Complex non‐invasive fibrosis models are more accurate than simple models in non‐alcoholic fatty liver disease

  title={Complex non‐invasive fibrosis models are more accurate than simple models in non‐alcoholic fatty liver disease},
  author={Leon A. Adams and Jacob George and Elisabetta Bugianesi and Enrico Rossi and Willem Bastiaan de Boer and David van der Poorten and Helena L. Ching and Max K. Bulsara and Gary P. Jeffrey},
  journal={Journal of Gastroenterology and Hepatology},
Background and Aim:  Significant hepatic fibrosis is prognostic of liver morbidity and mortality in non‐alcoholic fatty liver disease (NAFLD); however, it remains unclear whether non‐invasive fibrosis models can determine this end‐point. We therefore compared the accuracy of simple bedside versus complex fibrosis models across a range of fibrosis in a multi‐centre NAFLD cohort. 

Diabetes impacts prediction of cirrhosis and prognosis by non‐invasive fibrosis models in non‐alcoholic fatty liver disease

  • L. BertotG. Jeffrey L. Adams
  • Medicine
    Liver international : official journal of the International Association for the Study of the Liver
  • 2018
The ability of non‐invasive fibrosis models to determine cirrhosis and outcomes in NAFLD patients with and without diabetes is examined.

Systematic review and meta‐analysis: non‐invasive detection of non‐alcoholic fatty liver disease related fibrosis in the obese

  • G. OoiS. Mgaieth W. Brown
  • Medicine, Biology
    Obesity reviews : an official journal of the International Association for the Study of Obesity
  • 2018
Current evidence for common non‐invasive tests for NAFLD‐related fibrosis in obesity is reviewed to assess the impact of pathophysiological changes of obesity on these tests.

Review article: the diagnosis of non‐alcoholic fatty liver disease – availability and accuracy of non‐invasive methods

Non‐alcoholic fatty liver disease (NAFLD) encompasses a wide spectrum of clinical conditions, actually representing an emerging disease of great clinical interest. Currently, its diagnosis requires

Non-invasive fibrosis assessment in non-alcoholic fatty liver disease

The Fibrosis 4 (FIB-4) index, calculated by combining age, platelet count and serum aminotransferases (serum aspartate transaminase [AST] and alanine transaminase [ALT] levels), has moderate accuracy

Steatosis affects the sensitivity but not the specificity of non‐invasive fibrosis tests in non‐alcoholic fatty liver disease – implications for screening strategies

  • N. ZakeriE. Tsochatzis
  • Medicine
    Liver international : official journal of the International Association for the Study of the Liver
  • 2018
Alcoholic fatty liver disease – implications for screening strategies Nekisa Zakeri, Emmanuel A. Tsochatzis, MD, PhD, UCL Institute for Liver and Digestive Health, Royal Free Hospital and UCL.

ELF score ≥9.8 indicates advanced hepatic fibrosis and is influenced by age, steatosis and histological activity

  • K. FaganC. Pretorius E. Powell
  • Medicine
    Liver international : official journal of the International Association for the Study of the Liver
  • 2015
This study was designed to determine the diagnostic accuracy of the manufacturer's cut‐off value (≥9.8) in identifying advanced fibrosis.

Noninvasive Markers of Fibrosis and Inflammation in Nonalcoholic Fatty Liver Disease

Of the various serum markers, cytokeratin-18 seems to best predict NASH, the NAFLD Fibrosis Score is most closely correlated with fibrosis, and transient elastography can be used for diagnosis of cirrhosis, or to exclude cirrhotic disease, although its utility is limited by obesity.

The ability of Hepascore to predict liver fibrosis in chronic liver disease: a meta‐analysis

A meta‐analysis was performed to evaluate the pooled diagnostic performance of Hepascore and to compare it for different aetiologies of chronic liver disease.

Fibrosis in nonalcoholic Fatty liver disease: mechanisms and clinical implications.

This review focuses on fibrosis based on clinical and basic perspectives, highlighting its molecular mechanisms, clinical consequences of fibrosis, the diagnostic approach and management strategies.

Noninvasive Assessment of Fibrosis in Patients with Nonalcoholic Fatty Liver Disease

The evidence for the use of noninvasive fibrosis tests in patients with NAFLD is presented and such tests can be used as first line tests to rule out patients without advanced fibrosis and thus prevent unnecessary secondary care referrals in a significant number of patients.



Assessment of asymptomatic liver fibrosis in alcoholic patients using fibroscan: prospective comparison with seven non‐invasive laboratory tests

This data indicates that routine screening for liver fibrosis in heavy‐drinking patients with a history of liver disease or cirrhosis is a challenge and needs to be improved.

Long‐term follow‐up of patients with NAFLD and elevated liver enzymes

It is concluded that nonalcoholic fatty liver disease with elevated liver enzymes is associated with a clinically significant risk of developing end‐stage liver disease and Survival is lower in patients with NASH, and most NAFLD patients will develop diabetes or impaired glucose tolerance in the long term.

Noninvasive markers of fibrosis in nonalcoholic fatty liver disease: Validating the European Liver Fibrosis Panel and exploring simple markers

The ELF panel has good diagnostic accuracy in an independent validation cohort of patients with NAFLD and the addition of established simple markers augments the diagnostic performance across different stages of fibrosis, which will potentially allow superior stratification of patients for emerging therapeutic strategies.

Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: Selected practical issues in their evaluation and management

Health care providers should not only focus on liver disease but also concentrate on aggressively modifying and treating their cardiovascular risk factors.

The NAFLD fibrosis score: A noninvasive system that identifies liver fibrosis in patients with NAFLD

A simple scoring system accurately separates patients with nonalcoholic fatty liver disease with and without advanced fibrosis, rendering liver biopsy for identification ofAdvanced fibrosis unnecessary in a substantial proportion of patients.

Design and validation of a histological scoring system for nonalcoholic fatty liver disease

A strong scoring system and NAS for NAFLD and NASH with reasonable inter‐rater reproducibility that should be useful for studies of both adults and children with any degree ofNAFLD are presented.

Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease

Transient elastography is accurate in most NAFLD patients and is useful as a screening test to exclude advanced fibrosis, and liver biopsy may be considered in patients with liver stiffness of at least 7.9 kPa.

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

An easily calculated score based on readily available clinical data can reliably exclude the presence of advanced fibrosis in patients with NAFLD, particularly among non-diabetics.

Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease.

Sampling variability of liver biopsy in nonalcoholic fatty liver disease.

Histologic lesions of NASH are unevenly distributed throughout the liver parenchyma; therefore, sampling error of liver biopsy can result in substantial misdiagnosis and staging inaccuracies.