Performance of APRI and FIB-4 Scores Compared to FibroScan: A Cross-Sectional Study in a Black Sub-Saharan African Population.

IF 1.8 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hepatic Medicine : Evidence and Research Pub Date : 2025-07-15 eCollection Date: 2025-01-01 DOI:10.2147/HMER.S533064

Jean-Bonny Nsumbu, Jean-Robert Makulo, Trésor Mutombo Tshiswaka, Christian Kisoka Lusunsi, Charles Nlombi Mbendi

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Abstract

Background and aim: Several non-invasive tests are used to assess liver fibrosis and cirrhosis in patients with liver disease. However, most validation studies have not included populations in sub-Saharan Africa. This study aimed to evaluate the diagnostic performance of the APRI and FIB-4 scores in a Congolese cohort.

Patients and methods: A cohort of patients in Kinshasa underwent FibroScan and laboratory testing to calculate APRI and FIB-4 scores. Pearson correlation, sensitivity, specificity, and ROC curve analyses were used to evaluate the performance of these non-invasive scores against FibroScan. Cirrhosis was defined as liver stiffness ≥14 kPa by FibroScan. Thresholds for APRI and FIB-4 scores predicting cirrhosis were set at ≥ 1.5 and ≥ 2.67, respectively.

Results: The study included 316 patients (mean ± SD age: 48.1 ± 14.1 years; 60.8% male; 10.1% with diabetes; 37.1% obese; 14.2% with hepatitis B; 6.7% with hepatitis C; 25.6% with a history of alcohol use). The Pearson correlation between APRI and FibroScan was r = 0.210 (p < 0.001), while the correlation between FIB-4 and FibroScan was better (r = 0.478, p < 0.001). In subgroup analyses, FIB-4 correlated with FibroScan only among patients with alcohol use or hepatitis B or C, APRI only correlated with FibroScan in alcohol dependent patients. The sensitivity and specificity of APRI were 29.7% and 97.9% respectively, compared to 60.0% and 93.3% for FibroScan. The areas under the ROC curve were 0.8462 for APRI and 0.8312 for FIB-4, with thresholds lower than those reported in the literature: 0.422 for APRI and 1.285 for FIB-4, but these varied according to the subgroup.

Conclusion: APRI and FIB-4 scores demonstrate high specificity but low sensitivity for diagnosing cirrhosis in this population. Their diagnostic performance is notably better in patients with alcohol-related liver disease or viral hepatitis, but poor among those with diabetes or obesity.

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APRI和FIB-4评分与FibroScan相比的表现：撒哈拉以南非洲黑人人口的横断面研究

背景和目的：几种非侵入性检查用于评估肝病患者的肝纤维化和肝硬化。然而，大多数验证研究没有包括撒哈拉以南非洲的人口。本研究旨在评估刚果队列中APRI和FIB-4评分的诊断性能。患者和方法：金沙萨的一组患者接受了纤维扫描和实验室测试，以计算APRI和FIB-4评分。使用Pearson相关性、敏感性、特异性和ROC曲线分析来评估这些无创评分相对于FibroScan的表现。肝硬化定义为肝硬度≥14 kPa。预测肝硬化的APRI和FIB-4评分阈值分别为≥1.5和≥2.67。结果：共纳入316例患者(平均±SD年龄：48.1±14.1岁；男性60.8%;10.1%患有糖尿病；37.1%的肥胖;乙型肝炎14.2%；6.7%为丙型肝炎；25.6%有酒精使用史)。APRI与FibroScan的Pearson相关性为r = 0.210 (p < 0.001)， FIB-4与FibroScan的相关性较好（r = 0.478, p < 0.001）。在亚组分析中，FIB-4仅在酒精使用或乙型或丙型肝炎患者中与纤维扫描相关，APRI仅在酒精依赖患者中与纤维扫描相关。APRI的敏感性和特异性分别为29.7%和97.9%，而FibroScan的敏感性和特异性分别为60.0%和93.3%。APRI和FIB-4的ROC曲线下面积分别为0.8462和0.8312，阈值低于文献报道：APRI为0.422，FIB-4为1.285，但这些阈值因亚组而异。结论：APRI和FIB-4评分在该人群中诊断肝硬化具有高特异性但低敏感性。它们对酒精相关性肝病或病毒性肝炎患者的诊断效果明显较好，但对糖尿病或肥胖症患者的诊断效果较差。

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

Hepatic Medicine : Evidence and Research GASTROENTEROLOGY & HEPATOLOGY-

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审稿时长

16 weeks

期刊介绍： Hepatic Medicine: Evidence and Research is an international, peer-reviewed, open access, online journal. Publishing original research, reports, editorials, reviews and commentaries on all aspects of adult and pediatric hepatology in the clinic and laboratory including the following topics: Pathology, pathophysiology of hepatic disease Investigation and treatment of hepatic disease Pharmacology of drugs used for the treatment of hepatic disease Although the main focus of the journal is to publish research and clinical results in humans; preclinical, animal and in vitro studies will be published where they will shed light on disease processes and potential new therapies. Issues of patient safety and quality of care will also be considered. As of 1st April 2019, Hepatic Medicine: Evidence and Research will no longer consider meta-analyses for publication.