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- Title
Evaluation of the fibrosis‐4 index for detection of advanced fibrosis among individuals at risk for intestinal failure–associated liver disease.
- Authors
Micic, Dejan; Huard, Genevieve; Lee, Sang Mee; Fiel, M. Isabel; Moon, Jang; Schiano, Thomas D.; Iyer, Kishore
- Abstract
Background: Intestinal failure–associated liver disease (IFALD) refers to the spectrum of liver injury secondary to IF and parenteral nutrition use. Our aim was to evaluate the use of noninvasive indices of liver fibrosis to detect advanced fibrosis among individuals at risk for IFALD. Methods: We performed a secondary analysis of a retrospective study, including all liver biopsies performed on individuals undergoing intestinal transplantation (ITx) between January 2000 and May 2014. To determine the clinical utility of detecting advanced fibrosis, receiver operating characteristic curves were developed. Comparison between the area under the curves was performed by DeLong test. Results: Fifty‐three patients had a liver biopsy performed at the time of ITx; 13 of 53 (24.5%) patients had advanced fibrosis. The fibrosis‐4 (FIB‐4) index positively correlated to the stage of fibrosis on liver biopsy (r = 0.426, P =.002). When compared against the FIB‐4 index, the aspartate aminotransferase to platelet ratio index had a significantly decreased ability to correctly identify the presence of advanced fibrosis (P =.019). When determining the cutoff value with 90% specificity for the detection of advanced fibrosis, a FIB‐4 index of ≥4.4 had a sensitivity of 0.462 and a positive predictive value of 0.6. Conclusion: In this retrospective cohort study, we found a positive correlation between the FIB‐4 index and the liver fibrosis stage as characterized by the Brunt classification. This evaluation of the FIB‐4 index against liver biopsies supports the use of the FIB‐4 index in the detection of liver fibrosis in IF.
- Subjects
BIOPSY; FIBROSIS; LIVER diseases; COMPARATIVE studies; INTESTINAL diseases; RECEIVER operating characteristic curves; SENSITIVITY &; specificity (Statistics); SECONDARY analysis; ASPARTATE aminotransferase
- Publication
JPEN Journal of Parenteral & Enteral Nutrition, 2022, Vol 46, Issue 3, p678
- ISSN
0148-6071
- Publication type
Article
- DOI
10.1002/jpen.2135