External validation of the non-alcoholic fatty liver disease fibrosis score for assessing advanced fibrosis in Korean patients

Korean NAFLD study group (KNSG)

Research output: Contribution to journalArticle

Abstract

Background: The degree of liver fibrosis in non-alcoholic fatty liver disease (NAFLD) is a critical predictive factor for patient prognosis. This study was intended to perform external validation of the various fibrosis prediction models for assessing advanced fibrosis in Korean NAFLD patients. Methods: A retrospective study of 412 patients with NAFLD confirmed by liver biopsy in hospitals affiliated with the Koran NAFLD study group was conducted and the predictive ability of existing liver fibrosis prediction models including NAFLD fibrosis score (NFS), BARD, and fibrosis-4 were compared. Results: Among 412 samples, 328 liver slides were suitable for evaluation. Advanced fibrosis was present in 60 (18.3%) of the patient samples. Univariate analysis found that the group with advanced fibrosis showed low alanine aminotransferase values and high aspartate aminotransferase/alanine aminotransferase ratios as well as a high incidence of diabetes. However, multivariate analysis showed that only the presence of diabetes and triglycerides was independent risk factors. The receiver operating characteristic was 0.64 in NFS, 0.58 in fibrosis-4, and 0.594 in the BARD model. The NFS was found to be the best at predicting advanced fibrosis among the three prediction models. The negative predictive value which predicts advanced fibrosis using the low cutoff (<−1.455) was high (86.6%). However, the positive predictive value which predicts advanced fibrosis using the high cutoff (>0.676) was 50.0% when we applied the NFS. Conclusion: Negative predictive value using the low cutoff value was high, but positive predictive value using the high cutoff value was low in a Korean NAFLD cohort using NFS.

Original languageEnglish
Pages (from-to)1094-1099
Number of pages6
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume32
Issue number5
DOIs
Publication statusPublished - 2017 May 1

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Liver Cirrhosis
Fibrosis
Alanine Transaminase
Non-alcoholic Fatty Liver Disease
Liver
Aspartate Aminotransferases
ROC Curve
Triglycerides
Multivariate Analysis
Retrospective Studies
Biopsy

Keywords

  • clinical
  • metabolism
  • NAFLD
  • NASH

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

External validation of the non-alcoholic fatty liver disease fibrosis score for assessing advanced fibrosis in Korean patients. / Korean NAFLD study group (KNSG).

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 32, No. 5, 01.05.2017, p. 1094-1099.

Research output: Contribution to journalArticle

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title = "External validation of the non-alcoholic fatty liver disease fibrosis score for assessing advanced fibrosis in Korean patients",
abstract = "Background: The degree of liver fibrosis in non-alcoholic fatty liver disease (NAFLD) is a critical predictive factor for patient prognosis. This study was intended to perform external validation of the various fibrosis prediction models for assessing advanced fibrosis in Korean NAFLD patients. Methods: A retrospective study of 412 patients with NAFLD confirmed by liver biopsy in hospitals affiliated with the Koran NAFLD study group was conducted and the predictive ability of existing liver fibrosis prediction models including NAFLD fibrosis score (NFS), BARD, and fibrosis-4 were compared. Results: Among 412 samples, 328 liver slides were suitable for evaluation. Advanced fibrosis was present in 60 (18.3{\%}) of the patient samples. Univariate analysis found that the group with advanced fibrosis showed low alanine aminotransferase values and high aspartate aminotransferase/alanine aminotransferase ratios as well as a high incidence of diabetes. However, multivariate analysis showed that only the presence of diabetes and triglycerides was independent risk factors. The receiver operating characteristic was 0.64 in NFS, 0.58 in fibrosis-4, and 0.594 in the BARD model. The NFS was found to be the best at predicting advanced fibrosis among the three prediction models. The negative predictive value which predicts advanced fibrosis using the low cutoff (<−1.455) was high (86.6{\%}). However, the positive predictive value which predicts advanced fibrosis using the high cutoff (>0.676) was 50.0{\%} when we applied the NFS. Conclusion: Negative predictive value using the low cutoff value was high, but positive predictive value using the high cutoff value was low in a Korean NAFLD cohort using NFS.",
keywords = "clinical, metabolism, NAFLD, NASH",
author = "{Korean NAFLD study group (KNSG)} and Jun, {Dae Won} and Kim, {Sang Gyune} and Park, {Sang Hoon} and Jin, {So Young} and Lee, {Ji Sung} and Lee, {Jin Woo} and Kim, {Moon Young} and Choi, {Dae Hee} and Cho, {Yong Kyun} and Yeon, {Jong Eun} and Sohn, {Joo Hyun}",
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T1 - External validation of the non-alcoholic fatty liver disease fibrosis score for assessing advanced fibrosis in Korean patients

