Comparison of non-invasive scores for the evaluation of liver fibrosis in subjects with metabolic dysfunction-associated fatty liver disease (MAFLD)
Bryan A. Priego-Parra1,2, Arturo Triana-Romero3, Raúl Bernal-Reyes4, María E. Icaza-Chávez4, Sophia E. Martínez-Vázquez4, Ana D. Cano-Contreras2, Héctor Vivanco-Cid2, José M. Remes-Troche2
1 Centro de Investigaciones Biomédicas, Universidad Veracruzana
2 Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana
3 Unidad Médica de Alta Especialidad (UMAE) Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez", Centro Médico Nacional Siglo XXl
4 Grupo de Investigación MAFLD de la Asociación Mexicana de Gastroenterología
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"apellidos" => "Priego-Parra" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "aff0001" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">2</span>" "identificador" => "aff0002" ] ] ] 1 => array:3 [ "nombre" => "Arturo" "apellidos" => "Triana-Romero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">3</span>" "identificador" => "aff0003" ] ] ] 2 => array:3 [ "nombre" => "Raúl" "apellidos" => "Bernal-Reyes" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">4</span>" "identificador" => "aff0004" ] ] ] 3 => array:3 [ "nombre" => "María E." "apellidos" => "Icaza-Chávez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">4</span>" "identificador" => "aff0004" ] ] ] 4 => array:3 [ "nombre" => "Sophia E." "apellidos" => "Martínez-Vázquez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">4</span>" "identificador" => "aff0004" ] ] ] 5 => array:3 [ "nombre" => "Ana D." "apellidos" => "Cano-Contreras" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">2</span>" "identificador" => "aff0002" ] ] ] 6 => array:3 [ "nombre" => "Héctor" "apellidos" => "Vivanco-Cid" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">2</span>" "identificador" => "aff0002" ] ] ] 7 => array:3 [ "nombre" => "José M." "apellidos" => "Remes-Troche" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">2</span>" "identificador" => "aff0002" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Centro de Investigaciones Biomédicas, Universidad Veracruzana" "etiqueta" => "1" "identificador" => "aff0001" ] 1 => array:3 [ "entidad" => "Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana" "etiqueta" => "2" "identificador" => "aff0002" ] 2 => array:3 [ "entidad" => "Unidad Médica de Alta Especialidad (UMAE) Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez", Centro Médico Nacional Siglo XXl" "etiqueta" => "3" "identificador" => "aff0003" ] 3 => array:3 [ "entidad" => "Grupo de Investigación MAFLD de la Asociación Mexicana de Gastroenterología" "etiqueta" => "4" "identificador" => "aff0004" ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="para0005" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Ethical statement</span></p><p id="para0006" class="elsevierStylePara elsevierViewall">The protocol was registered and approved by the Ethics Committee. The identity of the patients is protected. Consentment was obtained.</p><p id="para0007" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Declaration of interests</span></p><p id="para0008" class="elsevierStylePara elsevierViewall">None</p><p id="para0009" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Funding</span></p><p id="para0010" class="elsevierStylePara elsevierViewall">This research was supported by CONAHCYT grant CVU 1138232 and Proyecto de Ciencia Básica #256235<elsevierMultimedia ident="fig0001"></elsevierMultimedia></p><p id="para0012" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Figure 1</span>. Receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic performance of different non-invasive scores for hepatic fibrosis in subjects with metabolic-associated fatty liver disease (MAFLD). Hepatic fibrosis was assessed using liver transient elastography, with a threshold of ≥8 kPa indicating the presence of fibrosis.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "resumen" => "<span id="abss0001" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0001">Introduction and Objectives</span><p id="spara001" class="elsevierStyleSimplePara elsevierViewall">Metabolic-associated fatty liver disease (MAFLD) poses a significant risk for progression to advanced liver diseases, underscoring the need for early detection. This study aims to assess and compare the diagnostic efficacy of non-invasive markers (APRI, FIB-4, Hepamet, and NAFLD Score (NFS) in detecting hepatic fibrosis among MAFLD patients.</p></span> <span id="abss0002" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0002">Materials and Patients</span><p id="spara002" class="elsevierStyleSimplePara elsevierViewall">A retrospective examination was performed on adults with MAFLD who had undergone transient liver elastography. Hepatic fibrosis was identified at a cut-off point of ≥8 kPa. APRI, FIB-4, Hepamet, and NFS scores were evaluated with cut-off points determined via the Youden index. Receiver Operating Characteristic (ROC) curves and their areas were computed. All participants provided informed consent.</p></span> <span id="abss0003" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0003">Results</span><p id="spara003" class="elsevierStyleSimplePara elsevierViewall">Our cohort consisted of 150 MAFLD patients, the median age of 55 years (48-65), comprising 66.2% (129) females and 33.88% (66) males. The median BMI was 32.1 (28.8-35.6), kPa was 5.6 (4.6-7.8), and CAP was 310 (280-341). Hepatic fibrosis was evident in 24.7% (37) of the participants. Among the evaluated scores, APRI exhibited superior diagnostic performance, achieving an area under the curve of 0.72, followed by FIB-4 (0.66), Hepamet (0.64), and NFS (0.62). The cut-off points of 0.50 for APRI, 1.65 for FIB-4, 0.05 for Hepamet, and -0.75 for NFS yielded sensitivities of 86%, 82%, 86%, and 81%, respectively (Fig 1).</p></span> <span id="abss0004" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0004">Conclusions</span><p id="spara004" class="elsevierStyleSimplePara elsevierViewall">Non-invasive scoring systems, notably APRI, demonstrate valuable potential in evaluating hepatic fibrosis among Mexican MAFLD patients. Utilization of adjusted cut-off points enhances test efficiency, thereby facilitating early detection of individuals at greater risk of disease progression.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abss0001" "titulo" => "Introduction and Objectives" ] 1 => array:2 [ "identificador" => "abss0002" "titulo" => "Materials and Patients" ] 2 => array:2 [ "identificador" => "abss0003" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abss0004" "titulo" => "Conclusions" ] ] ] ] "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0001" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr52.jpeg" "Alto" => 1184 "Ancho" => 1500 "Tamanyo" => 100530 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "alt0001" "detalle" => "Unlabelled imag" "rol" => "short" ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/16652681/00000029000000S2/v2_202404250742/S1665268124002461/v2_202404250742/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/16652681/00000029000000S2/v2_202404250742/S1665268124002461/v2_202404250742/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1665268124002461?idApp=UINPBA00004N" ]
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