The Appropriate Opportunity for Evaluating Liver Fibrosis by Using the FIB-4 Index in Patients with Nonalcoholic Fatty Liver Disease in Japan
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Laboratory and Clinical Parameters
2.3. Liver Histology
2.4. DNA Preparation and SNP Genotyping
2.5. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Correlation between Histological Change and Change in FIB-4 Index
3.3. Changes in the FIB-4 Index During the Follow-Up Period and Accuracy for Advanced Fibrosis
3.4. Factors Associated with a FIB-4 Index >2.67 at 5 Years
4. Discussion
Author Contributions
Funding
Conflicts of Interest
References
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Variable n = 272 | Baseline | 1 Year | 5 Years | p (Baseline and 5 Years) |
---|---|---|---|---|
Sex, male | 122 (44.9%) | |||
Age, years | 60 (21–83) | |||
PNPLA3, CC/CG/GG | 35/93/87 | |||
Hyperlipidemia | 184 (67.6%) | |||
T2DM | 137 (50.4%) | |||
Hypertension | 112 (41.2%) | |||
BMI, kg/m2 | 26.9 (18.9–43.0) | 26.5 (17.2–43.0) | 26.4 (17.4–46.2) | <0.001 |
Albumin, g/dL | 4.4 (3.1–5.3) | 4.4 (3.0–5.6) | 4.3 (2.5–5.6) | 0.013 |
AST, IU/L | 44 (12–217) | 32 (14–166) | 31 (11–158) | <0.001 |
ALT, IU/L | 62 (7–266) | 38 (4–278) | 34 (3–180) | <0.001 |
GGT, IU/L | 61 (14–533) | 47 (15–415) | 39 (8–405) | <0.001 |
Platelet count, ×103/μL | 213 (46–454) | 217 (46–393) | 207 (25–433) | 0.089 |
Total cholesterol, mg/dL | 202 (66–350) | 202 (74–334) | 198 (87–301) | 0.061 |
Triglycerides, mg/dL | 146 (18–739) | 140 (32–692) | 132 (37–593) | 0.179 |
LDL-C, mg/dL | 124 (44–301) | 120 (48–286) | 118 (38–232) | 0.007 |
HDL-C, mg/dL | 54 (21-151) | 54 (23–138) | 54 (23–134) | 0.490 |
FPG, mg/dL | 102 (60–420) | 106 (68–258) | 111 (62–279) | <0.001 |
FIB-4 index | 1.64 (0.31–9.84) | 1.45 (0.32–11.73) | 1.74 (0.31–15.86) | 0.099 |
Type IV collagen 7s, ng/mL | 4.6 (2.6–11.0) | 4.8 (2.8–17.0) | 4.8 (1.6–17.0) | 0.557 |
Fibrosis stage (0/1/2/3/4) | 83/99/44/30/16 |
Variable n = 52 | At Initial Biopsy | At Second Biopsy | p |
---|---|---|---|
Sex, male | 22 (42.3%) | ||
Age, years | 68 (21–83) | ||
Hyperlipidemia | 33 (63.5%) | ||
T2DM | 26 (50.0%) | ||
Hypertension | 24 (46.2%) | ||
BMI, kg/m2 | 26.4 (18.9––43.0) | 26.6 (19.0–49.5) | 0.486 |
Albumin, g/dL | 4.3 (3.2–4.9) | 4.1 (3.4–5.1) | 0.001 |
AST, IU/L | 57 (22–186) | 38 (15–211) | <0.001 |
ALT, IU/L | 83 (20–358) | 46 (7–251) | <0.001 |
GGT, IU/L | 73 (22–306) | 45 (8–316) | 0.009 |
Platelet count, ×103/μL | 207 (105–417) | 195 (93–403) | 0.040 |
Total cholesterol, mg/dL | 201 (117–292) | 191 (93–436) | 0.203 |
Triglycerides, mg/dL | 153 (71–559) | 130 (60–351) | 0.022 |
LDL-C, mg/dL | 104 (43–225) | 124 (43–209) | 0.035 |
HDL-C, mg/dL | 50 (22–85) | 51 (28–95) | 0.748 |