AU - Korean NAFLD study group (KNSG)

AU - Jun, Dae Won

AU - Kim, Sang Gyune

AU - Park, Sang Hoon

AU - Jin, So Young

AU - Lee, Ji Sung

AU - Lee, Jin Woo

AU - Kim, Moon Young

AU - Choi, Dae Hee

AU - Cho, Yong Kyun

AU - Yeon, Jong Eun

AU - Sohn, Joo Hyun

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Background: The degree of liver fibrosis in non-alcoholic fatty liver disease (NAFLD) is a critical predictive factor for patient prognosis. This study was intended to perform external validation of the various fibrosis prediction models for assessing advanced fibrosis in Korean NAFLD patients. Methods: A retrospective study of 412 patients with NAFLD confirmed by liver biopsy in hospitals affiliated with the Koran NAFLD study group was conducted and the predictive ability of existing liver fibrosis prediction models including NAFLD fibrosis score (NFS), BARD, and fibrosis-4 were compared. Results: Among 412 samples, 328 liver slides were suitable for evaluation. Advanced fibrosis was present in 60 (18.3%) of the patient samples. Univariate analysis found that the group with advanced fibrosis showed low alanine aminotransferase values and high aspartate aminotransferase/alanine aminotransferase ratios as well as a high incidence of diabetes. However, multivariate analysis showed that only the presence of diabetes and triglycerides was independent risk factors. The receiver operating characteristic was 0.64 in NFS, 0.58 in fibrosis-4, and 0.594 in the BARD model. The NFS was found to be the best at predicting advanced fibrosis among the three prediction models. The negative predictive value which predicts advanced fibrosis using the low cutoff (<−1.455) was high (86.6%). However, the positive predictive value which predicts advanced fibrosis using the high cutoff (>0.676) was 50.0% when we applied the NFS. Conclusion: Negative predictive value using the low cutoff value was high, but positive predictive value using the high cutoff value was low in a Korean NAFLD cohort using NFS.

AB - Background: The degree of liver fibrosis in non-alcoholic fatty liver disease (NAFLD) is a critical predictive factor for patient prognosis. This study was intended to perform external validation of the various fibrosis prediction models for assessing advanced fibrosis in Korean NAFLD patients. Methods: A retrospective study of 412 patients with NAFLD confirmed by liver biopsy in hospitals affiliated with the Koran NAFLD study group was conducted and the predictive ability of existing liver fibrosis prediction models including NAFLD fibrosis score (NFS), BARD, and fibrosis-4 were compared. Results: Among 412 samples, 328 liver slides were suitable for evaluation. Advanced fibrosis was present in 60 (18.3%) of the patient samples. Univariate analysis found that the group with advanced fibrosis showed low alanine aminotransferase values and high aspartate aminotransferase/alanine aminotransferase ratios as well as a high incidence of diabetes. However, multivariate analysis showed that only the presence of diabetes and triglycerides was independent risk factors. The receiver operating characteristic was 0.64 in NFS, 0.58 in fibrosis-4, and 0.594 in the BARD model. The NFS was found to be the best at predicting advanced fibrosis among the three prediction models. The negative predictive value which predicts advanced fibrosis using the low cutoff (<−1.455) was high (86.6%). However, the positive predictive value which predicts advanced fibrosis using the high cutoff (>0.676) was 50.0% when we applied the NFS. Conclusion: Negative predictive value using the low cutoff value was high, but positive predictive value using the high cutoff value was low in a Korean NAFLD cohort using NFS.

KW - clinical

KW - metabolism

KW - NAFLD

KW - NASH

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DO - 10.1111/jgh.13648

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JO - Journal of Gastroenterology and Hepatology (Australia)

JF - Journal of Gastroenterology and Hepatology (Australia)

SN - 0815-9319

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