Comparison of non-invasive fibrosis scores to predict increased liver stiffness in the general population with unknown liver disease: Searching for the primary physician's best friend

Pablo Coste, Elba Llop, Cristie Perelló, Marta Hernández, Marta López, Javier Abad, Carlos Ferre, José Luis Martínez, Natalia Fernández, José Luis Calleja

Producció científica: Article en revista indexadaArticleAvaluat per experts

3 Cites (Scopus)

Resum

Background: Serum-based scores (SBS) appear to be a high applicability strategy for assessment of liver fibrosis in primary care. Aim of the study was to evaluate their performance to detect ≥F2 in a general population and to design a highly-applicable strategy for screening. Methods: prospective population-based cohort study in randomly identified subjects, aged 40–70y. Medical history, blood tests and elastography were obtained, ≥F2 was determined by using LSM cutoff ≥9.2/7.8 kPa for M/XL probe and SBS diagnostic accuracies were evaluated. Results: 986 patients were analyzed. LSM prevalence estimate suggestive of ≥F2 was 1.9% and Metabolic Sindrome (MS) (OR 3.4, 1.3–9.0;p = 0.01), was the only factor independently associated with ≥F2, with increasing prevalence according to the number of criteria (0 criterion:0%,1:0.3%,2:2.8%,3:2.4%,4:6.9%,5:14.3%;p<0.001). FLI and NFS were the two best-performing tests in the cross-sectional study, with AUROCs for ≥F2 of 0.89 (95%CI,0.84- 0.95) and 0.82 (95%CI,0.74–0.90), respectively. Predefined cutoff for FLI≥60 (Sn89.5%, Sp72.1%, NPV99.9%) and NFS≥-1.455 (Sn83.3%, Sp68%, NPV99.6%) showed adequate diagnostic accuracy. Based on these findings, a 3- step algorithm strategy to detect liver fibrosis in the community setting is proposed (Sn84.2%, Sp75.2%, NVP99.6%). Conclusions: A staged risk-stratification model improves the detection of ≥F2 in the community setting, while reducing unnecessary referrals.

Idioma originalAnglès
Pàgines (de-a)1209-1214
Nombre de pàgines6
RevistaDigestive and Liver Disease
Volum54
Número9
DOIs
Estat de la publicacióPublicada - de set. 2022
Publicat externament

Fingerprint

Navegar pels temes de recerca de 'Comparison of non-invasive fibrosis scores to predict increased liver stiffness in the general population with unknown liver disease: Searching for the primary physician's best friend'. Junts formen un fingerprint únic.

Com citar-ho