Accuracy of noninvasive scoring systems to assess advanced liver fibrosis in Thai patients with nonalcoholic fatty liver disease

Treeprasertsuk, Sombat; Piyachaturawat, Panida; Soontornmanokul, Tanassanee; Wisedopas-Klaikaew, Naruemon; Komolmit, Piyawat; Tangkijavanich, Pisit

doi:10.5372/1905-7415.1000.521

Figures & Tables

The area under the receiver operating characteristic curve (AUROC) of the 4 noninvasive scoring systems to identify Thai patients with nonalcoholic fatty liver disease with advance liver fibrosis (F3–4) at baseline. AST, aspartate aminotransferase; ALT, alanine aminotransferase; BARD, BMI ≥28 kg/m2 (1 point), AST/ALT Ratio ≥0.8 (2 point); FIB-4 score, Fibrosis–4-score; NAFLD, nonalcoholic fatty liver disease; NPV, negative predictive value; PPV, positive predictive value

Baseline characteristics of 139 Thai patients with nonalcoholic fatty liver disease

Variable	Total (n=139)	No/mild fibrosis Advanced fibrosis (F0-F2)(n=139)	Advanced fibrosis (F3-F4)(n=9)	P
Age (years)	40.9 (13.3)	40.3 (13.0)	48.8 (15.5)	0.07^{Student t test.}
Male sex (%)	65 (47%)	61 (47%)	4 (44%)	1.00t
BMI (kg/m²)^median	36.1 (14.7)	40.6 (14.8)	29.4 (8.6)	0.01^{Student t test.}
BMI >28 (kg/m²)	102 (73%)	97 (75%)	5 (56%)	0.23t
Diabetes mellitus (DM)	53 (38%)	47 (36%)	6 (67%)	0.08t
IFG/DM	75 (54%)	67 (52%)	8 (89%)	0.04t
AST (IU/L)^median	38.0 (39.4)	38.0 (34.6)	39 (81.2)	0.24 Mann-Whitney U test, t, χ² test
ALT (IU/L)^median	56.0 (47.2)	56.0 (47.7)	59.0 (40.7)	0.29*
Albumin (g/L)	4.4 (0.4)	4.4 (0.4)	4.4 (0.3)	0.84^{Student t test.}
Platelet (×10⁹/L)	267 (64.2)	270 (64.3)	222 (43.7)	0.02 Mann-Whitney U test, t, χ² test
Total cholesterol (mg/dL)	198 (46.6)	197 (45.5)	214 (60.8)	0.44 Mann-Whitney U test, t, χ² test
Triglyceride (mg/dL)	146 (60.8)	145 (60.9)	164 (59.6)	0.31 Mann-Whitney U test, t, χ² test
HDL (mg/dL)	45.6 (12.1)	45.5 (12.4)	46.8 (8.1)	0.53 Mann-Whitney U test, t, χ² test
LDL (mg/dL)	125 (42.1)	125 (41.1)	135 (56.2)	0.61 Mann-Whitney U test, t, χ² test
FPG (mg/dL)	112 (33.2)	109 (30.9)	142 (49.2)	0.01 Mann-Whitney U test, t, χ² test
HbA1C (%)	7.38 (8.7)	7.36 (9.0)	7.59 (1.7)	0.08^{Student t test.}
AST/ALT ratio	0.78 (0.37)	0.78 (0.38)	0.85 (0.38)	0.59^{Student t test.}
BARD score				0.48^{Student t test.}
0	10 (7%)	10 (8%)	0 (0)
1	45 (32%)	43 (33%)	2 (22%)
2	41 (30%)	37 (29%)	4 (44%)
3	26 (19%)	24 (19%)	2 (22%)
4	17 (12%)	16 (12%)	1 (11%)
FIB-4 score	0.98 (0.79)	0.91 (0.61)	1.9 (1.9)	0.17^{Student t test.}

NAFLD Fibrosis Score	-1.37 (1.70)	-1.418 (1.748)	-0.772 (0.668)	0.03^{Student t test.}

Comparison of the diagnostic ability of the 4 noninvasive scoring systems for advanced fibrosis between 2 studies

	Shah et al. [16]	Present study
Baseline characteristics
Impaired fasting glucose or DM	19.4%	54%
Body mass index (mean; kg/m²)	34 (6.3)	36 (14.7)
%F3-F4	54%	6%
	AUROC of noninvasive scoring system
AST/ALT	0.74	0.57
BARD score	0.70	0.58
FIB-4 score	0.80	0.74
NAFLD Fibrosis Score	0.77	0.66

Comparison of the 4 noninvasive scoring systems for the diagnosis of advanced fibrosis in 139 Thai patients with nonalcoholic fatty liver disease

Non-invasive scoring system	Cutoff ≥	Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)	Accuracy	Patients avoiding liver biopsy	False negative result
AST/ALT	0.8	44.4	64.6	8.0	94.4	63	89 (64%)	5 (4%)
BARD score	2.0	77.8	40.0	8.2	96.3	42	54 (39%)	2 (1%)
FIB-4 score	1.3	55.6	83.5	19.2	96.4	79	110 (81%)	4 (3%)
NAFLD	–1.455	88.9	48.0	11.0	98.4	48	61 (46%)	1 (1%)
Fibrosis Score

Accuracy of noninvasive scoring systems to assess advanced liver fibrosis in Thai patients with nonalcoholic fatty liver disease

Figures & Tables

Figure 1

Baseline characteristics of 139 Thai patients with nonalcoholic fatty liver disease

Comparison of the diagnostic ability of the 4 noninvasive scoring systems for advanced fibrosis between 2 studies

Comparison of the 4 noninvasive scoring systems for the diagnosis of advanced fibrosis in 139 Thai patients with nonalcoholic fatty liver disease

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