The Predictive Value of Time-Varying Noninvasive Scores on Long-Term Prognosis of NAFLD in South Korea.

IF 2.7 4区医学 Q2 Medicine Canadian Journal of Gastroenterology and Hepatology Pub Date : 2024-09-16 eCollection Date: 2024-01-01 DOI:10.1155/2024/5667986

Sung Won Chung, Min Kyung Park, Xiao Zhang, Tongtong Wang, Thomas Jemielita, Gail Fernandes, Samuel S Engel, Heejoon Jang, Yun Bin Lee, Eun Ju Cho, Jeong-Hoon Lee, Su Jong Yu, Jung-Hwan Yoon, Yoon Jun Kim

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Abstract

Background: This study aimed to examine whether repeated measurements on noninvasive fibrosis scores during follow-up improve long-term nonalcoholic fatty liver disease (NAFLD) outcome prediction.

Methods: A cohort study of 2,280 NAFLD patients diagnosed at the Seoul National University Hospital from 2001 to 2015 was conducted. Multivariable Cox regression models with baseline and designated time-point measurements of the fibrosis-4 index (FIB-4) and NAFLD fibrosis score (NFS) were used to assess the association between these scores and overall mortality, liver-related outcomes, and cardiovascular events.

Results: Higher baseline NFS (high versus low probability for advanced fibrosis groups) was associated with higher risk of mortality (adjusted hazard ratio (aHR), (95% confidence interval (CI)), 2.80, [1.39-5.63]) and liver-related outcomes (3.70, [1.27-10.78]). Similar findings were observed for the association of baseline FIB-4 with mortality (2.49, [1.46-4.24]) and liver-related outcomes (11.50, [6.17-21.44]). In models considering designated time-point measurements of the scores, stronger associations were noted. For NFS, a higher time-point measurement was associated with a significantly higher risk of mortality (3.01, [1.65-5.49]) and liver-related outcomes (6.69, [2.62-17.06]). For FIB-4, higher time-point measurements were associated with significantly higher mortality (3.01, [1.88-4.82]) and liver-related outcomes (13.26, [6.89-25.53]). An annual increase in FIB-4 (2.70, [1.79-4.05]) or NFS (4.68, [1.52-14.44]) was associated with an increased risk of liver-related outcomes. No association between NFS/FIB-4 and risk of cardiovascular events was observed in both models.

Conclusions: Higher aHRs describing the associations of FIB-4/NFS with overall mortality and liver-related outcomes were observed in the models that included designated time-point measurements of the scores. In addition to the baseline measurement, a routine monitoring on these scores may be important in predicting prognosis of NAFLD patients.

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韩国非酒精性脂肪肝长期预后的时变无创评分预测价值。

背景：本研究旨在探讨随访期间重复测量无创纤维化评分是否能改善非酒精性脂肪肝的长期预后：本研究旨在探讨随访期间重复测量无创纤维化评分是否能改善非酒精性脂肪肝（NAFLD）的长期预后：该研究对2001年至2015年期间在首尔国立大学医院确诊的2280名非酒精性脂肪肝患者进行了队列研究。采用纤维化-4指数（FIB-4）和非酒精性脂肪肝纤维化评分（NFS）基线和指定时间点测量值的多变量Cox回归模型，评估这些评分与总死亡率、肝脏相关结局和心血管事件之间的关系：较高的基线NFS（高与低概率的晚期纤维化组）与较高的死亡风险（调整后危险比（aHR），（95%置信区间（CI）），2.80，[1.39-5.63]）和肝脏相关结果（3.70，[1.27-10.78]）相关。基线 FIB-4 与死亡率（2.49，[1.46-4.24]）和肝脏相关结果（11.50，[6.17-21.44]）的关系也有类似的结果。在考虑分数的指定时间点测量值的模型中，相关性更强。就 NFS 而言，时间点测量值越高，死亡风险（3.01，[1.65-5.49]）和肝脏相关结果（6.69，[2.62-17.06]）就越高。对于 FIB-4，更高的时间点测量值与更高的死亡率（3.01，[1.88-4.82]）和肝脏相关结果（13.26，[6.89-25.53]）显著相关。FIB-4（2.70，[1.79-4.05]）或NFS（4.68，[1.52-14.44]）的年增长率与肝脏相关结果的风险增加有关。两个模型均未观察到NFS/FIB-4与心血管事件风险之间的关联：结论：FIB-4/NFS与总死亡率和肝脏相关结局的相关性的aHR值较高，这是在包括指定时间点的评分测量值的模型中观察到的。除了基线测量外，对这些评分进行常规监测可能对预测非酒精性脂肪肝患者的预后很重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Canadian Journal of Gastroenterology and Hepatology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

4.80

自引率

0.00%

发文量

审稿时长

37 weeks

期刊介绍： Canadian Journal of Gastroenterology and Hepatology is a peer-reviewed, open access journal that publishes original research articles, review articles, and clinical studies in all areas of gastroenterology and liver disease - medicine and surgery. The Canadian Journal of Gastroenterology and Hepatology is sponsored by the Canadian Association of Gastroenterology and the Canadian Association for the Study of the Liver.