1
|
Mu Y, Peng C, Chang H, Wang S, Zuo X. Prognostic value of liver stiffness in metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2024. [PMID: 38685902 DOI: 10.17235/reed.2024.10353/2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
BACKGROUND AND AIMS Liver stiffness measurement, assessed by vibration-controlled transient elastography, has been recognized as a powerful tool for liver fibrosis assessment. The potential of liver stiffness measurement to predict clinically relevant outcomes in fatty liver disease has received considerable attention. This study aimed to investigate the prediction of liver-related events in metabolic dysfunction-associated steatotic liver disease patients by liver stiffness measurement value on transient elastography. METHODS We systematically searched the Electronic databases including PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov until 6 September 2023. The hazard ratios adjusted for confounders were extracted and pooled by random-effects model analysis. RESULTS A total of 20587 individuals from 7 studies were included. The pooled HRs were 18.65 (95% CI 9.95-34.95, P < 0.01, I2 = 0%) in the stratification analysis of the highest versus lowest liver stiffness measurement categories. In 1-kPa analysis, the risk of liver-related events was increased with 1 kPa increment (HR 1.05, 95% CI 1.03-1.07, P < 0.01, I2 = 74.47%). CONCLUSIONS Metabolic dysfunction-associated steatotic liver disease patients with high liver stiffness measurement values were at an increased risk of liver-related events. Liver stiffness measurement can be used as a prognostic tool to achieve risk stratification in fatty liver patients.
Collapse
Affiliation(s)
- Yijun Mu
- Gastroenterology, Qilu Hospital of Shandong University, china
| | - Cheng Peng
- Gastroenterology, Qilu Hospital of Shandong University, china
| | - Huijun Chang
- Gastroenterology, Qilu Hospital of Shandong University, china
| | - Shaotong Wang
- Gastroenterology, Qilu Hospital of Shandong University, china
| | - Xiuli Zuo
- Gastroenterology, Qilu Hospital of Shandong University, china
| |
Collapse
|
2
|
Biswas S, Shalimar. Editorial: The tip of the non-alcoholic fatty liver disease iceberg-the more we know, the smaller it gets? JGH Open 2023; 7:671-673. [PMID: 37908289 PMCID: PMC10615171 DOI: 10.1002/jgh3.12996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 10/25/2023] [Indexed: 11/02/2023]
Affiliation(s)
- Sagnik Biswas
- Department of Gastroenterology and Human Nutrition All India Institute of Medical Sciences New Delhi India
| | - Shalimar
- Department of Gastroenterology and Human Nutrition All India Institute of Medical Sciences New Delhi India
| |
Collapse
|
3
|
Anand A, Shalimar, Arora U, Asadullah M, Shivashankar R, Biswas S, Vaishnav M, Aggarwal A, Kandasamy D, Kondal D, Rautela G, Peerzada A, Grover B, Amarchand R, Nayak B, Sharma R, Ramakrishnan L, Prabhakaran D, Krishnan A, Tandon N. ABDA Score: A Non-invasive Model to Identify Subjects with Fibrotic Non-alcoholic Steatohepatitis in the Community. J Clin Exp Hepatol 2023; 13:742-752. [PMID: 37693275 PMCID: PMC10482999 DOI: 10.1016/j.jceh.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/22/2023] [Indexed: 09/12/2023] Open
Abstract
Background Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis (NASH) are prevalent in the community, especially among those with metabolic syndrome. Patients with fibrotic NASH are at increased risk of liver-related-events. Currently available non-invasive tests have not been utilized for screening for fibrotic NASH among the community. We aimed to develop a screening tool for fibrotic NASH among community members. Methods We included two large cohorts aimed at assessing cardiovascular disease among community members. Fibrotic NASH was defined using the FibroScan-aspartate aminotransferase score of ≥0.67 that identifies ≥F2 fibrosis and a non-alcoholic fatty liver disease activity score ≥4 with a specificity of 90%. Metabolic parameters, biochemical tests and anthropometry were used to develop a multivariate model. Results The derivation cohort (n = 1660) included a population with a median age 45 years, 42.5% males, metabolic syndrome in 66% and 2.7% (n = 45) with fibrotic NASH. Multivariate analysis identified the four significant variables (Age, body mass index , Diabetes and alanine aminotransferas levels) used to derive an ABDA score. The score had high diagnostic accuracy (the area under receiver-operating characteristic curve, 0.952) with adequate internal validity. An ABDA score ≥-3.52 identified fibrotic NASH in the derivation cohort with a sensitivity and specificity of 88.9% and 88.3%. The score was validated in a second cohort (n = 357) that included 21 patients (5.9%) with fibrotic NASH, where it demonstrated a high area under receiver-operating characteristic curve (0.948), sensitivity (81%) and specificity (89.3%). Conclusions ABDA score utilizes four easily available parameters to identify fibrotic NASH with high accuracy in the community.
Collapse
Affiliation(s)
- Abhinav Anand
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
| | - Shalimar
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
| | - Umang Arora
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
| | - Md Asadullah
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Roopa Shivashankar
- Division of Non-communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Sagnik Biswas
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
| | - Manas Vaishnav
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
| | - Arnav Aggarwal
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
| | | | - Dimple Kondal
- Public Health Foundation of India, Gurgaon, Haryana, India
| | | | - Ariba Peerzada
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Bhanvi Grover
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Ritvik Amarchand
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Baibaswata Nayak
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
| | - Raju Sharma
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Lakshmy Ramakrishnan
- Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | | | - Anand Krishnan
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
4
|
Singh SP, Anirvan P. NAFLD in Indians: A Myopic Yet Alarming Perspective. J Clin Exp Hepatol 2023; 13:7-9. [PMID: 36647401 PMCID: PMC9840069 DOI: 10.1016/j.jceh.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 11/30/2022] [Indexed: 01/18/2023] Open
Key Words
- CC, compensated cirrhosis
- DC, decompensated cirrhosis
- ESLD, end stage liver disease
- GI, Gastro-Intestinal
- HCC, hepatocellular carcinoma
- HE, hepatic encephalopathy
- LRE, liver-related events
- NAFL, non-alcoholic fatty liver
- NAFLD, non-alcoholic fatty liver disease
- NASH, non-alcoholic steatohepatitis
- NC, non-cirrhosis
Collapse
Affiliation(s)
- Shivaram P. Singh
- Kalinga Gastroenterology Foundation, Bajrakabati Road, Cuttack, 753007, India
| | - Prajna Anirvan
- Kalinga Gastroenterology Foundation, Bajrakabati Road, Cuttack, 753007, India
| |
Collapse
|