Diagnosis of fibrosis using blood markers and logistic regression in Southeast Asian patients with non-alcoholic fatty liver disease
Document Type
Article
Publication Date
2-23-2021
Abstract
Non-alcoholic fatty liver disease (NAFLD) is one of the main causes of fibrosis. Liver biopsy remains the gold standard for the confirmation of fibrosis in NAFLD patients. Effective and non-invasive diagnosis of advanced fibrosis is essential to disease surveillance and treatment decisions. Herein we used routine medical test markers and logistic regression to differentiate early and advanced fibrosis in NAFLD patients from China, Malaysia, and India (n(1) = 540, n(2) = 147, and n(3) = 97) who were confirmed by liver biopsy. Nine parameters, including age, body mass index, fasting blood glucose, presence of diabetes or impaired fasting glycemia, alanine aminotransferase, gamma-glutamyl transferase, triglyceride, and aspartate transaminase/platelet count ratio, were selected by stepwise logistic regression, receiver operating characteristic curve (ROC), and hypothesis testing and were used for model construction. The area under the ROC curve (auROC) of the model was 0.82 for differentiating early and advanced fibrosis (sensitivity = 0.69, when specificity = 0.80) in the discovery set. Its diagnostic ability remained good in the two independent validation sets (auROC = 0.89 and 0.71) and was consistently superior to existing panels such as the FIB-4 and NAFLD fibrosis score. A web-based tool, LiveFbr, was developed for fast access to our model. The new model may serve as an attractive tool for fibrosis classification in NAFLD patients.
Keywords
NAFLD, Hepatic fibrosis, Advanced fibrosis, FIB-4, NFS, Logistic regression
Divisions
fac_med
Funders
National Key Research and Development Program of China[2019YFA0802300],National Key Research and Development Program of China[2017YFC0906800],National Natural Science Foundation of China (NSFC)[31972935],Shenzhen Science, Technology and Innovation Commission[2020(82)],Shanghai Municipal Science and Technology Major Project[2017SHZDZX01]
Publication Title
Frontiers in Medicine
Volume
8
Publisher
Frontiers Media
Publisher Location
AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE, CH-1015, SWITZERLAND