Darren Jun Hao Tan, Nobuharu Tamaki, Beom Kyung Kim, Karn Wijarnpreecha, Majd Bassam Aboona, Claire Faulkner, Charlotte Kench, Shirin Salimi, Abdul-Hamid Sabih, Wen Hui Lim, Pojsakorn Danpanichkul, Benjamin Tay, Yiqing Teh, John Mok, Benjamin Nah, Cheng Han Ng, Mark Muthiah, Anand V Kulkarni, Sung Won Lee, Ken Liu, Rohit Loomba, Daniel Q Huang
{"title":"MASLD相关肝细胞癌中低FIB-4的流行率：一项多中心研究","authors":"Darren Jun Hao Tan, Nobuharu Tamaki, Beom Kyung Kim, Karn Wijarnpreecha, Majd Bassam Aboona, Claire Faulkner, Charlotte Kench, Shirin Salimi, Abdul-Hamid Sabih, Wen Hui Lim, Pojsakorn Danpanichkul, Benjamin Tay, Yiqing Teh, John Mok, Benjamin Nah, Cheng Han Ng, Mark Muthiah, Anand V Kulkarni, Sung Won Lee, Ken Liu, Rohit Loomba, Daniel Q Huang","doi":"10.1111/apt.18346","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Major society guidelines recommend the fibrosis-4 index (FIB-4) as the initial step to risk stratifying people with metabolic dysfunction-associated steatotic liver disease (MASLD). We aimed to evaluate the proportion of people with MASLD-related hepatocellular carcinoma (HCC) and a low FIB-4.</p><p><strong>Methods: </strong>This cohort study included 613 consecutive adults (33% female) diagnosed with MASLD-related HCC from January 2008 to August 2023 at seven international centres in Australia, India, Japan, South Korea, Singapore and the United States. The primary objective was to determine the proportion of participants with a low FIB-4, defined as FIB-4 < 1.3, or < 2 if age > 65 years, in people without cirrhosis.</p><p><strong>Results: </strong>The mean (±SD) age and body mass index were 71 (±11) years and 27 (±7) kg/m<sup>2</sup>, respectively. Overall, 235 participants (38%) did not have known cirrhosis. The median FIB-4 was 3.90 (IQR 2.42-6.42). A total of 78 participants (13%) had a low FIB-4. Among participants without known cirrhosis (n = 235), 62 participants (26%) had a low FIB-4. Participants with a low FIB-4 had larger median total tumour diameter (p < 0.001) and lower median serum alpha-fetoprotein (p = 0.005), compared to participants without a low FIB-4. Cirrhosis was associated with lower odds of low FIB-4, but not other factors such as male sex, type 2 diabetes, or obesity.</p><p><strong>Conclusion: </strong>More than a quarter of those with MASLD-related HCC without cirrhosis have a low FIB-4. The proposed clinical care pathways may not identify these people for further evaluation.</p>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":" ","pages":""},"PeriodicalIF":6.6000,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prevalence of Low FIB-4 in MASLD-Related Hepatocellular Carcinoma: A Multicentre Study.\",\"authors\":\"Darren Jun Hao Tan, Nobuharu Tamaki, Beom Kyung Kim, Karn Wijarnpreecha, Majd Bassam Aboona, Claire Faulkner, Charlotte Kench, Shirin Salimi, Abdul-Hamid Sabih, Wen Hui Lim, Pojsakorn Danpanichkul, Benjamin Tay, Yiqing Teh, John Mok, Benjamin Nah, Cheng Han Ng, Mark Muthiah, Anand V Kulkarni, Sung Won Lee, Ken Liu, Rohit Loomba, Daniel Q Huang\",\"doi\":\"10.1111/apt.18346\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Major society guidelines recommend the fibrosis-4 index (FIB-4) as the initial step to risk stratifying people with metabolic dysfunction-associated steatotic liver disease (MASLD). We aimed to evaluate the proportion of people with MASLD-related hepatocellular carcinoma (HCC) and a low FIB-4.</p><p><strong>Methods: </strong>This cohort study included 613 consecutive adults (33% female) diagnosed with MASLD-related HCC from January 2008 to August 2023 at seven international centres in Australia, India, Japan, South Korea, Singapore and the United States. The primary objective was to determine the proportion of participants with a low FIB-4, defined as FIB-4 < 1.3, or < 2 if age > 65 years, in people without cirrhosis.</p><p><strong>Results: </strong>The mean (±SD) age and body mass index were 71 (±11) years and 27 (±7) kg/m<sup>2</sup>, respectively. Overall, 235 participants (38%) did not have known cirrhosis. The median FIB-4 was 3.90 (IQR 2.42-6.42). A total of 78 participants (13%) had a low FIB-4. Among participants without known cirrhosis (n = 235), 62 participants (26%) had a low FIB-4. Participants with a low FIB-4 had larger median total tumour diameter (p < 0.001) and lower median serum alpha-fetoprotein (p = 0.005), compared to participants without a low FIB-4. Cirrhosis was associated with lower odds of low FIB-4, but not other factors such as male sex, type 2 diabetes, or obesity.</p><p><strong>Conclusion: </strong>More than a quarter of those with MASLD-related HCC without cirrhosis have a low FIB-4. The proposed clinical care pathways may not identify these people for further evaluation.</p>\",\"PeriodicalId\":121,\"journal\":{\"name\":\"Alimentary Pharmacology & Therapeutics\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":6.6000,\"publicationDate\":\"2024-10-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Alimentary Pharmacology & Therapeutics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/apt.18346\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Alimentary Pharmacology & Therapeutics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/apt.18346","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Prevalence of Low FIB-4 in MASLD-Related Hepatocellular Carcinoma: A Multicentre Study.
Background: Major society guidelines recommend the fibrosis-4 index (FIB-4) as the initial step to risk stratifying people with metabolic dysfunction-associated steatotic liver disease (MASLD). We aimed to evaluate the proportion of people with MASLD-related hepatocellular carcinoma (HCC) and a low FIB-4.
Methods: This cohort study included 613 consecutive adults (33% female) diagnosed with MASLD-related HCC from January 2008 to August 2023 at seven international centres in Australia, India, Japan, South Korea, Singapore and the United States. The primary objective was to determine the proportion of participants with a low FIB-4, defined as FIB-4 < 1.3, or < 2 if age > 65 years, in people without cirrhosis.
Results: The mean (±SD) age and body mass index were 71 (±11) years and 27 (±7) kg/m2, respectively. Overall, 235 participants (38%) did not have known cirrhosis. The median FIB-4 was 3.90 (IQR 2.42-6.42). A total of 78 participants (13%) had a low FIB-4. Among participants without known cirrhosis (n = 235), 62 participants (26%) had a low FIB-4. Participants with a low FIB-4 had larger median total tumour diameter (p < 0.001) and lower median serum alpha-fetoprotein (p = 0.005), compared to participants without a low FIB-4. Cirrhosis was associated with lower odds of low FIB-4, but not other factors such as male sex, type 2 diabetes, or obesity.
Conclusion: More than a quarter of those with MASLD-related HCC without cirrhosis have a low FIB-4. The proposed clinical care pathways may not identify these people for further evaluation.
期刊介绍：
Alimentary Pharmacology & Therapeutics is a global pharmacology journal focused on the impact of drugs on the human gastrointestinal and hepato-biliary systems. It covers a diverse range of topics, often with immediate clinical relevance to its readership.
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