Non-alcoholic fatty liver disease Noninvasive scores
|
Non-Alcoholic Fatty Liver Disease Microchapters |
|
Differentiating Non-Alcoholic Fatty Liver Disease from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case studies |
|
Non-alcoholic fatty liver disease Noninvasive scores On the Web |
|
American Roentgen Ray Society Images of Non-alcoholic fatty liver disease Noninvasive scores |
|
Non-alcoholic fatty liver disease Noninvasive scores in the news |
|
Blogs on Non-alcoholic fatty liver disease Noninvasive scores |
|
Directions to Hospitals Treating Non-alcoholic fatty liver disease |
|
Risk calculators and risk factors for Non-alcoholic fatty liver disease Noninvasive scores |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
| Components | AUC | Link | |
|---|---|---|---|
| LiverRisk score[1] | seven predictors: age, glucose, cholesterol, AST , ALT , GGT , platelet count | 0.72[2] | liverriskscore.com (Proprietary) |
| NAFLD Fibrosis Score (NFS)[3] | seven predictors: age, hyperglycemia, BMI, platelet count, albumin, and AST/ALT ratio | 0.72 (at-risk population for F3)[4] | MedCalc |
| NAFLD-MESA[5] | eight predictors: age, sex, race/ethnicity, type 2 diabetes, smoking, BMI, GGT, and triglycerides | 0.83 (general population for steatosis)[5] | |
| NAFLD-Clinical Index[5] (NAFLD-MESA with labs excluded) |
six predictors: age, sex, race/ethnicity, type 2 diabetes, smoking, BMI | 0.78 (general population for steatosis)[5] | |
| FIB-4 Index | four predictors: age, AST, ALT, platelet count | 0.61 (at-risk population for F3)[2] 0.68 (at-risk population for F3)[4] |
MedCalc University of Washington |
| MAF-5 (Metabolic Dysfunction-associated Fibrosis)[2] | fix predictors: waist circumference, BMI, diabetes, AST, and platelet count | 0.81 (at-risk population for F3)[2] | |
| AST-platelet ratio index (APRI) | two predictors: AST and platelet count | MedCalc |
FIB-4 index at MedCalc and https://www.hepatitisc.uw.edu/page/clinical-calculators/fib-4 . For assessing need for biopsy in hepatitis B and hepatitis C.[4]
Metabolic Dysfunction-associated Fibrosis (MAF-5) has been compared to the FIB-4 for predicting fibrosis was defined as liver stiffness = 8.0 kPa.[2] The MAF-5 includes the factors: waist circumference, body mass index (calculated as kg / m2), diabetes, aspartate aminotransferase, and platelets. The MAF-5 had a higher area under the curve (AUC).
NAFLD fibrosis score uses Age, hyperglycemia, body mass index, platelet count, albumin, and AST/ALT ratio.MedCalc[3][4]
The NAFLD-MESA Index Clinical Index[5]
The NAFLD-MESA Index uses "eight predictors: age, sex, race/ethnicity, type 2 diabetes, smoking history, body mass index, gamma-glutamyltransferase (GGT), and triglycerides (TG)"[5] The score predicted NAFLD by liver computed tomography (≤ 40 Hounsfield units indicating > 30% hepatic steatosis) with AUC = 0.80.
The LiverRisk score *https://www.liverriskscore.com/) uses seven predictors (age, glucose, cholesterol, AST , ALT , GGT , platelet count) and may be more accurate than the FIB-4 or aspartate transferase to platelet ratio index (APRI) at predicting liver stiffness measurements with AUC 0.83 [95% CI [0·78–0·89]) versus the FIB-4 Index (95% CI 0.68 [0.61–0.75]. The score predicted 6 kPa or more, 10 kPa or more, and 15 kPa[1]. These kPa thresholds correspond to:
- 6 kPa: no fibrosis
- 10 kPa: between F3 and F4 fibrosis
- 15 kPa: above F4 fibrosis
Fibrotic NASH Index (FNI) which contains the AST, HDL, HbA1c[6].
AST-platelet ratio index (APRI) MedCalc
Imaging
Liver stiffness measurements: "LS of 8 and 12.5 kPa represent generally accepted cut-off values for F3 and F4 fibrosis. LS highly correlates with portal pressure, and esophageal varices are likely at values >20 kPa."[7]
- LS of 8 suggests F3 fibrosis
- LS of 12.5 kPa suggests F4 fibrosis
CT scan: "≤ 40 Hounsfield units indicating > 30% hepatic steatosis"[5].
References
- ↑ 1.0 1.1 Serra-Burriel M, Juanola A, Serra-Burriel F, Thiele M, Graupera I, Pose E; et al. (2023). "Development, validation, and prognostic evaluation of a risk score for long-term liver-related outcomes in the general population: a multicohort study". Lancet. doi:10.1016/S0140-6736(23)01174-1. PMID 37572680 Check
|pmid=value (help). - ↑ 2.0 2.1 2.2 2.3 2.4 van Kleef LA, Francque SM, Prieto-Ortiz JE, Sonneveld MJ, Sanchez-Luque CB, Prieto-Ortiz RG; et al. (2024). "Metabolic Dysfunction-Associated Fibrosis 5 (MAF-5) Score Predicts Liver Fibrosis Risk and Outcome in the General Population With Metabolic Dysfunction". Gastroenterology. doi:10.1053/j.gastro.2024.03.017. PMID 38513745 Check
|pmid=value (help). - ↑ 3.0 3.1 Angulo P, Hui JM, Marchesini G, Bugianesi E, George J, Farrell GC; et al. (2007). "The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD". Hepatology. 45 (4): 846–54. doi:10.1002/hep.21496. PMID 17393509.
- ↑ 4.0 4.1 4.2 4.3 Graupera I, Thiele M, Serra-Burriel M, Caballeria L, Roulot D, Wong GL; et al. (2022). "Low Accuracy of FIB-4 and NAFLD Fibrosis Scores for Screening for Liver Fibrosis in the Population". Clin Gastroenterol Hepatol. 20 (11): 2567–2576.e6. doi:10.1016/j.cgh.2021.12.034. PMID 34971806 Check
|pmid=value (help). - ↑ 5.0 5.1 5.2 5.3 5.4 5.5 5.6 Rodriguez LA, Shiboski SC, Bradshaw PT, Fernandez A, Herrington D, Ding J; et al. (2021). "Predicting Non-Alcoholic Fatty Liver Disease for Adults Using Practical Clinical Measures: Evidence from the Multi-ethnic Study of Atherosclerosis". J Gen Intern Med. 36 (9): 2648–2655. doi:10.1007/s11606-020-06426-5. PMC 8390627 Check
|pmc=value (help). PMID 33501527 Check|pmid=value (help). - ↑ Tavaglione F, Jamialahmadi O, De Vincentis A, Qadri S, Mowlaei ME, Mancina RM; et al. (2023). "Development and Validation of a Score for Fibrotic Nonalcoholic Steatohepatitis". Clin Gastroenterol Hepatol. 21 (6): 1523–1532.e1. doi:10.1016/j.cgh.2022.03.044. PMID 35421583 Check
|pmid=value (help). - ↑ Mueller S, Sandrin L (2010). "Liver stiffness: a novel parameter for the diagnosis of liver disease". Hepat Med. 2: 49–67. doi:10.2147/hmer.s7394. PMC 3846375. PMID 24367208.