycated isomer, type IV collagen 7S, free apoptosis inhibitor of the macrophage, and a combination of single nucleoside polymorphisms, are expected to be established. Considering the large size of the NAFLD population, optimal screening tests must meet several criteria, including high sensitivity, cost effectiveness, and availability.

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The novel cutoff points for the FIB4 index categorized by age increase the diagnostic accuracy in NAFLD: a multi-center study

Abstract: FIB4 index cutoff points for predicting advanced fibrosis in NAFLD increased with age. Cutoff points modified by age improved the diagnostic accuracy of estimations of advanced liver fibrosis using the FIB4 index.

Cited by 95 publications

References 20 publications

Effects of Sodium-Glucose Cotransporter 2 Inhibitors on Hepatic Fibrosis in Patients With Type 2 Diabetes: A Chart-Based Analysis

Effects of Sodium-Glucose Cotransporter 2 Inhibitors on Hepatic Fibrosis in Patients With Type 2 Diabetes: A Chart-Based Analysis

Effect of luseogliflozin on hepatic fat content in type 2 diabetes patients with non‐alcoholic fatty liver disease: A prospective, single‐arm trial (LEAD trial)

Surveillance of Hepatocellular Carcinoma in Nonalcoholic Fatty Liver Disease

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