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Evaluation of Six Noninvasive Methods for the Detection of Fibrosis in Chinese Patients with Obesity and Nonalcoholic Fatty Liver Disease

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Abstract

Purpose

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the world, and liver fibrosis has been proven to be associated with liver disease related events and total mortality. Several noninvasive methods have been developed, but whether those methods are suitable for the detection of fibrosis in Chinese patients with obesity and NAFLD has not been completely elucidated. This study aimed to compare the efficacy of fibrosis-4 (FIB-4), aspartate transaminase to platelet ratio index (APRI), modified aspartate transaminase to platelet ratio index (m-APRI), BARD (BARD (BMI (body mass index) > 28 = 1 point, AAR (aspartate aminotransferase/alanine aminotransferase) > 0.8 = 2 points, DM (diabetes mellitus) = 1 point)), NAFLD fibrosis score (NFS), and shear wave elastography (SWE) in the evaluation of the degree of liver fibrosis in Chinese patients with obesity and NAFLD.

Materials and Methods

A retrospective study consisted of 100 patients. The accuracy of FIB-4, APRI, m-APRI, BARD, NFS, and SWE in the assessment of significant or advanced liver fibrosis in Chinese patients with obesity and NAFLD was compared.

Results

Weight and alanine aminotransferase (ALT) were independent risk factors for liver fibrosis. SWE, APRI, and m-APRI had significant efficiency in the diagnosis of significant fibrosis in patients with obesity and NAFLD. APRI and SWE were superior to the other methods in the diagnosis of significant and advanced liver fibrosis in patients with obesity and NAFLD. APRI and SWE showed no statistically significant difference in diagnostic efficiency.

Conclusions

Weight and ALT are independent risk factors for liver fibrosis progression in NAFLD patients. SWE and APRI have predictive value for significant and advanced fibrosis of NAFLD in Chinese patients with obesity.

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Funding

The study is supported by the National Natural Science Foundation of China (81502613), Sichuan Province Science and Technology Support Program (2014SZ0002-5), Xindu Social Science and Technology Development Project (20160740401), and Sichuan Science and Technology Program (2022YFS0167).

Author information

Author notes

  1. Gang Chen and Jun-cheng Yang contributed equally to this work.

Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Laboratory of Bariatric and Metabolic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, China

    Gang Chen, Jun-cheng Yang, Gui-xiang Zhang, Zhong Cheng & Xiao Du

  2. Department of General Surgery, The Second Clinical Medical College, The Fifth People’s Hospital affiliated to Chengdu University of Traditional Chinese Medicine, Chengdu, China

    Gang Chen

  3. Department of General Surgery, Ya’an People’s Hospital, Yaan, China

    Xiao Du

Authors
  1. Gang Chen
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  2. Jun-cheng Yang
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  3. Gui-xiang Zhang
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  4. Zhong Cheng
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  5. Xiao Du
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Corresponding author

Correspondence to Xiao Du.

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Ethics Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Key Points

• Weight and alanine aminotransferase (ALT) were independent risk factors for liver fibrosis.

• APRI and SWE were superior to the other methods in the diagnosis of significant and advanced liver fibrosis in patients with obesity and NAFLD.

• APRI and SWE showed no statistically significant difference in diagnostic efficiency.

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Chen, G., Yang, Jc., Zhang, Gx. et al. Evaluation of Six Noninvasive Methods for the Detection of Fibrosis in Chinese Patients with Obesity and Nonalcoholic Fatty Liver Disease. OBES SURG 32, 3619–3626 (2022). https://doi.org/10.1007/s11695-022-06251-1

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  • DOI: https://doi.org/10.1007/s11695-022-06251-1

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