دورية أكاديمية
Diagnostic accuracy of the Fibrosis-4 index for advanced liver fibrosis in metabolic dysfunction-associated steatotic liver disease with type 2 diabetes: A systematic review and meta-analysis.
| العنوان: | Diagnostic accuracy of the Fibrosis-4 index for advanced liver fibrosis in metabolic dysfunction-associated steatotic liver disease with type 2 diabetes: A systematic review and meta-analysis. |
|---|---|
| المؤلفون: | Han JW; The Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Korea.; Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic Korea., Kim HY; The Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Korea.; Department of Internal Medicine, College of Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, Bucheon, Republic Korea., Yu JH; Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Republic Korea., Kim MN; Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic Korea., Chon YE; Department of Gastroenterology, CHA Bundang Medical Center, CHA University, Seongnam, Republic Korea., An JH; Department of Gastroenterology and Hepatology, Hanyang University College of Medicine, Guri, Republic Korea., Jin YJ; Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Republic Korea., Choi M; Clinical Evidence Research, National Evidence-based Healthcare Collaborating Agency (NECA), Seoul, Republic Korea., Kim SU; Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Republic Korea., Lee HA; Department of Internal Medicine, College of Medicine, Chung-Ang University Hospital, Seoul, Republic Korea., Jun DW; Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic Korea. |
| المصدر: | Clinical and molecular hepatology [Clin Mol Hepatol] 2024 Jul 25. Date of Electronic Publication: 2024 Jul 25. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Korean Association for the Study of the Liver Country of Publication: Korea (South) NLM ID: 101586730 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2287-285X (Electronic) Linking ISSN: 22872728 NLM ISO Abbreviation: Clin Mol Hepatol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Seoul, Korea : Korean Association for the Study of the Liver |
| مستخلص: | Background/aims: The Fibrosis-4 index (FIB-4) is a non-invasive test widely used to rule out advanced liver fibrosis (AF) in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). However, its diagnostic accuracy in MASLD patients with type 2 diabetes mellitus (T2DM) are controversial due to the high prevalence of AF in this population. Methods: Research focusing on the diagnostic accuracy of FIB-4 for liver fibrosis as validated by liver histology in MASLD patients with T2DM was included, and 12 studies (n=5,624) were finally included in the meta-analysis. Sensitivity, specificity, hierarchical summary receiver operating characteristic (HSROC), positive predictive values (PPVs), and negative predictive values (NPVs) at low cutoffs (1.3-1.67) and high cutoffs (2.67-3.25) for ruling in and out AF, were calculated. Results: At low cutoffs, the meta-analysis revealed a sensitivity of 0.74, specificity of 0.62, and HSROC of 0.75. At high cutoffs, the analysis showed a sensitivity of 0.33, specificity of 0.92, and HSROC of 0.85, suggesting FIB-4 as useful for identifying or excluding AF. In subgroup analyses, high mean age and F3 prevalence were associated with lower sensitivity. The calculated NPV and PPV were 0.82 and 0.49 at low cutoffs, whereas the NPV was 0.28 and the PPV was 0.70 at high cutoffs. There were insufficient estimated NPVs <0.90 at a hypothesized prevalence of AF >30% at an FIB-4 cutoff range of 1.3-1.67. Conclusions: Collectively, FIB-4 has moderate diagnostic accuracy for identifying or excluding AF in MASLD patients with T2DM, but more evidence must be accumulated due to the limited number of currently reported studies and their heterogeneity. |
| تواريخ الأحداث: | Date Created: 20240724 Latest Revision: 20240731 |
| رمز التحديث: | 20240731 |
| DOI: | 10.3350/cmh.2024.0330 |
| PMID: | 39048521 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2287-285X |
|---|---|
| DOI: | 10.3350/cmh.2024.0330 |