ONO Masafumi
   Department   School of Medicine(Tokyo Women's Medical University Adachi Medical Center), School of Medicine
Article types Original article
Language English
Peer review Peer reviewed
Title New scoring system combining the FIB-4 index and cytokeratin-18 fragments for predicting steatohepatitis and liver fibrosis in patients with nonalcoholic fatty liver disease.
Journal Formal name:Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals
ISSN code:13665804/1354750X
Domestic / ForeginForegin
Volume, Issue, Page 23(4),pp.328-334
Author and coauthor Tada Toshifumi, Kumada Takashi, Toyoda Hidenori, Saibara Toshiji, Ono Masafumi, Kage Masayoshi
Publication date 2018/05
Summary PURPOSE:To establish a new scoring system as a noninvasive tool for predicting steatohepatitis and liver fibrosis in patients with nonalcoholic fatty liver disease (NAFLD).METHODS:A total of 170 patients histologically diagnosed with nonalcoholic steatohepatitis (NASH) (n = 130) or nonalcoholic fatty liver (NAFL) (n = 40) were enrolled. We analyzed receiver operating characteristic (ROC) curves and performed multivariate analysis to predict steatohepatitis and liver fibrosis.RESULTS:Multivariate analysis showed that cytokeratin-18 fragment (CK18-F) levels (≥278 U/L) (odds ratio [OR], 4.46; 95% confidence interval [CI], 1.42-14.00; p = 0.010) and the FIB-4 index (≥1.46) (OR, 4.54; 95% CI, 1.93-29.50; p = 0.004) were independently associated with prediction of NASH. We then established a new scoring system (named the FIC-22 score) for predicting NASH using CK18-F levels and FIB-4 index. The areas under the ROC curve (AUROCs) of the FIC-22 score and NAFIC score were 0.82 (95% CI, 0.75-0.89) and 0.71 (95% CI, 0.62-0.78) (p = 0.044). Additionally, the AUROC of the FIC-22 score for predicting the presence of fibrosis (F ≥ 1) was 0.78 (95% CI, 0.70-0.85).CONCLUSIONS:In patients with NAFLD, the FIC-22 score had high predictive accuracy not only for steatohepatitis but also for the presence of liver fibrosis.
DOI 10.1080/1354750X.2018.1425915
PMID 29308929