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ID 33886
本文ファイル
著者
Sumida, Yoshio
Yoneda, Masato
Itoh, Yoshito
Ono, Masafumi
Fujii, Hideki
Eguchi, Yuichiro
Suzuki, Yasuaki
Aoki, Noriaki
Kanemasa, Kazuyuki
Fujita, Koji
Saibara, Toshiji
Kawada, Norifumi
Fujimoto, Kazuma
Kohgo, Yutaka
Yoshikawa, Toshikazu
Okanoue, Takeshi
Japan Study Group of Nonalcoholic Fatty Liver Disease (JSG-NAFLD)
NDC
医学
抄録(英)
Background: A reliable and inexpensive noninvasive marker of hepatic fibrosis is required in patients with nonalcoholic fatty liver disease (NAFLD). FIB4 index (based on age, aspartate aminotransferase [AST] and alanine aminotransferase [ALT] levels, and platelet counts) is expected to be useful for evaluating hepatic fibrosis. We validated the performance of FIB4 index in a Japanese cohort with NAFLD.

Methods: The areas under the receiver operating characteristic curves (AUROC) for FIB4 and six other markers were compared, based on data from 576 biopsy-proven NAFLD patients. Advanced fibrosis was defined as stage 3-4 fibrosis. FIB4 index was assessed as: age (yr) × AST (IU/L)/(platelet count (109/L) × √ALT (IU/L))

Results: Advanced fibrosis was found in 64 (11%) patients. The AUROC for FIB4 index was superior to those for the other scoring systems for differentiating between advanced and mild fibrosis. Only 6 of 308 patients with a FIB4 index below the proposed low cut-off point (< 1.45) were under-staged, giving a high negative predictive value of 98%. Twenty-eight of 59 patients with a FIB4 index above the high cut-off point (> 3.25) were over-staged, giving a low positive predictive value of 53%. Using these cutoffs, 91% of the 395 patients with FIB-4 values outside 1.45-3.25 would be correctly classified. Implementation of the FIB4 index in the Japanese population would avoid 58% of liver biopsies.

Conclusion: The FIB4 index was superior to other tested noninvasive markers of fibrosis in Japanese patients with NAFLD, with a high negative predictive value for excluding advanced fibrosis. The small number of cases of advanced fibrosis in this cohort meant that this study had limited power for validating the high cut-off point.
掲載誌名
BMC Gastroenterology
12巻
2号
出版年月日
2012
出版者
BioMed Central Ltd.
ISSN
1471-230X
NCID
出版者DOI
言語
英語
NII資源タイプ
学術雑誌論文
広大資料タイプ
学術雑誌論文
DCMIタイプ
text
フォーマット
application/pdf
著者版フラグ
publisher
権利情報
(c) 2012 Sumida et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
関連情報URL
部局名
医歯薬学総合研究科