オノ　マサフミ   Ono Masafumi   小野　正文    所属   医学部 医学科（附属足立医療センター）    職種   非常勤講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Noninvasive scoring systems in patients with nonalcoholic fatty liver disease with normal alanine aminotransferase levels.
掲載誌名	正式名：Journal of gastroenterology 略　 称：J Gastroenterol ISSNコード：14355922/09441174
掲載区分	国外
巻・号・頁	48(9),pp.1051-60
著者・共著者	Yoneda Masato, Imajo Kento, Eguchi Yuichiro, Fujii Hideki, Sumida Yoshio, Hyogo Hideyuki, Ono Masafumi, Suzuki Yasuaki, Kawaguchi Takumi, Aoki Noriaki, Sata Michio, Kanemasa Kazuyuki, Kohgo Yutaka, Saibara Toshiji, Chayama Kazuaki, Itoh Yoshito, Yoshikawa Toshikazu, Anzai Keizo, Fujimoto Kazuma, Okanoue Takeshi, Nakajima Atsushi,
発行年月	2013/09
概要	BACKGROUND:The severity of liver fibrosis must be estimated to determine the prognosis, for surveillance, and for optimal treatment of nonalcoholic fatty liver disease (NAFLD). However, the severity of hepatic fibrosis tends to be underestimated in patients with normal ALT.METHODS:We investigated histological data and scoring systems (FIB-4 index, NAFLD fibrosis score, BARD score, and AST/ALT ratio) of 1,102 liver-biopsy-confirmed NAFLD patients.RESULTS:A total of 235 NAFLD patients with normal ALT were estimated to exist. The ratio of advanced fibrosis (stage 3-4) was seen in 16.1 % of subjects with normal ALT. Scoring systems, especially the FIB-4 index and NAFLD fibrosis score, were clinically very useful (AUROC >0.8), even in patients with normal ALT. Furthermore, with resetting of the cutoff values, the FIB-4 index (>1.659) and NAFLD fibrosis score (>0.735) were found to have a higher sensitivity and higher specificity for the prediction of advanced fibrosis, and all of these scoring systems (FIB-4 index, NAFLD fibrosis score, BARD score, and AST/ALT ratio) had higher negative predictive values (>90.3 %). By using the resetting cutoff value, liver biopsy could have been avoided in 60.4 % (FIB-4), 66.4 % (NAFLD fibrosis score), 51.9 % (BARD score), and 62.1 % (AST/ALT ratio).CONCLUSIONS:We reset the cutoff values of numerous non-invasive scoring systems to improve their clinical usefulness in the prediction of liver fibrosis in NAFLD patients with normal ALT, and these non-invasive scoring systems with the reset cutoff values could be of substantial benefit to reduce the number of liver biopsies performed.
DOI	10.1007/s00535-012-0704-y
PMID	23184095