Details

Autor(en) / Beteiligte

• Zhou, Yu‐Jie
• Gao, Feng
• Liu, Wen‐Yue
• Wong, Grace Lai‐Hung
• Mahadeva, Sanjiv
• Raihan Nik Mustapha, Nik
• Wang, Xiao‐Dong
• Chan, Wah‐Kheong
• Wong, Vincent Wai‐Sun
• Zheng, Ming‐Hua

Titel

Screening for compensated advanced chronic liver disease using refined Baveno VI elastography cutoffs in Asian patients with nonalcoholic fatty liver disease

Ist Teil von

• Alimentary pharmacology & therapeutics, 2021-08, Vol.54 (4), p.470-480

Ort / Verlag

Chichester: Wiley Subscription Services, Inc

Erscheinungsjahr

2021

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Summary Background Recently, Papatheodoridi et al proposed to refine the Baveno VI elastography dual‐cutoffs and introduce an algorithm for the detection of compensated advanced chronic liver disease (cACLD) in asymptomatic European patients with chronic liver diseases. Aims To validate the performance of the dual‐cutoffs (8/12 kPa) and the proposed algorithm to identify patients with cACLD in three well‐characterised Asian nonalcoholic fatty liver disease (NAFLD) cohorts. Methods We included 830 patients with biopsy‐proven NAFLD. Liver stiffness was measured using transient elastography (FibroScan). Results cACLD was found in 21.8% of patients. Compared with the original Baveno VI elastography criteria (10/15 kPa), the new cutoffs showed a comparable specificity and a higher sensitivity for identifying cACLD. We developed a simplified risk model incorporating age, liver stiffness value, and platelet count, which outperformed liver stiffness measurement alone in two Chinese cohorts (P = 0.001), and was further validated in a Malaysian cohort (P = 0.04). Overall, the “two‐step” screening of cACLD improved classification rates from 73.5% by the original dual‐cutoffs to 86.7%. Notably, usage of our simplified risk model resulted in significantly lower false‐negative rate than the refined screening approach by Papatheodoridi et al (27.1% vs 41.4%; P = 0.01). Conclusions The dual elastography cutoffs of 8 and 12 kPa are more appropriate to identify cACLD in Asian patients with NAFLD. In combination with a simplified risk model in unclassified patients, the two‐step approach showed a classification rate of about 85%. Recently, a refined Baveno VIelastography dual‐cutoffs (8/12 kPa) combined with a risk formula forunclassified patients was proposed in a European study, which showed improvedclassification rates than original cutoffs of 10/15 kPa. In this study, we successfullyvalidated the superiority of the newly‐proposed LS dual‐cutoffs (8/12 kPa) forcompensated advanced chronic liver disease (cACLD) detection in three well‐characterized Asian nonalcoholicfatty liver disease (NAFLD) cohorts, andproposed a simplified risk model for Asian NAFLD patients with LS between 8 and12 kPa. The ‘two‐step’ screening of cACLD can accuratelyclassify about 85% NAFLD patients in Asian population.