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The novel cutoff points for the FIB4 index categorized by age increase the diagnostic accuracy in NAFLD: a multi-center study

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript

A Correction to this article was published on 25 May 2018

This article has been updated

Abstract

Background

The FIB4 index is clinically useful, but because its formula includes age, the appropriate cutoff point may differ by age group. Here, new FIB4 index cutoff points were validated using cohort data from 14 hepatology centers in Japan.

Methods

The FIB4 index was determined in biopsy-confirmed NAFLD patients (n = 1050) who were divided into four groups: ≤ 49, 50–59, 60–69, and ≥ 70 years. ROC analysis predicted advanced fibrosis in each age group; low and high cutoff points were defined by a sensitivity and specificity of 90%. The new and conventional cutoffs were compared for detecting advanced fibrosis.

Results

The modified low and high cutoff points were 1.05 and 1.21 in ≤ 49 years, 1.24 and 1.96 in 50–59 years, 1.88 and 3.24 in 60–69 years, and 1.95 and 4.56 in ≥ 70 years. In ≥ 60 years, the false-negative rate was increased using the modified high cutoff point, and the high cutoff point was better with the conventional cutoff point. The new proposed low and high cutoff points are 1.05 and 1.21 in ≤ 49 years, 1.24 and 1.96 in 50–59 years, 1.88 and 2.67 in 60–69 years, and 1.95 and 2.67 in ≥ 70 years; these cutoff points improved the accuracy of advanced fibrosis diagnosis.

Conclusions

FIB4 index cutoff points for predicting advanced fibrosis in NAFLD increased with age. Cutoff points modified by age improved the diagnostic accuracy of estimations of advanced liver fibrosis using the FIB4 index.

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Change history

  • 25 May 2018

    The coauthor Masashi Yoneda’s affiliation has been incorrectly published in the original publication of the article. The correct affiliation is provided in this correction.

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Acknowledgements

We have no funds and grants in this study.

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Authors and Affiliations

  1. Department of Gastroenterology, North Medical Center of Kyoto Prefectural University of Medicine, Yosanocho, Japan

    Hiroshi Ishiba

  2. Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Hiroshi Ishiba, Yuya Seko & Yoshito Itoh

  3. Division of Hepatology and Pancreatology, Department of Internal Medicine, Aichi Medical University, Nagakute, Japan

    Yoshio Sumida

  4. Center for Digestive and Liver Diseases, Nara City Hospital, Nara, Japan

    Saiyu Tanaka, Kojiro Mori & Kazuyuki Kanemasa

  5. Division of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    Masato Yoneda, Kento Imajo & Atsushi Nakajima

  6. Department of Gastroenterology, JA Hiroshima Kouseiren General Hospital, Hiroshima, Japan

    Hideyuki Hyogo

  7. Department of Gastroenterology and Hepatology, Kochi Medical School, Kochi, Japan

    Masafumi Ono & Toshiji Saibara

  8. Department of Hepatology, Graduate School of Medicine, Osaka City University, Osaka, Japan

    Hideki Fujii

  9. Department of Internal Medicine, Saga Medical School, Saga University, Saga, Japan

    Yuichiro Eguchi, Hirokazu Takahashi & Kazuma Fujimoto

  10. Department of Gastroenterology, Nayoro City General Hospital, Nayoro, Japan

    Yasuaki Suzuki

  11. Department of Gastroenterology and Metabolism, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

    Masashi Yoneda, Takashi Nakahara & Kazuaki Chayama

  12. Department of Pathology, Nara City Hospital, Nara, Japan

    Keiji Shimada & Sunsuke Imai

  13. Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan

    Takumi Kawaguchi

  14. Hepatology Center, Saiseikai Suita Hospital, Suita, Japan

    Toshihide Shima & Takeshi Okanoue

Authors
  1. Hiroshi Ishiba
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  2. Yoshio Sumida
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  3. Saiyu Tanaka
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  4. Masato Yoneda
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  5. Hideyuki Hyogo
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  6. Masafumi Ono
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  7. Hideki Fujii
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  8. Yuichiro Eguchi
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  9. Yasuaki Suzuki
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  10. Masashi Yoneda
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  11. Hirokazu Takahashi
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  12. Takashi Nakahara
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  13. Yuya Seko
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  15. Kazuyuki Kanemasa
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  16. Keiji Shimada
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  17. Sunsuke Imai
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  18. Kento Imajo
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  19. Takumi Kawaguchi
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  20. Atsushi Nakajima
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  21. Kazuaki Chayama
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  23. Toshihide Shima
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  26. Yoshito Itoh
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Consortia

for the Japan Study Group of Non-Alcoholic Fatty Liver Disease (JSG-NAFLD)

Contributions

HI and SY: concept, design and writing of article. ST, MY, HH, HF, YS, MY, HT, TN, YS, KM, KK, KI: Date Procedures. KS, SI: Pathologist. MO, YE, TK, MY, AN, KC, TS, TS, KF, TO: Obserever. YI: Director of this study.

Corresponding author

Correspondence to Yoshio Sumida.

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All authors do not have any financial of conflicts.

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Ishiba, H., Sumida, Y., Tanaka, S. et al. The novel cutoff points for the FIB4 index categorized by age increase the diagnostic accuracy in NAFLD: a multi-center study. J Gastroenterol 53, 1216–1224 (2018). https://doi.org/10.1007/s00535-018-1474-y

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  • DOI: https://doi.org/10.1007/s00535-018-1474-y

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