巴西代谢性脂肪变性肝病相关的显著和晚期纤维化患病率以及fib-4和振动控制弹性成像的相关准确性——一项国家登记

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology Pub Date : 2025-09-01 DOI:10.1016/j.aohep.2025.101991

Cristiane Alves Villela-Nogueira , Cristiane Valle Tovo , Nathalie Carvalho Leite , Mário Reis Álvares-da-Silva , Claudia Alexandra Ivantes , Claudia Alves Couto , Giovanni Faria Silva , Edson Roberto Parise , Ana Carolina Cardoso , Natalia Ballassiano Wajsbrot , Luis Fernando Ferreira , Muriel Manica , Gabriela Perdomo Coral , Matheus Michalczuk , Rafael Biesek Novaes , Brian Vinícius Batista Pinheiro , Rosangela Réa , Luciana Costa Faria , Fernando Gomes Romeiro , Leila Priscilla Pinheiro da Silva , Claudia P.M.S. Oliveira

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引用次数: 0

摘要

介绍和目的最近关于巴西严重和晚期masld相关纤维化患病率的数据尚不清楚。我们的目的是根据不同的地理区域评估严重（SF, F≥2）和晚期（AF, F≥F3）纤维化的患病率，以及FIB-4和VCTE肝弹性成像（Fibroscan, Echosens, Fr）分别诊断SF和AF的准确性。患者和方法这是一项在10个巴西大学中心（东南部，n=6；东北部，n=1；南部，n=3）进行的分段研究。登记了人口统计学、临床、实验室、VCTE （Fibroscan®、Echosens、Fr）测量的肝脏硬度和肝活检（LB）结果。以LB为参考，绘制SF和AF的FIB-4和VCTE的auroc。结果共纳入2905例患者，其中女性53%，白人64%，51±14岁，T2DM 44%。根据LB (n=2122)，大多数为南方（72%;p<0.001）， F0-F1占75%，F2占12%，F3占9%，F4占4%。VCTE的大部分数据来自东南部（n = 1084,85%）。LSM<； 8 kPa、8 ~ 12 kPa和≥12 kPa分别占44%、25%和31%。东南地区大部分患者LSM≥12 kPa （p = 0.01）。81%的患者FIB-4评分为1.3分。对于F3， FIB-4和LSM的AUROC分别为0.75 （95% CI: 0.70-0.80; p<0.01）和0.72 (95% CI: 0.68-0.77; p<0.01)，对于F2， FIB-4的AUROC为0.67 (95% CI: 0.62-0.72; p<0.01)， VCTE的AUROC为0.64 （95% CI: 0.60-0.69; p<0.01）。结论MASLD合并房颤患者多来自东南部地区。VCTE主要出现在东南部，影响了其他地区MASLD的逐步纤维化分层，并证明了南部LB比例较高的原因。FIB-4和Fibroscan®肝弹性成像的准确性对房颤诊断较好，但对SF诊断不准确。

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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METABOLIC ASSOCIATED STEATOTIC LIVER DISEASE-RELATED SIGNIFICANT AND ADVANCED FIBROSIS' PREVALENCE IN BRAZIL AND THE ASSOCIATED ACCURACY OF FIB-4 AND VIBRATION-CONTROLLED ELASTOGRAPHY - A NATIONAL REGISTER

Introduction and Objectives

Recent data regarding the prevalence of significant and advanced MASLD-related fibrosis in Brazil is unknown. We aimed to evaluate the prevalence of significant (SF, F≥2) and advanced (AF, F≥F3) fibrosis according to its different geographic regions, and the accuracy of FIB-4 and liver elastography by VCTE (Fibroscan, Echosens, Fr) for the diagnosis of SF and AF respectively.

Patients and Methods

This was a sectional study in ten Brazilian University Centers (Southeast, n=6; Northeast, n=1; South, n=3). Demographic, clinic, laboratory, liver stiffness measurement by VCTE (Fibroscan®, Echosens, Fr), and liver biopsy (LB) results were registered. The AUROCs for FIB-4 and VCTE regarding SF and AF were plotted with LB as a reference.

Results

2905 patients were included (53% women, 64% white, 51 ± 14 yrs, 44% T2DM) According to LB (n=2122), most form the South (72%; p<0.001), 75% were F0-F1, 12% F2, 9% F3 and 4% F4. Most data from VCTE are from Southeast (n = 1084, 85%). LSM< 8 kPa, between 8 and 12 kPa and ≥ 12 kPa was observed in 44%, 25% and 31% of patients. Most patients from the Southeast region presented a LSM ≥ 12 kPa (p = 0.01). FIB-4 score was <1.3 in 81% of patients. For F3, the AUROC for FIB-4 and LSM were 0.75 (95% CI: 0.70-0.80; p<0.01) and 0.72 (95% CI: 0.68-0.77; p<0.01) respectively and for F2, 0.67 (95% CI: 0.62-0.72; p<0.01) for FIB-4 and 0.64 (95% CI: 0.60-0.69; p<0.01) for VCTE.

Conclusions

Most MASLD patients with AF are from the Southeast. VCTE is primarily available in the Sotheast, affecting the stepwise fibrosis stratification of MASLD in other regions and justifying the higher proportion of LB in the South. The accuracy of FIB-4 and liver elastography by Fibroscan® is good for diagnosing AF, but not for SF.

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来源期刊

Annals of hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.60%

发文量

183

审稿时长

4-8 weeks

期刊介绍： Annals of Hepatology publishes original research on the biology and diseases of the liver in both humans and experimental models. Contributions may be submitted as regular articles. The journal also publishes concise reviews of both basic and clinical topics.