Alexander Miller, MD1, Na Li, MD, PhD1, Alice Hinton, PhD2, Khalid Mumtaz, MD1
1The Ohio State University Wexner Medical Center, Columbus, OH; 2The Ohio State University, Columbus, OH
Introduction: The prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing worldwide. Hepatic fibrosis is the most important predictor for its prognosis. Various lab-based scoring tests have been developed as non-invasive measures to assess for hepatic fibrosis. The aim of this study was to examine the performance of these tests compared to the liver biopsy.
Methods: This is a retrospective study that included 354 biopsy-proven NAFLD patients. The sensitivity, specificity, positive predictive value, negative predictive value and area under the receiver operating characteristic (AUROC) curve of aspartate aminotransferase to platelet ratio (APRI), Fibrosis-4 (FIB-4), and NAFLD fibrosis score (NFS) were compared to histological fibrosis between groups without (F0-2) and with advanced hepatic fibrosis (F3-4).
Results: The mean age of our study population was 50±13 years. The mean BMI was 33.92 ±8.51 kg/m2. The majority were whites (87.29%) and females (57.63%). The overall mean prevalence of F0-2 fibrosis and F3-4 were 73.7% and 26.3%, respectively. Patients with NFS ≤0.675 were less likely to have advanced hepatic fibrosis (P=0.011) compared to those who had NFS >0.675. With NFS ≤0.675 and >0.675, the sensitivity and specificity for advanced hepatic fibrosis were 37.6% and 76.2%, and the AUROC was 0.56. The sensitivities and specificities of NFS, APRI and FIB-4 for detecting advanced histological fibrosis are shown in the table.
Discussion: This is the largest study comparing various lab-based scoring tests with the liver biopsy. The performance of lab-based scoring tests is overall not satisfactory. Therefore, new tests or a combination of these tests with other modality such as elastography is warranted to reliably assess the stages of hepatic fibrosis.
Citation: Alexander Miller, MD; Na Li, MD, PhD; Alice Hinton, PhD; Khalid Mumtaz, MD. P1526 - PERFORMANCE OF LAB-BASED SCORING TESTS FOR THE ASSESSMENT OF HEPATIC FIBROSIS COMPARED TO THE LIVER BIOPSY AMONG PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE. Program No. P1526. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.