Noninvasive Fibrosis Screening in Fatty Liver Disease Among Vulnerable Populations: Impact of Diabetes and Obesity on FIB-4 Score Accuracy.

Autor:	Kim RG; Division of Gastroenterology and Hepatology, Department of Medicine, University of California, San Francisco, San Francisco, CA., Deng J; David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA., Reaso JN; Division of Gastroenterology and Hepatology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA., Grenert JP; Division of Surgical Pathology, Department of Pathology and Laboratory Medicine, University of California, San Francisco, San Francisco, CA.; Liver Center, University of California San Francisco, San Francisco, CA., Khalili M; Division of Gastroenterology and Hepatology, Department of Medicine, University of California, San Francisco, San Francisco, CA.; Division of Gastroenterology and Hepatology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA.; Liver Center, University of California San Francisco, San Francisco, CA.
Jazyk:	angličtina
Zdroj:	Diabetes care [Diabetes Care] 2022 Oct 01; Vol. 45 (10), pp. 2449-2451.
DOI:	10.2337/dc22-0556
Abstrakt:	Objective: Fatty liver disease (FLD) is prevalent in diabetes, and both disproportionately affect vulnerable populations. The FIB-4 index is recommended to screen for advanced liver fibrosis. Limited data have suggested that diabetes may impact FIB-4. Research Design and Methods: We evaluated FIB-4 accuracy for advanced fibrosis compared with liver biopsy in the presence of diabetes and obesity. Results: Among 363 FLD patients receiving care in San Francisco's safety net health care system from August 2009 to February 2020, characteristics were as follows: median age 51 years, 46% male, 59% Hispanic, 68% obese, 33% with diabetes, and 31% with advanced fibrosis on histology. Overall, the c-statistic for FIB-4 was 0.79, but was worse in patients with diabetes, 0.68, than without, 0.85 (P = 0.003). Accuracy also varied by weight, at 0.65, 0.85, and 0.75 for normal weight, overweight, and obese, respectively, although not significantly (P = 0.24). Conclusions: The findings highlight limitations of FIB-4 in screening for advanced liver fibrosis, particularly in individuals with diabetes. (© 2022 by the American Diabetes Association.)
Databáze:	MEDLINE
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