Role of FIB-4 for reassessment of hepatic fibrosis burden in referral center

Abstract Low cut-off of FIB-4 is a widely used formula to exclude advanced liver fibrosis in primary care centers. However, the range of reported threshold of FIB-4 to rule in advanced fibrosis is too broad across etiologies, and no consensus has been reached. In the present study, we investigated t...

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Autores principales:	Yun Hwa Roh, Bo-Kyeong Kang, Dae Won Jun, Chul-min Lee, Mimi Kim
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/6a7ed62afb2942a6a93d65a1a9ed6627
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spelling	oai:doaj.org-article:6a7ed62afb2942a6a93d65a1a9ed66272021-12-02T14:34:03ZRole of FIB-4 for reassessment of hepatic fibrosis burden in referral center10.1038/s41598-021-93038-62045-2322https://doaj.org/article/6a7ed62afb2942a6a93d65a1a9ed66272021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-93038-6https://doaj.org/toc/2045-2322Abstract Low cut-off of FIB-4 is a widely used formula to exclude advanced liver fibrosis in primary care centers. However, the range of reported threshold of FIB-4 to rule in advanced fibrosis is too broad across etiologies, and no consensus has been reached. In the present study, we investigated the role of FIB-4 for a reassessment of hepatic fibrosis burden in a referral center. We compared the diagnostic performance of FIB-4 among patients with liver disease of various causes and tried to find an optimal cut-off value for predicting advanced fibrosis. Among 1068 patients, the AUROC of FIB-4 to diagnose advanced fibrosis showed no significant difference among the various etiologies of liver disease, ranging from 0.783 to 0.821. The optimal cut-off value obtained by maximizing Youden's index was 2.68, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for predicting advanced fibrosis were 70.7%, 79.1%, 43.5%, and 92.2%, respectively. The PPV was low in patients with autoimmune disease (6.67%). When we incorporated the new cut-off of FIB-4 into abdominal ultrasound findings, 81% of unnecessary work-ups would be appropriately avoided. In conclusion, the cut-off value of 2.68 showed an acceptable PPV while maintaining a high NPV to predict advanced fibrosis, most etiology except for autoimmune diseases. This result could assist in establishing an appropriate timing to reassess the hepatic fibrosis burden during monitoring in the referral center.Yun Hwa RohBo-Kyeong KangDae Won JunChul-min LeeMimi KimNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Yun Hwa Roh Bo-Kyeong Kang Dae Won Jun Chul-min Lee Mimi Kim Role of FIB-4 for reassessment of hepatic fibrosis burden in referral center
description	Abstract Low cut-off of FIB-4 is a widely used formula to exclude advanced liver fibrosis in primary care centers. However, the range of reported threshold of FIB-4 to rule in advanced fibrosis is too broad across etiologies, and no consensus has been reached. In the present study, we investigated the role of FIB-4 for a reassessment of hepatic fibrosis burden in a referral center. We compared the diagnostic performance of FIB-4 among patients with liver disease of various causes and tried to find an optimal cut-off value for predicting advanced fibrosis. Among 1068 patients, the AUROC of FIB-4 to diagnose advanced fibrosis showed no significant difference among the various etiologies of liver disease, ranging from 0.783 to 0.821. The optimal cut-off value obtained by maximizing Youden's index was 2.68, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for predicting advanced fibrosis were 70.7%, 79.1%, 43.5%, and 92.2%, respectively. The PPV was low in patients with autoimmune disease (6.67%). When we incorporated the new cut-off of FIB-4 into abdominal ultrasound findings, 81% of unnecessary work-ups would be appropriately avoided. In conclusion, the cut-off value of 2.68 showed an acceptable PPV while maintaining a high NPV to predict advanced fibrosis, most etiology except for autoimmune diseases. This result could assist in establishing an appropriate timing to reassess the hepatic fibrosis burden during monitoring in the referral center.
format	article
author	Yun Hwa Roh Bo-Kyeong Kang Dae Won Jun Chul-min Lee Mimi Kim
author_facet	Yun Hwa Roh Bo-Kyeong Kang Dae Won Jun Chul-min Lee Mimi Kim
author_sort	Yun Hwa Roh
title	Role of FIB-4 for reassessment of hepatic fibrosis burden in referral center
title_short	Role of FIB-4 for reassessment of hepatic fibrosis burden in referral center
title_full	Role of FIB-4 for reassessment of hepatic fibrosis burden in referral center
title_fullStr	Role of FIB-4 for reassessment of hepatic fibrosis burden in referral center
title_full_unstemmed	Role of FIB-4 for reassessment of hepatic fibrosis burden in referral center
title_sort	role of fib-4 for reassessment of hepatic fibrosis burden in referral center
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/6a7ed62afb2942a6a93d65a1a9ed6627
work_keys_str_mv	AT yunhwaroh roleoffib4forreassessmentofhepaticfibrosisburdeninreferralcenter AT bokyeongkang roleoffib4forreassessmentofhepaticfibrosisburdeninreferralcenter AT daewonjun roleoffib4forreassessmentofhepaticfibrosisburdeninreferralcenter AT chulminlee roleoffib4forreassessmentofhepaticfibrosisburdeninreferralcenter AT mimikim roleoffib4forreassessmentofhepaticfibrosisburdeninreferralcenter
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Role of FIB-4 for reassessment of hepatic fibrosis burden in referral center

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