Nonalcoholic fatty liver scoring panels shortcut for fibro scanning results or not

Abstract

Introduction: Liver steatosis has a wide range of conditions from simple steatosis to non-alcoholic steatohepatitis, fibrosis, and eventually cirrhosis. Several panels and scoring systems have been introduced to differentiate steatosis with or without advanced fibrosis and also the degree of fibrosis. This study aimed to evaluate eleven different scoring panels in patients with steatosis and compare their results with Fibro Scan.  

Methods: The study was performed on 122 NAFLD patients who were confirmed by ultrasound. The patients were referred to the gastroenterologist in Razi hospital in the north of Iran from September 2017 to April 2018. All patients underwent Fibro Scan. Multiple scoring systems were calculated using the laboratory values. These results were compared with the results of Fibro Scan. AUC for each panel was calculated.

Results: In This study, 62 (50.8%) were men. The mean age of the patients was 47.1±11.7 years.  There were significant differences between patients with or without advanced fibrosis in three panels of APRI, NIPPON, and FIB4 (p=0.03, p=0.01, p=0.005, respectively). AUROC for APRI, NIPPON, and FIB4 were, 0.695 (CI=0.58-0.8, p=0.001), 0.642 (CI: 0.5-0.74, p=0.015) and 0.684 (CI: 0.5-0.7, p=0.002), respectively. None of the other panels had enough sensitivity for the diagnosis of advanced fibrosis.

Conclusion: Given the cost-effectiveness of panels, their ease of calculation, and noninvasiveness, FIB4, NIPPON and APRI can be used as useful tools for following, and also for predicting progression to advanced fibrosis.