Utility and limitations of Hepascore and transient elastography to detect advanced hepatic fibrosis in HFE hemochromatosis

Abstract Aspartate aminotransferase-to-platelet ratio index (APRI) and Fibrosis-4 Index (Fib4) have been validated against liver biopsy for detecting advanced hepatic fibrosis in HFE hemochromatosis. We determined the diagnostic utility for advanced hepatic fibrosis of Hepascore and transient elasto...

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Autores principales:	Sim Yee Ong, Tiffany Khoo, Amanda J. Nicoll, Lyle Gurrin, Thomas Worland, Puraskar Pateria, Louise E. Ramm, Adam Testro, Gregory J. Anderson, Richard Skoien, Lawrie W. Powell, Grant A. Ramm, John K. Olynyk, Martin B. Delatycki
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/7d1d5a7b6a9c4eeb9724bc31eb9c0869
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spelling	oai:doaj.org-article:7d1d5a7b6a9c4eeb9724bc31eb9c08692021-12-02T16:26:30ZUtility and limitations of Hepascore and transient elastography to detect advanced hepatic fibrosis in HFE hemochromatosis10.1038/s41598-021-94083-x2045-2322https://doaj.org/article/7d1d5a7b6a9c4eeb9724bc31eb9c08692021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-94083-xhttps://doaj.org/toc/2045-2322Abstract Aspartate aminotransferase-to-platelet ratio index (APRI) and Fibrosis-4 Index (Fib4) have been validated against liver biopsy for detecting advanced hepatic fibrosis in HFE hemochromatosis. We determined the diagnostic utility for advanced hepatic fibrosis of Hepascore and transient elastography compared with APRI and Fib4 in 134 newly diagnosed HFE hemochromatosis subjects with serum ferritin levels > 300 µg/L using area under the receiver operator characteristic curve (AUROC) analysis and APRI- (> 0.44) or Fib4- (> 1.1) cut-offs for AHF, or a combination of both. Compared with APRI, Hepascore demonstrated an AUROC for advanced fibrosis of 0.69 (95% CI 0.56–0.83; sensitivity = 69%, specificity = 65%; P = 0.01) at a cut-off of 0.22. Using a combination of APRI and Fib4, the AUROC for Hepascore for advanced fibrosis was 0.70 (95% CI 0.54–0.86, P = 0.02). Hepascore was not diagnostic for detection of advanced fibrosis using the Fib4 cut-off. Elastography was not diagnostic using either APRI or Fib4 cut-offs. Hepascore and elastography detected significantly fewer true positive or true negative cases of advanced fibrosis compared with APRI and Fib4, except in subjects with serum ferritin levels > 1000 µg/L. In comparison with APRI or Fib4, Hepascore or elastography may underdiagnose advanced fibrosis in HFE Hemochromatosis, except in individuals with serum ferritin levels > 1000 µg/L.Sim Yee OngTiffany KhooAmanda J. NicollLyle GurrinThomas WorlandPuraskar PateriaLouise E. RammAdam TestroGregory J. AndersonRichard SkoienLawrie W. PowellGrant A. RammJohn K. OlynykMartin B. DelatyckiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sim Yee Ong Tiffany Khoo Amanda J. Nicoll Lyle Gurrin Thomas Worland Puraskar Pateria Louise E. Ramm Adam Testro Gregory J. Anderson Richard Skoien Lawrie W. Powell Grant A. Ramm John K. Olynyk Martin B. Delatycki Utility and limitations of Hepascore and transient elastography to detect advanced hepatic fibrosis in HFE hemochromatosis
description	Abstract Aspartate aminotransferase-to-platelet ratio index (APRI) and Fibrosis-4 Index (Fib4) have been validated against liver biopsy for detecting advanced hepatic fibrosis in HFE hemochromatosis. We determined the diagnostic utility for advanced hepatic fibrosis of Hepascore and transient elastography compared with APRI and Fib4 in 134 newly diagnosed HFE hemochromatosis subjects with serum ferritin levels > 300 µg/L using area under the receiver operator characteristic curve (AUROC) analysis and APRI- (> 0.44) or Fib4- (> 1.1) cut-offs for AHF, or a combination of both. Compared with APRI, Hepascore demonstrated an AUROC for advanced fibrosis of 0.69 (95% CI 0.56–0.83; sensitivity = 69%, specificity = 65%; P = 0.01) at a cut-off of 0.22. Using a combination of APRI and Fib4, the AUROC for Hepascore for advanced fibrosis was 0.70 (95% CI 0.54–0.86, P = 0.02). Hepascore was not diagnostic for detection of advanced fibrosis using the Fib4 cut-off. Elastography was not diagnostic using either APRI or Fib4 cut-offs. Hepascore and elastography detected significantly fewer true positive or true negative cases of advanced fibrosis compared with APRI and Fib4, except in subjects with serum ferritin levels > 1000 µg/L. In comparison with APRI or Fib4, Hepascore or elastography may underdiagnose advanced fibrosis in HFE Hemochromatosis, except in individuals with serum ferritin levels > 1000 µg/L.
format	article
author	Sim Yee Ong Tiffany Khoo Amanda J. Nicoll Lyle Gurrin Thomas Worland Puraskar Pateria Louise E. Ramm Adam Testro Gregory J. Anderson Richard Skoien Lawrie W. Powell Grant A. Ramm John K. Olynyk Martin B. Delatycki
author_facet	Sim Yee Ong Tiffany Khoo Amanda J. Nicoll Lyle Gurrin Thomas Worland Puraskar Pateria Louise E. Ramm Adam Testro Gregory J. Anderson Richard Skoien Lawrie W. Powell Grant A. Ramm John K. Olynyk Martin B. Delatycki
author_sort	Sim Yee Ong
title	Utility and limitations of Hepascore and transient elastography to detect advanced hepatic fibrosis in HFE hemochromatosis
title_short	Utility and limitations of Hepascore and transient elastography to detect advanced hepatic fibrosis in HFE hemochromatosis
title_full	Utility and limitations of Hepascore and transient elastography to detect advanced hepatic fibrosis in HFE hemochromatosis
title_fullStr	Utility and limitations of Hepascore and transient elastography to detect advanced hepatic fibrosis in HFE hemochromatosis
title_full_unstemmed	Utility and limitations of Hepascore and transient elastography to detect advanced hepatic fibrosis in HFE hemochromatosis
title_sort	utility and limitations of hepascore and transient elastography to detect advanced hepatic fibrosis in hfe hemochromatosis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/7d1d5a7b6a9c4eeb9724bc31eb9c0869
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Utility and limitations of Hepascore and transient elastography to detect advanced hepatic fibrosis in HFE hemochromatosis

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