Comparison of blood-based liver fibrosis scores in the Mount Sinai Health System, MASLD Registry, and NHANES 2017-2020 study.

IF 5.6 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Hepatology Communications Pub Date : 2024-08-26 eCollection Date: 2024-09-01 DOI:10.1097/HC9.0000000000000515
Robert Chen, Ben Omega Petrazzini, Girish Nadkarni, Ghislain Rocheleau, Meena B Bansal, Ron Do
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引用次数: 0

Abstract

Background: Liver fibrosis is a critical public health concern, necessitating early detection to prevent progression. This study evaluates the recently developed LiverRisk score and steatosis-associated Fibrosis Estimator (SAFE) score against established indices for prognostication and/or fibrosis prediction in 4diverse cohorts, including participants with metabolic dysfunction-associated steatotic liver disease (MASLD).

Methods: We used data from the Mount Sinai Data Warehouse (32,828 participants without liver disease diagnoses), the Mount Sinai MASLD/MASH Longitudinal Registry (422 participants with MASLD), and National Health and Nutrition Examination Survey 2017-2020 (4133 participants representing the general population) to compare LiverRisk score, FIB-4 index, APRI, and SAFE score. Analyses included Cox proportional hazards regressions, Kaplan-Meier estimates, and classification metrics to evaluate performance in prognostication and fibrosis prediction.

Results: In Mount Sinai Data Warehouse, LiverRisk score was significantly associated with future liver-related outcomes but did not significantly outperform FIB-4 or APRI for predicting any of the outcomes. In the general population, LiverRisk score and SAFE score outperformed FIB-4 and APRI in identifying fibrosis, but LiverRisk score underperformed among participants who were non-White or had type 2 diabetes. Among participants with MASLD, SAFE score outperformed FIB-4 and APRI in 1 of 2 cohorts, but there were generally few significant performance differences between all 4 scores.

Conclusions: LiverRisk score does not consistently outperform existing predictors in diverse populations, and further validation is needed before adoption in settings with significant differences from the original derivation cohorts. It remains necessary to replicate the ability of these scores to predict liver-specific mortality, as well as to develop diagnostic tools for liver fibrosis that are accessible and substantially better than current scores, especially among patients with MASLD and other chronic liver conditions.

西奈山健康系统、MASLD 注册和 NHANES 2017-2020 研究中基于血液的肝纤维化评分比较。
背景:肝纤维化是一个重要的公共卫生问题,需要及早发现以防止恶化。本研究评估了最近开发的肝脏风险评分(LiverRisk score)和脂肪变性相关纤维化估算器(SAFE)评分,并将其与已有的预后和/或纤维化预测指标进行对比,这些指标适用于 4 个不同的队列,包括患有代谢功能障碍相关脂肪性肝病(MASLD)的参与者:我们利用西奈山数据仓库(32828 名未确诊肝病的参与者)、西奈山 MASLD/MASH 纵向登记(422 名患有 MASLD 的参与者)和 2017-2020 年全国健康与营养调查(4133 名代表普通人群的参与者)的数据来比较 LiverRisk 评分、FIB-4 指数、APRI 和 SAFE 评分。分析包括 Cox 比例危险回归、Kaplan-Meier 估计和分类指标,以评估预后和纤维化预测的性能:结果:在西奈山数据仓库中,LiverRisk评分与未来肝脏相关预后有显著相关性,但在预测任何预后方面都没有明显优于FIB-4或APRI。在普通人群中,肝脏风险评分和SAFE评分在识别肝纤维化方面优于FIB-4和APRI,但在非白人或患有2型糖尿病的参与者中,肝脏风险评分表现不佳。在患有MASLD的参与者中,SAFE评分在两个队列中的一个队列中的表现优于FIB-4和APRI,但所有4个评分之间的表现差异一般不大:结论:肝脏风险评分在不同人群中的表现并不总是优于现有的预测指标,在与原始推导队列有显著差异的环境中采用前还需要进一步验证。仍有必要复制这些评分预测肝脏特异性死亡率的能力,并开发易于使用且大大优于现有评分的肝纤维化诊断工具,尤其是在MASLD和其他慢性肝病患者中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Hepatology Communications
Hepatology Communications GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
8.00
自引率
2.00%
发文量
248
审稿时长
8 weeks
期刊介绍: Hepatology Communications is a peer-reviewed, online-only, open access journal for fast dissemination of high quality basic, translational, and clinical research in hepatology. Hepatology Communications maintains high standard and rigorous peer review. Because of its open access nature, authors retain the copyright to their works, all articles are immediately available and free to read and share, and it is fully compliant with funder and institutional mandates. The journal is committed to fast publication and author satisfaction. ​
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