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- Title
Diagnostic and prognostic performance of the SAFE score in non‐alcoholic fatty liver disease.
- Authors
Li, Guanlin; Lin, Huapeng; Sripongpun, Pimsiri; Liang, Lilian Y.; Zhang, Xinrong; Wong, Vincent W.S.; Wong, Grace L.H.; Kim, W. Ray; Yip, Terry C.F.
- Abstract
Background & Aims: The steatosis‐associated fibrosis estimator (SAFE) score was developed to detect clinically significant liver fibrosis in patients with NAFLD in the United States. We compare the performance of the SAFE score and other non‐invasive tests to diagnose liver fibrosis and to correlate the scores with liver‐related outcomes in patients with NAFLD in Hong Kong. Methods: This was a retrospective cohort study involving two data sets. The first cohort was a biopsy cohort of NAFLD patients (n = 279), and the second was a territory‐wide cohort of NAFLD patients (n = 4603) retrieved from a territory‐wide electronic healthcare database in Hong Kong. Results: In detecting significant fibrosis, liver stiffness measured by transient elastography had the highest area under the receiver operating characteristic curve (AUROC) (.844), followed by SAFE score (.773). SAFE score had the highest AUROC among blood‐based algorithms (.773 vs..746 for FIB‐4,.697 for APRI). Based on cut‐off values of SAFE score (0 and 100 points), 854 (18.6%), 1596 (34.6%) and 2153 (46.8%) were in the low‐, intermediate‐ and high‐risk groups, respectively, in the territory‐wide cohort. Six (.7%), 15 (.9%) and 59 (2.7%) developed liver‐related events in those three groups respectively. Among patients who had liver‐related events at 5 years, using the high cut‐off, SAFE score could predict 84.9% of patients accurately, compared to 40.9% for FIB‐4 and 27.2% for APRI. Conclusion: The SAFE score performed well and better than other blood‐based markers in diagnosing significant fibrosis and predicting liver‐related events in Asian patients with NAFLD.
- Subjects
HONG Kong (China); FATTY liver; NON-alcoholic fatty liver disease; ACOUSTIC radiation force impulse imaging; HEPATIC fibrosis; LIVER histology; RECEIVER operating characteristic curves; ASIANS
- Publication
Liver International, 2024, Vol 44, Issue 1, p15
- ISSN
1478-3223
- Publication type
Article
- DOI
10.1111/liv.15718