دورية أكاديمية
أعرض في EDS

Using FIB-4 score as a screening tool in the assessment of significant liver fibrosis (F2) in patients with transfusion-dependent beta thalassaemia: a cross-sectional study.

التفاصيل البيبلوغرافية
العنوان: Using FIB-4 score as a screening tool in the assessment of significant liver fibrosis (F2) in patients with transfusion-dependent beta thalassaemia: a cross-sectional study.
المؤلفون: Padeniya P; Adolescent and Adult Thalassaemia Care Center (University Medical Unit), North Colombo Teaching Hospital, No. 10, Sirima Bandaranayake Mawatha, Kadawatha, Sri Lanka padmapani@kln.ac.lk.; Department of Anatomy, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka., Ediriweera DS; Health Data Science Unit, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka., De Silva AP; Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka., Niriella MA; Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka., Premawardhena A; Adolescent and Adult Thalassaemia Care Center (University Medical Unit), North Colombo Teaching Hospital, No. 10, Sirima Bandaranayake Mawatha, Kadawatha, Sri Lanka.; Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
المصدر: BMJ open [BMJ Open] 2022 Sep 26; Vol. 12 (9), pp. e061156. Date of Electronic Publication: 2022 Sep 26.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
مواضيع طبية MeSH: Elasticity Imaging Techniques* , Hepatitis C, Chronic* , beta-Thalassemia*/diagnosis, Adolescent ; Adult ; Aspartate Aminotransferases ; Biomarkers ; Cross-Sectional Studies ; Female ; Hepatitis C Antibodies ; Humans ; Liver/pathology ; Liver Cirrhosis/pathology ; Male ; ROC Curve
مستخلص: Objective: To evaluate the performance of the fibrosis-4 (FIB-4) score as a screening tool to detect significant liver fibrosis (F2) compared with transient elastography (TE), among chronic transfusion-dependent beta-thalassaemia (TDT) patients in a resource-poor setting.
Design: A cross-sectional study.
Setting: Adolescent and Adult Thalassaemia Care Centre (University Medical Unit), Kiribathgoda, Sri Lanka.
Participants: 45 TDT patients who had undergone more than 100 blood transfusions with elevated serum ferritin >2000 ng/mL were selected for the study. Patients who were serologically positive for hepatitis C antibodies were excluded.
Outcome Measures: TE and FIB-4 scores were estimated at the time of recruitment in all participants. Predefined cut-off values for F2, extracted from previous TE and FIB-4 scores studies, were compared. A new cut-off value for the FIB-4 score was estimated using receiver operating characteristics curve analysis to improve the sensitivity for F2 prediction.
Results: Of the selected 45 TDT patients, 22 (49%) were males. FIB-4 score showed a significant linear correlation with TE (r=0.52;p<0.0003). The FIB-4 score was improbable to lead to a false classification of TDT patients to have F2 when the FIB-4 cut-off value was 1.3. On the other hand, it had a very low diagnostic yield in missing almost all (except one) of those who had F2. Using a much-lowered cut-off point of 0.32 for FIB-4, we improved the pick-up rate of F2 to 72%.
Conclusions: Regardless of the cut-off point, the FIB-4 score cannot be used as a good screening tool to pick up F2 in patients with TDT, irrespective of their splenectomy status. On the contrary, at a 1.3 cut-off value, though FIB-4 is a very poor detector for F2 fibrosis, it will not erroneously diagnose F2 fibrosis in those who do not have it.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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فهرسة مساهمة: Keywords: anaemia; hepatobiliary disease; hepatology
المشرفين على المادة: 0 (Biomarkers)
0 (Hepatitis C Antibodies)
EC 2.6.1.1 (Aspartate Aminotransferases)
تواريخ الأحداث: Date Created: 20220927 Date Completed: 20220929 Latest Revision: 20221010
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC9516150
DOI: 10.1136/bmjopen-2022-061156
PMID: 36167380
قاعدة البيانات: MEDLINE
الوصف
تدمد:2044-6055
DOI:10.1136/bmjopen-2022-061156