Endocrine Abstracts

Objective: Increasing obesity rates are causing a surge in non-alcoholic fatty liver disease (NAFLD) prevalence which may progress further to non-alcoholic steatohepatitis (NASH) to cirrhosis. The utility of Fibroscan was shown in stratifying risk for significant liver disease in patients with obesity but it has a limited availability. The aim of the study was to compare the accuracy of Fibrosis-4 (FIB-4)) score to diagnose advanced fibrosis in overweight and obesity patients.

Methods: We conducted the study in 369 (145 men, 224 women) patients aged between 18-75 years old and body mass index over 25 kg/m² from department of endocrinology and metabolism disease and gastroenterology, School of Medicine, Recep Tayyip Erdoğan University. We performed a fibroscan assessment and collected biochemical, demographic, and clinical data. Patients were categorized as group I with mild/moderate fibrosis (F0- F2) and group II with advanced fibrosis (AF) (F3-F4) based on fıbroscan liver stiffness measurement (LSM).

Results: FIB-4 score was significantly higher in group 2 than group 1 (P<0.001). There was no significant difference in alanine transaminase level (P:0.15) and platelet count (P:0.32) between the groups whereas gamma glutamyl transferase and aspartate transaminase levels were significantly higher in group 2 (P:0.003 andp:0.003, respectively). There was a positive correlation between FIB-4 score and LSM (r:0.416, P<0.001). The cutoff point of 1.04 for FIB-4 score provided 70% sensitivity and 62% specificity with an area under the curve equal to 72% (P<0.001).

Conclusion: FIB-4 score could predict advanced fibrosis in overweight and obesity patients particularly in settings where fibroscan assessment is limited. Based on this score, patients can be followed for progression of NAFLD, and prompt treatment modification could be implemented.

Reference: 1. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology 77(5):p 1797-1835, May 2023. 2. Kumari B, Kumar R, Sharma S, et al. Diagnostic Accuracy of FIB-4 and FIB-5 Scores as Compared to Fibroscan for Assessment of Liver Fibrosis in Patients With Non-Alcoholic Fatty Liver Disease. Cureus. 2021; 13(8):e17622. 3. Mózes FE, Lee JA, Selvaraj EA, et al. Diagnostic accuracy of non-invasive tests for advanced fibrosis in patients with NAFLD: an individual patient data meta-analysis. Gut. 2022; 71(5):1006-1019.