한빛사논문
- 조회243
을지대학교 의과대학
Joo Hyun Oh 1,#, Sang Bong Ahn 1,#, Seon Cho 2, Eun-Hee Nah 2, Eileen L. Yoon 3,4 †, Dae Won Jun 3,4 †
1Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University College of Medicine, Seoul
2Department of Laboratory Medicine, Health Promotion Research Institute, Seoul, Korea
3Hanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, Korea
4Department of Internal Medicine, Hanyang University, College of Medicine, Seoul
#Joo Hyun Oh and Sang Bong Ahn contributed equally to this work as co-first authors.
†Dae Won Jun and Eileen L. Yoon contributed equally to this work as co-corresponding authors.
Abstract
Background and aims: Noninvasive tests (NITs) for liver fibrosis have been recognized for their clinical utility in metabolic dysfunction-associated steatotic liver disease (MASLD). However, their diagnostic efficacy in detecting liver fibrosis is notably reduced in patients with alcohol-related liver disease. Therefore, ascertaining the reliability of NITs in patients with MASLD with increased alcohol intake (MetALD) is essential.
Methods: In this cross-sectional study, we reviewed data from 7,918 health check-up participants who underwent both magnetic resonance elastography (MRE) and ultrasound for the diagnosis of hepatic steatosis. The participants were categorized into MASLD and MetALD groups, and the performance of fibrosis-4 (FIB-4) and NAFLD fibrosis score (NFS) were assessed. Advanced hepatic fibrosis (F3) was defined as MRE ≥ 3.6 kPa.
Results: The prevalence of MetALD was 5.8% in this health check-up cohort, and 1.5% of these patients exhibited advanced hepatic fibrosis. Both MetALD and MASLD displayed similar metabolic profiles and hepatic fibrosis burdens. The diagnostic performance of FIB-4 and NFS for MRE ≥ 3.6 kPa showed no noticeable differences in the area under the receiver operating characteristic values between the two groups (0.85 vs. 0.80 in FIB-4). Moreover, the sensitivity (71.4%), specificity (77.3%), and both positive (4.6%) and negative (99.4%) predictive values of NITs for MetALD closely mirrored those observed for MASLD.
Conclusion: The newly defined MetALD exhibited a high FIB-4 performance, demonstrating reasonable sensitivity and negative predictive value for the initial screening of advanced hepatic fibrosis in MetALD.
Impact and implications: In this cross-sectional study, data from 7,918 participants who underwent MRE were analyzed to assess the performance of fibrosis-4 (FIB-4) and nonalcoholic fatty liver disease fibrosis scores in metabolic dysfunction-associated steatotic liver disease (MASLD) and MASLD with increased alcohol intake (MetALD). We found that the newly identified MetALD group had high diagnostic accuracy with FIB-4, similar to the MASLD population. These results highlight the potential of FIB-4 as a reliable screening tool for MetALD, even when specific subgroups are considered. Therefore, FIB-4 is a valuable screening tool for identifying advanced fibrosis in the MetALD population.
논문정보
- Research article
- 2024년 06월 (BRIC 등록일 2024-06-17)
- 국내 연구진
- 의약학 > 응용의학
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