Munteanu, M.; Tiniakos, D.; Anstee, Q.; Charlotte, F.; Marchesini, G.; Bugianesi, E.; Trauner, M.; Romero Gomez, M.; Oliveira, C.; Day, C.; Dufour, Jean-François; Bellentani, S.; Ngo, Y.; Traussnig, S.; Perazzo, H.; Deckmyn, O.; Bedossa, P.; Ratziu, V.; Poynard, T. (2016). Diagnostic performance of FibroTest, SteatoTest and ActiTest in patients with NAFLD using the SAF score as histological reference. Alimentary pharmacology & therapeutics, 44(8), pp. 877-889. Wiley-Blackwell 10.1111/apt.13770
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BACKGROUND:
Blood tests of liver injury are less well validated in non-alcoholic fatty liver disease (NAFLD) than in patients with chronic viral hepatitis.
AIMS:
To improve the validation of three blood tests used in NAFLD patients, FibroTest for fibrosis staging, SteatoTest for steatosis grading and ActiTest for inflammation activity grading.
METHODS:
We pre-included new NAFLD patients with biopsy and blood tests from a single-centre cohort (FibroFrance) and from the multicentre FLIP consortium. Contemporaneous biopsies were blindly assessed using the new steatosis, activity and fibrosis (SAF) score, which provides a reliable and reproducible diagnosis and grading/staging of the three elementary features of NAFLD (steatosis, inflammatory activity) and fibrosis with reduced interobserver variability. We used nonbinary-ROC (NonBinAUROC) as the main endpoint to prevent spectrum effect and multiple testing.
RESULTS:
A total of 600 patients with reliable tests and biopsies were included. The mean NonBinAUROCs (95% CI) of tests were all significant (P < 0.0001): 0.878 (0.864-0.892) for FibroTest and fibrosis stages, 0.846 (0.830-0.862) for ActiTest and activity grades, and 0.822 (0.804-0.840) for SteatoTest and steatosis grades. FibroTest had a higher NonBinAUROC than BARD (0.836; 0.820-0.852; P = 0.0001), FIB4 (0.845; 0.829-0.861; P = 0.007) but not significantly different than the NAFLD score (0.866; 0.850-0.882; P = 0.26). FibroTest had a significant difference in median values between adjacent stage F2 and stage F1 contrarily to BARD, FIB4 and NAFLD scores (Bonferroni test P < 0.05).
CONCLUSIONS:
In patients with NAFLD, SteatoTest, ActiTest and FibroTest are non-invasive tests that offer an alternative to biopsy, and they correlate with the simple grading/staging of the SAF scoring system across the three elementary features of NAFLD: steatosis, inflammatory activity and fibrosis.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology 04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie 04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie 04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine |
UniBE Contributor: |
Dufour, Jean-François |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0269-2813 |
Publisher: |
Wiley-Blackwell |
Language: |
English |
Submitter: |
Lilian Karin Smith-Wirth |
Date Deposited: |
23 Jan 2017 10:17 |
Last Modified: |
13 May 2023 19:57 |
Publisher DOI: |
10.1111/apt.13770 |
PubMed ID: |
27549244 |
BORIS DOI: |
10.7892/boris.91454 |
URI: |
https://boris.unibe.ch/id/eprint/91454 |
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