Non-invasive markers of liver fibrosis in fatty liver disease are unreliable in people of South Asian descent.
Non-invasive markers of liver fibrosis in fatty liver disease are unreliable in people of South Asian descent.
复制标题
DOI：
10.1136/flgastro-2017-100865
复制
发表时间：
2018-04
影响因子：
2.6
通讯作者：
Alazawi W
中科院分区：
文献类型：
--
作者：
De Silva S;Li W;Kemos P;Brindley JH;Mecci J;Samsuddin S;Chin-Aleong J;Feakins RM;Foster GR;Syn WK;Alazawi W
肝活检是确定非酒精性脂肪性肝病（NAFLD）损伤阶段和级别的最准确方法。鉴于活检的风险和局限性，使用非侵入性测试，如NAFLD纤维化评分，天冬氨酸转氨酶（AST）与血小板比率指数，Fib-4，AST/丙氨酸转氨酶比率和BARD。NAFLD和代谢综合征的患病率和严重程度因种族而异，但测试主要在白色人群中进行。我们验证了我们的假设，即与白色患者相比，南亚患者中包括代谢参数的非侵入性检测的准确性较低。回顾性横断面。专科肝脏中心。组织学证实的NAFLD患者。使用1周内采集的临床数据计算评分，并与组织学（Kleiner）进行比较。诊断测试特征。175名患者被确诊。与白色患者（n =79）相比，南亚人（n=90）更年轻，体重指数更低，肥胖比例更低，糖尿病和肝损伤的发生率相似。与白色患者相比，检测南亚患者晚期纤维化的敏感性较低。与南亚人相比，白色患者正确诊断的相对风险为1.86（95% CI 1.4至2.6）。在二元逻辑回归模型中，种族和血小板计数预测准确性。瞬态弹性成像在两个种族中具有同样的高度准确性。基于血液检测的非侵入性评分在南亚患者中不太准确，无论代谢参数如何。在设计NAFLD风险分层算法时应考虑种族。
Liver biopsy is the most accurate method for determining stage and grade of injury in non-alcoholic fatty liver disease (NAFLD). Given risks and limitations of biopsy, non-invasive tests such as NAFLD fibrosis score, aspartate transaminase (AST) to platelet ratio index, Fib-4, AST/alanine transaminase ratio and BARD are used. Prevalence and severity of NAFLD and metabolic syndrome vary by ethnicity, yet tests have been developed in largely white populations. We tested our hypothesis that non-invasive tests that include metabolic parameters are less accurate in South Asian compared with white patients. Retrospective cross-sectional. Specialist liver centre. Patients with histologically confirmed NAFLD. Scores calculated using clinical data taken within 1 week and compared with histology (Kleiner). Diagnostic test characteristics. 175 patients were identified. South Asians (n=90) were younger, had lower body mass index and lower proportion of obesity compared with white patients (n=79), with comparable rates of diabetes and liver injury. Tests are less sensitive at detecting advanced fibrosis in South Asian compared with white patients. Relative risk of correct diagnosis in white patients compared with South Asians is 1.86 (95% CI 1.4 to 2.6). In binary logistic regression models, ethnicity and platelet count predicted accuracy. Transient elastography was equally and highly accurate in both ethnicities. Blood test-based non-invasive scores are less accurate in South Asian patients, irrespective of metabolic parameters. Ethnicity should be considered when devising risk-stratification algorithms for NAFLD.
登录
查看更多内容
影响因子：
13.5
作者：
Loomba, Rohit;Wolfson, Tanya;Ang, Brandon;Hooker, Jonathan;Behling, Cynthia;Peterson, Michael;Valasek, Mark;Lin, Grace;Brenner, David;Gamst, Anthony;Ehman, Richard;Sirlin, Claude
通讯作者：
Sirlin, Claude
DOI：
10.1186/1476-5926-3-8
发表时间：
2004-09-23
期刊：
Comparative hepatology
影响因子：
--
作者：
Poynard T;Imbert-Bismut F;Munteanu M;Messous D;Myers RP;Thabut D;Ratziu V;Mercadier A;Benhamou Y;Hainque B
通讯作者：
Hainque B
影响因子：
13.5
作者：
Browning, JD;Szczepaniak, LS;Hobbs, HH
通讯作者：
Hobbs, HH
DOI：
10.3399/bjgp14x682273
发表时间：
2014-11
期刊：
The British journal of general practice : the journal of the Royal College of General Practitioners
影响因子：
--
作者：
Alazawi W;Mathur R;Abeysekera K;Hull S;Boomla K;Robson J;Foster GR
通讯作者：
Foster GR
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