FPG, mg/dL | 94 (60–260) | 96 (65–182) | 0.664 |
FIB-4 index | 2.12 (0.31–9.04) | 2.20 (0.26–3.14) | 0.973 |
Type IV collagen 7s, ng/mL | 5.3 (2.7–13.0) | 4.4 (2.6–9.5) | 0.002 |
Fibrosis stage (0/1/2/3/4) | 0/24/14/14/0 | 2/18/21/8/3 |
Stage at Second Biopsy | ||||||
---|---|---|---|---|---|---|
0 | 1 | 2 | 3 | 4 | Total | |
Stage at initial biopsy | ||||||
1 | 2 | 13 | 7 | 2 | 0 | 24 |
2 | 0 | 4 | 8 | 1 | 1 | 14 |
3 | 0 | 1 | 6 | 5 | 2 | 14 |
Total | 2 | 18 | 21 | 8 | 3 | 52 |
(a) | |||||
Baseline | 1 Year | ||||
Stage 3,4 | Stage 0–2 | Stage 3,4 | Stage 0–2 | ||
<1.30 | 8 | 75 | 11 | 100 | |
≧1.30 | 38 | 151 | 35 | 126 | |
≦2.67 | 17 | 147 | 26 | 186 | |
>2.67 | 29 | 79 | 20 | 40 | |
(b) | |||||
Sensitivity | Specificity | PPV | NPV | ||
Baseline | Low cut-off | 82.6 | 33.2 | 20.1 | 90.4 |
High cut-off | 63.0 | 65.0 | 26.9 | 89.6 | |
1 year | Low cut-off | 76.9 | 44.2 | 21.7 | 90.1 |
High cut-off | 43.4 | 82.3 | 33.3 | 87.7 |
Variable | Category | p Value | OR (95% CI) a | p Value |
---|---|---|---|---|
Age, year | Per 1 year | 1.05 (0.99–1.11) | 0.086 | |
BMI, kg/m2 | Per 1 kg/m2 | 0.97 (0.86–1.11) | 0.679 | |
Sex | 1: male | 0.002 | 0.34 (0.11–1.05) | 0.060 |
2: female | ||||
T2DM | 1: no | 0.089 | 0.86 (0.31–2.36) | 0.765 |
2: yes | ||||
PNPLA3 | 1: CC | 1 | ||
2: CG | 0.088 | 1.89 (0.31–11.41) | 0.490 | |
3: GG | 0.040 | 4.50 (0.74–27.32) | 0.102 | |
FIB-4 index at baseline | 1: −2.67 | <0.01 | 2.61 (0.88–7.69) | 0.082 |
2: >2.67 | ||||
FIB-4 index at 1 year | 1: −2.67 | <0.01 | 41.65 (13.11–132.33) | <0.01 |
2: >2.67 |
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Seko, Y.; Yano, K.; Takahashi, A.; Okishio, S.; Kataoka, S.; Okuda, K.; Umemura, A.; Yamaguchi, K.; Moriguchi, M.; Tanaka, S.; et al. The Appropriate Opportunity for Evaluating Liver Fibrosis by Using the FIB-4 Index in Patients with Nonalcoholic Fatty Liver Disease in Japan. Diagnostics 2020, 10, 842. https://doi.org/10.3390/diagnostics10100842
Seko Y, Yano K, Takahashi A, Okishio S, Kataoka S, Okuda K, Umemura A, Yamaguchi K, Moriguchi M, Tanaka S, et al. The Appropriate Opportunity for Evaluating Liver Fibrosis by Using the FIB-4 Index in Patients with Nonalcoholic Fatty Liver Disease in Japan. Diagnostics. 2020; 10(10):842. https://doi.org/10.3390/diagnostics10100842
Chicago/Turabian StyleSeko, Yuya, Kota Yano, Aya Takahashi, Shinya Okishio, Seita Kataoka, Keiichiroh Okuda, Atsushi Umemura, Kanji Yamaguchi, Michihisa Moriguchi, Saiyu Tanaka, and et al. 2020. "The Appropriate Opportunity for Evaluating Liver Fibrosis by Using the FIB-4 Index in Patients with Nonalcoholic Fatty Liver Disease in Japan" Diagnostics 10, no. 10: 842. https://doi.org/10.3390/diagnostics10100842