トクシゲ　カツトシ   TOKUSHIGE Katsutoshi   徳重　克年    所属   医学部 医学科（東京女子医科大学病院）    職種   客員教授
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	FIB-4 First in the Diagnostic Algorithm of Metabolic-Dysfunction-Associated Fatty Liver Disease in the Era of the Global Metabodemic.
掲載誌名	正式名：Life 略　 称：Life (Basel) ISSNコード：20751729/20751729
掲載区分	国外
巻・号・頁	11(2),pp.143
著者・共著者	Sumida Yoshio, Yoneda Masashi, Tokushige Katsutoshi, Kawanaka Miwa, Fujii Hideki, Yoneda Masato, Imajo Kento, Takahashi Hirokazu, Eguchi Yuichiro, Ono Masafumi, Nozaki Yuichi, Hyogo Hideyuki, Koseki Masahiro, Yoshida Yuichi, Kawaguchi Takumi, Kamada Yoshihiro, Okanoue Takeshi, Nakajima Atsushi, Japan Study Group Of Nafld Jsg-Nafld
発行年月	2021/02
概要	The prevalence of obesity or metabolic syndrome is increasing worldwide (globally metabodemic). Approximately 25% of the adult general population is suffering from nonalcoholic fatty liver disease (NAFLD), which has become a serious health problem. In 2020, global experts suggested that the nomenclature of NAFLD should be updated to metabolic-dysfunction-associated fatty liver disease (MAFLD). Hepatic fibrosis is the most significant determinant of all cause- and liver -related mortality in MAFLD. The non-invasive test (NIT) is urgently required to evaluate hepatic fibrosis in MAFLD. The fibrosis-4 (FIB-4) index is the first triaging tool for excluding advanced fibrosis because of its accuracy, simplicity, and cheapness, especially for general physicians or endocrinologists, although the FIB-4 index has several drawbacks. Accumulating evidence has suggested that vibration-controlled transient elastography (VCTE) and the enhanced liver fibrosis (ELF) test may become useful as the second step after triaging by the FIB-4 index. The leading cause of mortality in MAFLD is cardiovascular disease (CVD), extrahepatic malignancy, and liver-related diseases. MAFLD often complicates chronic kidney disease (CKD), resulting in increased simultaneous liver kidney transplantation. The FIB-4 index could be a predictor of not only liver-related mortality and incident hepatocellular carcinoma, but also prevalent and incident CKD, CVD, and extrahepatic malignancy. Although NITs as milestones for evaluating treatment efficacy have never been established, the FIB-4 index is expected to reflect histological hepatic fibrosis after treatment in several longitudinal studies. We here review the role of the FIB-4 index in the management of MAFLD.
DOI	10.3390/life11020143
PMID	33672864