Accuracy of steatosis and fibrosis NAFLD scores in relation to vibration controlled transient elastography: An NHANES analysis - 20/08/22
, Arthur J McCullough bHighlights |
• | NAFLD is the commonest chronic liver disease in the USA. |
• | An ultrasound scan is currently not recommended as a screening tool for all populations. |
• | Most patients with NAFLD are asymptomatic and remain undiagnosed. |
• | Scores based on commonly available biochemical tests are reliable in diagnosing NAFLD. |
• | Primary care providers can use HSI and FLI scores as an initial screening measure for NAFLD. |
Abstract |
Background |
Non-alcoholic fatty liver disease (NAFLD) is highly prevalent and increasing in the United States. Based on patient characteristics and biochemical profiles, predictive indices have been formulated to evaluate the presence and severity of NAFLD. This study evaluates the accuracy of these indices versus vibration-controlled transient elastography (VCTE™) to screen at-risk populations for NAFLD.
Methods |
Subjects from the NHANES datasets (2017-2018) without other liver diseases with completed VCTE™ data were studied (n = 5062). Hepatic steatosis and fibrosis scores were calculated and compared with controlled attenuation parameter (CAP) and elastography measurements of VCTE™, respectively.
Results |
The prevalence of NAFLD was 58.5%. Against a CAP cut-off value of ≥238 dB/m for diagnosing fatty liver, the US fatty liver index [US-FLI] had the highest positive predictive value (90%) and specificity (63.7%). The coefficient of correlation against CAP was strong for fatty liver index [FLI] (r = 0.645) and US-FLI (r = 0.608). The hepatic steatosis index [HSI] had the highest negative predictive value (82.1%) and sensitivity (75%) for ruling out steatosis. HSI and FLI, which use commonly obtained clinical parameters, had a high diagnostic odds ratios (21.2 and 18.6, respectively) compared to US-FLI (4.97), which requires insulin levels in the calculation. These findings were similar across all ethnicities studied.
Conclusion |
US-FLI is a reliable scoring system to diagnose patients with fatty liver. HSI and FLI are more easily calculated and can be used in clinical practices to diagnose NAFLD in at-risk populations.
Il testo completo di questo articolo è disponibile in PDF.Key words : NAFLD, Screening, Elastography, Non-invasive measurements
Abbreviations : BMI, CAP, FIB-4, FLI, NAFLD, NASH, NHANES, NPV, HSI, kPa, PPV, ROC, TG, TyG, US-FLI, VCTE
Mappa
Vol 46 - N° 7
Articolo 101997- Agosto 2022 Ritorno al numero
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