FibroScan-aspartate transaminase:A superior non-invasive model for diagnosing high-risk metabolic dysfunction-associated steatohepatitis

作     者：Jing-Ya Yin Tian-Yuan Yang Bing-Qing Yang Chen-Xue Hou Jun-Nan Li Yue Li Qi Wang 

作者机构：Center of Liver DiseasesBeijing Ditan HospitalCapital Medical UniversityBeijing 100015China Department of PathologyBeijing Ditan HospitalCapital Medical UniversityBeijing 100015China Beijing institute of infectious diseaseBeijing 100015China Beijing Key Laboratory of Emerging Infectious DiseasesInstitute of Infectious DiseasesBeijing Ditan HospitalCapital Medical UniversityBeijing 100015China 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2024年第30卷第18期

页      面：2440-2453页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Supported by National Natural Science Foundation of China,No.82170591 Natural Science Foundation of Beijing,No.7222097 

主　　题：Metabolic dysfunction-associated steatotic liver disease High-risk metabolic dysfunction-associated steatohepatitis Non-invasive models Liver biopsy Diagnostic value 

摘      要：BACKGROUND Non-alcoholic fatty liver disease(NAFLD)with hepatic histological NAFLD activity score≥4 and fibrosis stage F≥2 is regarded as“at risknon-alcoholic steatohepatitis(NASH).Based on an international consensus,NAFLD and NASH were renamed as metabolic dysfunction-associated steatotic liver disease(MASLD)and metabolic dysfunction-associated steatohepatitis(MASH),respectively;hence,we introduced the term“high-risk MASH.Diagnostic values of seven non-invasive models,including FibroScan-aspartate transaminase(FAST),fibrosis-4(FIB-4),aspartate transaminase to platelet ratio index(APRI),*** high-risk MASH have rarely been studied and compared in *** To assess the clinical value of seven non-invasive models as alternatives to liver biopsy for diagnosing high-risk *** A retrospective analysis was conducted on 309 patients diagnosed with NAFLD via liver biopsy at Beijing Ditan Hospital,between January 2012 and December *** screening for MASLD and the exclusion criteria,279 patients wereincluded and categorized into high-risk and non-high-risk MASH *** threshold values of each model,sensitivity,specificity,positive predictive value(PPV),and negative predictive values(NPV),were *** operating characteristic curves were constructed to evaluate their diagnostic efficacy based on the area under the curve(AUROC).RESULTS MASLD diagnostic criteria were met by 99.4%patients with *** MASLD population was analyzed in two cohorts:Overall population(279 patients)and the subgroup(117 patients)who underwent liver transient elastography(FibroScan).In the overall population,FIB-4 showed better diagnostic efficacy and higher PPV,with sensitivity,specificity,PPV,NPV,and AUROC of 26.9%,95.2%,73.5%,72.2%,and ***,Forns index,and aspartate transaminase to alanine transaminase ratio(ARR)showed moderate diagnostic efficacy,whereas S index and gamma-glutamyl transpeptidase to platelet ratio(GPR)were relatively *** the sub