Development of a simple metabolic score to predict liver fibrosis risk in chronic hepatitis B patients: A retrospective cross-sectional study.

Abstract

ObjectiveTo examine the association between metabolic abnormalities and liver fibrosis in patients with chronic hepatitis B and develop a simple predictive index.MethodsIn this retrospective cross-sectional study, 288 patients with chronic hepatitis B were evaluated. Significant fibrosis was defined as fibrosis-4 index ≥ 1.45 or liver stiffness ≥ 7.5 kPa. Variables with P < 0.10 in the univariate analysis were entered in a backward stepwise logistic regression. A fibrosis risk index was calculated from the constant term and β coefficients of significant predictors. Diagnostic performance was assessed using receiver operating characteristic curve analysis.ResultsBody mass index; fasting plasma glucose, triglyceride, uric acid, and gamma-glutamyl transferase levels; and presence of fatty liver and diabetes were independent predictors of fibrosis. The fibrosis risk index showed excellent discrimination (area under the curve = 0.928, 95% confidence interval: 0.898-0.954). The optimal cutoff (0.000148) yielded 91.6% sensitivity and 76.4% specificity.ConclusionMetabolic abnormalities are independently associated with liver fibrosis in patients with chronic hepatitis B patients. The fibrosis risk index is a simple, noninvasive tool that identifies high-risk patients for timely intervention.