Age distorts the interpretation of FIB-4.

IF 3.7 2区医学 Q1 MEDICAL LABORATORY TECHNOLOGY

Clinical chemistry and laboratory medicine Pub Date : 2025-08-26 DOI:10.1515/cclm-2025-0615

Arne Åsberg, Gunhild Garmo Hov, Lena Løfblad

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引用次数: 0

Abstract

Objectives: To determine whether the diagnostic accuracy of the liver fibrosis marker FIB-4 and the likelihood ratios (LRs) of specific FIB-4 values vary with age.

Methods: We used a published dataset of 540 patients diagnosed with non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis. Liver biopsy showed no or early fibrosis in 391 patients, and advanced fibrosis in 149. For each group we established the relation between the mean of the natural logarithm of FIB-4 (log(FIB-4)) and age, and the standard deviation (SD) of log(FIB-4) and age. Using a parametric method, we calculated the area under the ROC curve of FIB-4 as a function of the difference in mean values of log(FIB-4) between the two groups, and the ratio of the SDs of log(FIB-4). LRs were calculated as functions of age at 35, 50 and 65 years, using a parametric method.

Results: The mean log(FIB-4) increased with age in both groups. The SDs of log(FIB-4) did not change with age. There was a trend towards decreasing diagnostic accuracy with age, but this finding did not reach statistical significance. The area under the ROC curve was 0.73 using a parametric method that accounted for age, and 0.79 using a traditional non-parametric method that did not account for age. The LRs of specific FIB-4 values decreased with age.

Conclusions: Age distorts the estimation of both diagnostic accuracy and LRs.

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年龄扭曲了对FIB-4的解释。

目的：探讨肝纤维化标志物FIB-4的诊断准确性及FIB-4特异值的似然比（LRs）是否随年龄变化。方法：我们使用已发表的540例诊断为非酒精性脂肪性肝病（NAFLD）或非酒精性脂肪性肝炎患者的数据集。肝活检显示391例患者无纤维化或早期纤维化，149例晚期纤维化。对于每一组，我们建立了FIB-4的自然对数均值（log(FIB-4)）与年龄的关系，以及log（FIB-4）的标准差（SD）与年龄的关系。采用参数化方法，我们计算FIB-4的ROC曲线下面积，作为两组间log均值（FIB-4）差异的函数，以及log标准差（FIB-4）之比。使用参数方法计算LRs作为35岁、50岁和65岁年龄的函数。结果：两组的FIB-4平均值均随年龄增长而增加。原木（FIB-4）的SDs不随年龄变化。随着年龄的增长，诊断准确性有下降的趋势，但这一发现没有统计学意义。使用考虑年龄的参数方法，ROC曲线下面积为0.73，使用不考虑年龄的传统非参数方法，ROC曲线下面积为0.79。特异FIB-4值的LRs随年龄的增长而降低。结论：年龄扭曲了诊断准确性和LRs的估计。

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

Clinical chemistry and laboratory medicine 医学-医学实验技术

CiteScore

11.30

自引率

16.20%

发文量

306

审稿时长

3 months

期刊介绍： Clinical Chemistry and Laboratory Medicine (CCLM) publishes articles on novel teaching and training methods applicable to laboratory medicine. CCLM welcomes contributions on the progress in fundamental and applied research and cutting-edge clinical laboratory medicine. It is one of the leading journals in the field, with an impact factor over 3. CCLM is issued monthly, and it is published in print and electronically. CCLM is the official journal of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and publishes regularly EFLM recommendations and news. CCLM is the official journal of the National Societies from Austria (ÖGLMKC); Belgium (RBSLM); Germany (DGKL); Hungary (MLDT); Ireland (ACBI); Italy (SIBioC); Portugal (SPML); and Slovenia (SZKK); and it is affiliated to AACB (Australia) and SFBC (France). Topics: - clinical biochemistry - clinical genomics and molecular biology - clinical haematology and coagulation - clinical immunology and autoimmunity - clinical microbiology - drug monitoring and analysis - evaluation of diagnostic biomarkers - disease-oriented topics (cardiovascular disease, cancer diagnostics, diabetes) - new reagents, instrumentation and technologies - new methodologies - reference materials and methods - reference values and decision limits - quality and safety in laboratory medicine - translational laboratory medicine - clinical metrology Follow @cclm_degruyter on Twitter!