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Obesity Modifies th...
Obesity Modifies the Performance of Fibrosis Biomarkers in Nonalcoholic Fatty Liver Disease
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- Qadri, Sami (författare)
- Univ Helsinki, Finland; Helsinki Univ Hosp, Finland; Minerva Fdn, Finland
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- Ahlholm, Noora (författare)
- Univ Helsinki, Finland; Helsinki Univ Hosp, Finland; Minerva Fdn, Finland
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- Lonsmann, Ida (författare)
- Nordic Biosci Biomarkers & Res, Denmark
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- Pellegrini, Paola (författare)
- VLVbio AB, Sweden
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- Poikola, Anni (författare)
- Univ Helsinki, Finland; Helsinki Univ Hosp, Finland; Minerva Fdn, Finland
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- Luukkonen, Panu K. (författare)
- Univ Helsinki, Finland; Helsinki Univ Hosp, Finland; Minerva Fdn, Finland; Yale Univ, CT USA
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- Porthan, Kimmo (författare)
- Univ Helsinki, Finland; Helsinki Univ Hosp, Finland; Minerva Fdn, Finland
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- Juuti, Anne (författare)
- Helsinki Univ Hosp, Finland; Univ Helsinki, Finland
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- Sammalkorpi, Henna (författare)
- Helsinki Univ Hosp, Finland; Univ Helsinki, Finland
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- Penttilä, Anne K. (författare)
- Helsinki Univ Hosp, Finland; Univ Helsinki, Finland
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- D´Ambrosio, Roberta (författare)
- Fdn IRCCS Ca Granda Osped Maggiore Policlin, Italy
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- Soardo, Giorgio (författare)
- Univ Udine, Italy; Italian Liver Fdn, Italy
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- Leeming, Diana J. (författare)
- Nordic Biosci Biomarkers & Res, Denmark
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- Karsdal, Morten (författare)
- Nordic Biosci Biomarkers & Res, Denmark
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- Arola, Johanna (författare)
- Helsinki Univ Hosp, Finland; Univ Helsinki, Finland
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- Kechagias, Stergios, 1969- (författare)
- Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Mag- tarmmedicinska kliniken
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- Pelusi, Serena (författare)
- Fdn IRCCS Ca Granda Osped Maggiore Policlin, Italy; Univ Milan, Italy
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- Ekstedt, Mattias, 1976- (författare)
- Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Mag- tarmmedicinska kliniken
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- Valenti, Luca (författare)
- Fdn IRCCS Ca Granda Osped Maggiore Policlin, Italy; Univ Milan, Italy
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- Hagström, Hannes (författare)
- Karolinska Institutet
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- Yki-Järvinen, Hannele (författare)
- Univ Helsinki, Finland; Helsinki Univ Hosp, Finland; Minerva Fdn, Finland
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(creator_code:org_t)
- 2021-12-31
- 2022
- Engelska.
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Ingår i: Journal of Clinical Endocrinology and Metabolism. - : Oxford University Press. - 0021-972X .- 1945-7197. ; 107:5, s. e2008-e2020
- Relaterad länk:
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https://doi.org/10.1...
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https://liu.diva-por... (primary) (Raw object)
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- Context: Guidelines recommend blood-based fibrosis biomarkers to identify advanced nonalcoholic fatty liver disease (NAFLD), which is particularly prevalent in patients with obesity. Objective: To study whether the degree of obesity affects the performance of liver fibrosis biomarkers in NAFLD. Design: Cross-sectional cohort study comparing simple fibrosis scores [Fibrosis-4 Index (FIB-4); NAFLD Fibrosis Score (NFS); aspartate aminotransferase to platelet ratio index; BARD (body mass index, aspartate-to-alanine aminotransferase ratio, diabetes); Hepamet Fibrosis Score (HFS)] and newer scores incorporating neo-epitope biomarkers PRO-C3 (ADAPT, FIBC3) or cytokeratin 18 (MACK-3). Setting: Tertiary referral center. Patients: We recruited overweight/obese patients from endocrinology (n = 307) and hepatology (n = 71) clinics undergoing a liver biopsy [median body mass index (BMI) 40.3 (interquartile range 36.0-44.7) kg/m(2)]. Additionally, we studied 859 less obese patients with biopsy-proven NAFLD to derive BMI-adjusted cutoffs for NFS. Main Outcome Measures: Biomarker area under the receiver operating characteristic (AUROC), sensitivity, specificity, and predictive values to identify histological stage >= F3 fibrosis or nonalcoholic steatohepatitis with >= F2 fibrosis [fibrotic nonalcoholic steatohepatitis (NASH)]. Results: The scores with an AUROC >= 0.85 to identify >= F3 fibrosis were ADAPT, FIB-4, FIBC3, and HFS. For fibrotic NASH, the best predictors were MACK-3 and ADAPT. The specificities of NFS, BARD, and FIBC3 deteriorated as a function of BMI. We derived and validated new cutoffs for NFS to rule in/out >= F3 fibrosis in groups with BM Is <30.0, 30.0 to 39.9, and >= 40.0 kg/m(2). This optimized its performance at all levels of BMI. Sequentially combining FIB-4 with ADAPT or FIBC3 increased specificity to diagnose >= F3 fibrosis. Conclusions: In obese patients, the best-performing fibrosis biomarkers are ADAPT and the inexpensive FIB-4, which are unaffected by BMI. The widely used NFS loses specificity in obese individuals, which may be corrected with BMI-adjusted cutoffs.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
Nyckelord
- nonalcoholic fatty liver disease; nonalcoholic steatohepatitis; fibrosis; cirrhosis; biomarkers; obesity
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Qadri, Sami
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Ahlholm, Noora
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Lonsmann, Ida
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Pellegrini, Paol ...
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Poikola, Anni
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Luukkonen, Panu ...
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visa fler...
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Porthan, Kimmo
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Juuti, Anne
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Sammalkorpi, Hen ...
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Penttilä, Anne K ...
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D´Ambrosio, Robe ...
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Soardo, Giorgio
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Leeming, Diana J ...
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Karsdal, Morten
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Arola, Johanna
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Kechagias, Sterg ...
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Pelusi, Serena
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Ekstedt, Mattias ...
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Valenti, Luca
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Hagström, Hannes
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Yki-Järvinen, Ha ...
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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 Clini ...
- Av lärosätet
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Linköpings universitet
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Karolinska Institutet