A Model Incorporating Serum Alkaline Phosphatase for Prediction of Liver Fibrosis in Adults with Obesity and Nonalcoholic Fatty Liver Disease.
A Model Incorporating Serum Alkaline Phosphatase for Prediction of Liver Fibrosis in Adults with Obesity and Nonalcoholic Fatty Liver Disease.
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DOI：
10.3390/jcm10153311
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发表时间：
2021-07-27
影响因子：
3.9
通讯作者：
Ibdah JA
中科院分区：
文献类型：
--
作者：
Ali AH;Petroski GF;Diaz-Arias AA;Al Juboori A;Wheeler AA;Ganga RR;Pitt JB;Spencer NM;Hammoud GM;Rector RS;Parks EJ;Ibdah JA
我们通过组织学评估了接受代谢手术的肥胖患者血清碱性磷酸酶（ALP）与肝纤维化之间的关系，以及其他非侵入性参数。预定进行选择性减肥手术的患者被前瞻性地从减肥诊所招募。术中进行肝活检，并由不了解患者资料的病理学家评估肝脏组织学。终点为显著纤维化，定义为纤维化期≥2。通过逻辑回归确定纤维化的独立预测因素。招募了210名患者。肝脏组织学显示脂肪变性占87.1%，脂肪性肝炎占21.9%，显著纤维化占10%。显著纤维化的独立预测因子为ALP(优势比（OR） 1.03；95%置信区间（CI）， 1.01-1.05)，丙氨酸转氨酶（OR 1.02; 95% CI, 1.01-1.03），糖化血红蛋白（OR 1.58; 95% CI, 1.20-2.09）和体重指数（OR 1.06; 95% CI, 1.00-1.13）。建立基于树的模型预测显著纤维化，受试者工作特征（ROC）面积为0.845，敏感性为0.857，特异性为0.836，准确性为0.931。在肥胖手术患者中，应考虑血清ALP作为肝纤维化的独立生物标志物的适用性，并在更广泛的肥胖非酒精性脂肪性肝病患者中考虑。
We assessed the relationship between serum alkaline phosphatase (ALP) and liver fibrosis by histology, in addition to other noninvasive parameters, in obese patients undergoing metabolic surgery. Patients scheduled for elective bariatric surgery were prospectively recruited from a bariatric clinic. An intraoperative liver biopsy was performed, and liver histology was evaluated by a pathologist blinded to the patients’ data. The endpoint was significant fibrosis defined as fibrosis stage ≥ 2. Independent predictors of fibrosis were identified by logistic regression. Two hundred ten patients were recruited. Liver histology revealed steatosis in 87.1%, steatohepatitis in 21.9%, and significant fibrosis in 10%. Independent predictors of significant fibrosis were ALP (Odds Ratio (OR) 1.03; 95% Confidence interval (CI), 1.01–1.05), alanine aminotransferase (OR 1.02; 95% CI, 1.01–1.03), HbA1c (OR 1.58; 95% CI, 1.20–2.09), and body mass index (OR 1.06; 95% CI, 1.00–1.13). A tree-based model was developed to predict significant fibrosis, with a receiver operating characteristic (ROC) area of 0.845, sensitivity of 0.857, specificity of 0.836, and accuracy of 0.931. The applicability of serum ALP as an independent biomarker of liver fibrosis should be considered in obesity surgery patients, and in the broader context of obese patients with nonalcoholic fatty liver disease.
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影响因子：
9.8
作者：
Gholam, Pierre M.;Flancbaum, Louis;Kotler, Donald P.
通讯作者：
Kotler, Donald P.
影响因子：
9
作者：
Mattar, SG;Velcu, LM;Schauer, PR
通讯作者：
Schauer, PR
影响因子：
25.7
作者：
Machado, Mariana;Marques-Vidal, Pedro;Cortez-Pinto, Helena
通讯作者：
Cortez-Pinto, Helena
影响因子：
29.4
作者：
Angulo P;Kleiner DE;Dam-Larsen S;Adams LA;Bjornsson ES;Charatcharoenwitthaya P;Mills PR;Keach JC;Lafferty HD;Stahler A;Haflidadottir S;Bendtsen F
通讯作者：
Bendtsen F
影响因子：
3.3
作者：
Ozarda Y
通讯作者：
Ozarda Y