FAST and Agile-the MASLD drift: Validation of Agile 3+, Agile 4 and FAST scores in 246 biopsy-proven NAFLD patients meeting MASLD criteria of prevalent caucasian origin.

Autor: Taru MG; Faculty of Medicine, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania.; Regional Institute of Gastroenterology and Hepatology 'Octavian Fodor', Cluj-Napoca, Cluj, Romania.; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy., Tefas C; Faculty of Medicine, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania.; Regional Institute of Gastroenterology and Hepatology 'Octavian Fodor', Cluj-Napoca, Cluj, Romania., Neamti L; Faculty of Medicine, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania.; Regional Institute of Gastroenterology and Hepatology 'Octavian Fodor', Cluj-Napoca, Cluj, Romania., Minciuna I; Faculty of Medicine, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania.; Regional Institute of Gastroenterology and Hepatology 'Octavian Fodor', Cluj-Napoca, Cluj, Romania., Taru V; Faculty of Medicine, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania.; Regional Institute of Gastroenterology and Hepatology 'Octavian Fodor', Cluj-Napoca, Cluj, Romania.; Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria., Maniu A; Regional Institute of Gastroenterology and Hepatology 'Octavian Fodor', Cluj-Napoca, Cluj, Romania., Rusu I; Regional Institute of Gastroenterology and Hepatology 'Octavian Fodor', Cluj-Napoca, Cluj, Romania., Petrushev B; Regional Institute of Gastroenterology and Hepatology 'Octavian Fodor', Cluj-Napoca, Cluj, Romania., Procopciuc LM; Faculty of Medicine, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania., Leucuta DC; Faculty of Medicine, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania., Procopet B; Faculty of Medicine, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania.; Regional Institute of Gastroenterology and Hepatology 'Octavian Fodor', Cluj-Napoca, Cluj, Romania., Ferri S; Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Lupsor-Platon M; Faculty of Medicine, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania.; Regional Institute of Gastroenterology and Hepatology 'Octavian Fodor', Cluj-Napoca, Cluj, Romania., Stefanescu H; Regional Institute of Gastroenterology and Hepatology 'Octavian Fodor', Cluj-Napoca, Cluj, Romania.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 May 23; Vol. 19 (5), pp. e0303971. Date of Electronic Publication: 2024 May 23 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0303971
Abstrakt: Background: MASLD is a prevalent chronic liver condition with substantial clinical implications. This study aimed to assess the effectiveness of three new, elastography-based, scoring systems for advanced fibrosis ≥F3 (Agile 3+), cirrhosis F4 (Agile 4), and fibrotic NASH: NASH + NAS ≥4 + F≥2 (FAST score), in a cohort of biopsy-proven NAFLD meeting MASLD criteria. Our secondary aim was to compare their diagnostic performances with those of other fibrosis prediction tools: LSM-VCTE alone, and common, easily available scores (FIB-4 or APRI).
Methods: Single-center, retrospective study, on consecutive patients with baseline laboratory tests, liver biopsy, and reliable LSM-VCTE measurements. The discrimination between tests was evaluated by analyzing the AUROCs. Dual cut-off approaches were applied to rule-out and rule-in ≥F3, F4 and fibrotic NASH. We tested previously reported cut-off values and provided our best thresholds to achieve Se ≥85%, Se ≥90%, and Sp ≥90%, Sp ≥95%.
Results: Among 246 patients, 113 (45.9%) were women, and 75 (30.5%) presented diabetes. Agile 3+ and Agile 4 demonstrated excellent performance in identifying ≥F3 and F4, achieving AUROCs of 0.909 and 0.968, while the FAST score yielded acceptable results in distinguishing fibrotic NASH. When compared to FIB-4 and LSM-VCTE, both Agile 3+ and Agile 4 performed better than FIB-4 and had a similar performance to LSM-VCTE, but with higher diagnostic accuracy, hence reducing the grey zone.
Conclusion: Agile 3+ and Agile 4 are reliable, non-invasive tests for identifying advanced fibrosis or cirrhosis in MASLD patients, while FAST score demonstrates moderate performance in identifying fibrotic NASH.
Competing Interests: NO authors have competing interests.
(Copyright: © 2024 Taru et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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