دورية أكاديمية
Progressive changes in platelet counts and Fib-4 scores precede the diagnosis of advanced fibrosis in NASH patients.
| العنوان: | Progressive changes in platelet counts and Fib-4 scores precede the diagnosis of advanced fibrosis in NASH patients. |
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| المؤلفون: | Zijlstra MK; Department of Internal Medicine, NorthShore University Health System, Evanston, IL 60201, United States., Gampa A; Division of Gastroenterology and Hepatology, University of Chicago Pritzker School of Medicine, Chicago, IL 60637, United States., Joseph N; Department of Pathology, NorthShore University Health System, Evanston, IL 60201, United States., Sonnenberg A; Portland VA Medical Center, Portland, OR 97239, United States.; Department of Gastroenterology, Oregon Health Sciences University, Portland, OR 97201, United States., Fimmel CJ; Division of Gastroenterology, Department of Internal Medicine, NorthShore University Health System, Evanston, IL 60201, United States. clausfimmel@att.net. |
| المصدر: | World journal of hepatology [World J Hepatol] 2023 Feb 27; Vol. 15 (2), pp. 225-236. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Baishideng Publishing Group Country of Publication: United States NLM ID: 101532469 Publication Model: Print Cited Medium: Print ISSN: 1948-5182 (Print) NLM ISO Abbreviation: World J Hepatol Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Publication: 2014- : Pleasanton, CA : Baishideng Publishing Group Original Publication: Beijing, China : Baishideng |
| مستخلص: | Background: Cirrhosis and its complications develop in a subgroup of patients with non-alcoholic fatty liver disease (NASH). Early detection of liver fibrosis represents an important goal of clinical care. Aim: To test the hypothesis that the development of cirrhosis in nonalcoholic fatty liver disease patients is preceded by the long-term trends of platelet counts and Fib-4 scores. Methods: We identified all patients in our healthcare system who had undergone fibrosis staging by liver biopsy or magnetic resonance elastography (MRE) for non-alcoholic fatty liver disease during the past decade ( n = 310). Platelet counts, serum glutamic-pyruvic transaminase and serum glutamic oxalacetic transaminase values preceding the staging tests were extracted from the electronic medical record system, and Fib-4 scores were calculated. Potential predictors of advanced fibrosis were evaluated using multivariate regression analysis. Results: Significant decreases in platelet counts and increases in Fib-4 scores were observed in all fibrosis stages, particularly in patients with cirrhosis. In the liver biopsy group, the presence of cirrhosis was best predicted by the combination of the Fib-4 score at the time closest to staging ( P < 0.0001), the presence of diabetes ( P = 0.0001), and the correlation coefficient of the preceding time-dependent drop in platelet count ( P = 0.044). In the MRE group, Fib4 score ( P = 0.0025) and platelet drop ( P = 0.0373) were significant predictors. In comparison, the time-dependent rise of the Fib-4 score did not contribute in a statistically significant way. Conclusion: Time-dependent changes in platelet counts and Fib-4 scores contribute to the prediction of cirrhosis in NASH patients with biopsy- or MRE-staged fibrosis. Their incorporation into predictive algorithms may assist in the earlier identification of high-risk patients. Competing Interests: Conflict-of-interest statement: All authors have no conflict of interest to report. (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.) |
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| فهرسة مساهمة: | Keywords: Liver biopsy; Liver fibrosis; Magnetic resonance elastography; Non-alcoholic fatty liver disease; Prediction; cirrhosis |
| تواريخ الأحداث: | Date Created: 20230317 Latest Revision: 20230318 |
| رمز التحديث: | 20230320 |
| مُعرف محوري في PubMed: | PMC10011908 |
| DOI: | 10.4254/wjh.v15.i2.225 |
| PMID: | 36926233 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1948-5182 |
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| DOI: | 10.4254/wjh.v15.i2.225 |