Certain routine demographic, clinical, and laboratory values can be used to identify advanced fibrosis in patients with nonalcoholic fatty liver disease (NAFLD).
This method could render liver biopsy unnecessary in a large proportion of patients.These findings are published in the April issue of Hepatology, the official journal of the American Association for the Study of Liver Diseases (AASLD). Published by John Wiley & Sons, Inc., Hepatology is available online via Wiley InterScience.
The prevalence of NAFLD has risen in conjunction with obesity, diabetes, and the metabolic syndrome. It is the world's most common cause of chronic liver disease and afflicts one in three American adults, and one in ten American children or adolescents. NAFLD may progress to cirrhosis, liver failure, and hepatocellular carcinoma, especially in patients with more advanced fibrosis. Liver biopsy is currently the only reliable way to determine the severity of fibrosis. However, it is an expensive, invasive procedure.
Researchers led by Paul Angulo, MD, of the Mayo Clinic Foundation in Rochester, Minnesota, sought to develop a noninvasive way to determine advanced fibrosis in NAFLD patients using routinely determined and easily available clinical and biochemical variables. They studied 733 patients who had been diagnosed with NAFLD between 2000 and 2003, and who had undergone liver biopsies. For each patient, they collected demographic, clinical, and laboratory data. They used data from 480 patients to build a statistical model that predicted advanced liver fibrosis. They then tested the model using data from the remaining 253 patients.