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Non-invasive tests ...
Non-invasive tests accurately stratify patients with NAFLD based on their risk of liver-related events
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- Boursier, Jerome (författare)
- Ctr Hosp Univ Angers, France; Univ Angers, France
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- Hagstrom, Hannes (författare)
- Karolinska Institutet
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- Ekstedt, Mattias (författare)
- Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Mag- tarmmedicinska kliniken
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- Moreau, Clemence (författare)
- Univ Angers, France
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- Bonacci, Martin (författare)
- Intercept Pharmaceut, England; Intercept Pharmaceut Inc, NY USA
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- Cure, Sandrine (författare)
- Intercept Pharmaceut, England; Intercept Pharmaceut Inc, NY USA
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- Ampuero, Javier (författare)
- Univ Seville, Spain
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- Nasr, Patrik (författare)
- Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Mag- tarmmedicinska kliniken
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- Tallab, Lilian (författare)
- Karolinska Inst, Sweden
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- Canivet, Clemence M. (författare)
- Ctr Hosp Univ Angers, France; Univ Angers, France
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- Kechagias, Stergios (författare)
- Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Mag- tarmmedicinska kliniken
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- Sanchez, Yolanda (författare)
- Univ Seville, Spain
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- Dincuff, Eloise (författare)
- Ctr Hosp Univ Angers, France
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- Lucena, Ana (författare)
- Univ Seville, Spain
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- Roux, Marine (författare)
- Univ Angers, France
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- Riou, Jeremie (författare)
- Univ Angers, France
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- Trylesinski, Aldo (författare)
- Intercept Pharmaceut, England; Intercept Pharmaceut Inc, NY USA
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- Romero-Gomez, Manuel (författare)
- Univ Seville, Spain
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(creator_code:org_t)
- ELSEVIER, 2022
- 2022
- Engelska.
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Ingår i: Journal of Hepatology. - : ELSEVIER. - 0168-8278 .- 1600-0641. ; 76:5, s. 1013-1020
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Background & Aims: Previous studies on the prognostic significance of non-invasive liver fibrosis tests in non-alcoholic fatty liver disease (NAFLD) lack direct comparison to liver biopsy. We aimed to evaluate the prognostic accuracy of fibrosis-4 (FIB4) and vibration-controlled transient elastography (VCTE), compared to liver biopsy, for the prediction of liver-related events (LREs) in NAFLD. Methods: A total of 1,057 patients with NAFLD and baseline FIB4 and VCTE were included in a multicenter cohort. Of these patients, 594 also had a baseline liver biopsy. The main study outcome during follow-up was occurrence of LREs, a composite endpoint combining cirrhosis complications and/or hepatocellular carcinoma. Discriminative ability was evaluated using Harrells C-index. Results: FIB4 and VCTE showed good accuracy for the prediction of LREs, with Harrells C-indexes >0.80 (0.817 [0.768-0.866] vs. 0.878 [0.835-0.921], respectively, p = 0.059). In the biopsy subgroup, Harrells C-indexes of histological fibrosis staging and VCTE were not significantly different (0.932 [0.910-0.955] vs. 0.881 [0.832-0.931], respectively, p = 0.164), while both significantly outperformed FIB4 for the prediction of LREs. FIB4 and VCTE were independent predictors of LREs in the whole study cohort. The stepwise FIB4-VCTE algorithm accurately stratified the risk of LREs: compared to patients with "FIB4 <1.30", those with "FIB4 >- 1.30 then VCTE <8.0 kPa" had similar risk of LREs (adjusted hazard ratio [aHR] 1.3; 95% CI 0.3-6.8), whereas the risk of LREs significantly increased in patients with "FIB4 >1.30 then VCTE 8.0-12.0 kPa" (aHR 3.8; 95% CI 1.3-10.9), and even more for those with "FIB4 >-1.30 then VCTE >12.0 kPa" (aHR 12.4; 95% CI 5.1- 30.2). Conclusion: VCTE and FIB4 accurately stratify patients with NAFLD based on their risk of LREs. These non-invasive tests are alternatives to liver biopsy for the identification of patients in need of specialized management. Lay summary: The amount of fibrosis in the liver is closely associated with the risk of liver-related complications in nonalcoholic fatty liver disease (NAFLD). Liver biopsy currently remains the reference standard for the evaluation of fibrosis, but its application is limited by its invasiveness. Therefore, we evaluated the ability of non-invasive liver fibrosis tests to predict liver-related complications in NAFLD. Our results show that the blood test FIB4 and transient elastography stratify the risk of liver-related complications in NAFLD, and that transient elastography has similar prognostic accuracy as liver biopsy. These results support the use of non-invasive liver fibrosis tests instead of liver biopsy for the management of patients with NAFLD.(C) 2022 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
Nyckelord
- NAFLD; fibrosis; FIB4; Fibroscan; prognosis; liver-related event
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Boursier, Jerome
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Hagstrom, Hannes
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Ekstedt, Mattias
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Moreau, Clemence
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Bonacci, Martin
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Cure, Sandrine
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visa fler...
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Ampuero, Javier
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Nasr, Patrik
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Tallab, Lilian
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Canivet, Clemenc ...
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Kechagias, Sterg ...
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Sanchez, Yolanda
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Dincuff, Eloise
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Lucena, Ana
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Roux, Marine
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Riou, Jeremie
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Trylesinski, Ald ...
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Romero-Gomez, Ma ...
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Gastroenterologi
- Artiklar i publikationen
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Journal of Hepat ...
- Av lärosätet
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Linköpings universitet
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Karolinska Institutet