Distribution of Fibrosis-4 index and vibration-controlled transient elastography-derived liver stiffness measurement for patients with metabolic dysfunction-associated steatotic liver disease in health check-up

Yuji Ogawa¹, Wataru Tomeno², Yasushi Imamura³, Masaru Baba⁴, Takato Ueno⁵, Takashi Kobayashi⁶, Michihiro Iwaki⁶, Asako Nogami⁶, Takaomi Kessoku^{7

8}, Yasushi Honda⁶, Kazuo Notsumata⁹, Hirotoshi Fujikawa¹⁰, Megumi Kaai¹¹, Kento Imajo^{6

11}, Miwa Kawanaka¹², Hideyuki Hyogo¹³, Mitsurou Hisatomi¹⁴, Mamiko Takeuchi¹⁵, Taku Hakamada¹¹, Takashi Honda¹⁶, Miwa Tatsuta¹⁷, Asahiro Morishita¹⁸, Shigeru Mikami¹⁹, Ken Furuya⁴, Noriaki Manabe²⁰, Tomoari Kamada²¹, Takumi Kawaguchi²², Masato Yoneda⁶, Satoru Saito^{6

23}, Atsushi Nakajima⁶

Affiliations

¹ Department of Gastroenterology, NHO Yokohama Medical Center, Yokohama, Japan.
² Department of Gastroenterology, International University of Health and Welfare Atami Hospital, Atami, Japan.
³ Department of Hepatology, Kagoshima Kouseiren Hospital, Kagoshima, Japan.
⁴ Department of Gastroenterology and Hepatology, JCHO Hokkaido Hospital, Sapporo, Japan.
⁵ Division of Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Japan.
⁶ Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
⁷ Department of Palliative Care, International University of Health and Welfare Narita Hospital, Narita, Japan.
⁸ Department of Internal Medicine, Kanagawa Dental University Yokohama Clinic, Yokohama, Japan.
⁹ Department of Gastroenterology, Fukui-ken Saiseikai Hospital, Fukui, Japan.
¹⁰ Department of Gastroenterology, JCHO Yokohama Chuo Hospital, Yokohama, Japan.
¹¹ Department of Gastroenterology, Shin-yurigaoka General Hospital, Kawasaki, Japan.
¹² Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama, Japan.
¹³ Department of Internal Medicine, Hyogo Life Care Clinic Hiroshima, Hiroshima, Japan.
¹⁴ Department of Gastroenterology, Tsushima City Hospital, Tsushima, Japan.
¹⁵ Department of Gastroenterology, Anjo Kosei Hospital, Anjo, Japan.
¹⁶ Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
¹⁷ Department of Gastroenterology, KKR Takamatsu Hospital, Takamatsu, Japan.
¹⁸ Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kita-gun, Japan.
¹⁹ Department of Internal Medicine, Division of Gastroenterology, Kikkoman General Hospital, Noda, Japan.
²⁰ Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan.
²¹ Department of Health Care Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan.
²² Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
²³ Department of Gastroenterology, Sanno Hospital, Tokyo, Japan.

PMID: 39364641
DOI: 10.1111/hepr.14117

Distribution of Fibrosis-4 index and vibration-controlled transient elastography-derived liver stiffness measurement for patients with metabolic dysfunction-associated steatotic liver disease in health check-up

Yuji Ogawa et al. Hepatol Res. 2024.

. 2024 Oct 4.

doi: 10.1111/hepr.14117. Online ahead of print.

Authors

Affiliations

¹ Department of Gastroenterology, NHO Yokohama Medical Center, Yokohama, Japan.
² Department of Gastroenterology, International University of Health and Welfare Atami Hospital, Atami, Japan.
³ Department of Hepatology, Kagoshima Kouseiren Hospital, Kagoshima, Japan.
⁴ Department of Gastroenterology and Hepatology, JCHO Hokkaido Hospital, Sapporo, Japan.
⁵ Division of Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Japan.
⁶ Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
⁷ Department of Palliative Care, International University of Health and Welfare Narita Hospital, Narita, Japan.
⁸ Department of Internal Medicine, Kanagawa Dental University Yokohama Clinic, Yokohama, Japan.
⁹ Department of Gastroenterology, Fukui-ken Saiseikai Hospital, Fukui, Japan.
¹⁰ Department of Gastroenterology, JCHO Yokohama Chuo Hospital, Yokohama, Japan.
¹¹ Department of Gastroenterology, Shin-yurigaoka General Hospital, Kawasaki, Japan.
¹² Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama, Japan.
¹³ Department of Internal Medicine, Hyogo Life Care Clinic Hiroshima, Hiroshima, Japan.
¹⁴ Department of Gastroenterology, Tsushima City Hospital, Tsushima, Japan.
¹⁵ Department of Gastroenterology, Anjo Kosei Hospital, Anjo, Japan.
¹⁶ Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
¹⁷ Department of Gastroenterology, KKR Takamatsu Hospital, Takamatsu, Japan.
¹⁸ Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kita-gun, Japan.
¹⁹ Department of Internal Medicine, Division of Gastroenterology, Kikkoman General Hospital, Noda, Japan.
²⁰ Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan.
²¹ Department of Health Care Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan.
²² Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
²³ Department of Gastroenterology, Sanno Hospital, Tokyo, Japan.

PMID: 39364641
DOI: 10.1111/hepr.14117

Abstract

Aims: The multisociety consensus nomenclature has introduced steatotic liver disease (SLD) with diverse subclassifications, which are metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-associated steatotic liver disease (MetALD), alcohol-associated liver disease (ALD), specific etiology, and cryptogenic. We investigated their prevalence, as per the new definition, in individuals undergoing health check-ups. Additionally, we analyzed the distribution of Fibrosis-4 (FIB-4) index and vibration-controlled transient elastography (VCTE)-derived liver stiffness measurement (LSM) for MASLD.

Methods: In this cross-sectional study, 6530 subjects undergoing a health check-up in Japan were included. Conventional B-mode ultrasound was carried out on all 6530 subjects, and those with MASLD underwent VCTE.

Results: The prevalence of SLD was 39.5%, comprising MASLD 28.7%, MetALD 8.6%, ALD 1.2%, specific etiology SLD 0.3%, and cryptogenic SLD 0.7%. Subjects with VCTE-derived LSM ≥8 kPa constituted 2.1% of MASLD. FIB-4 ≥1.3 showed that the sensitivity, specificity, positive predictive value (PPV), and negative predictive value for diagnosing VCTE-derived LSM ≥8 kPa were 60.6%, 77.0%, 5.3%, and 98.9%, respectively. The referral rate to specialists was 23.8% using FIB-4 ≥1.30. "FIB-4 ≥1.3 in subjects <65 years and FIB-4 ≥2.0 in subjects ≥65 years" showed higher PPV (6.7%) and lower referral rate (17.1%) compared with FIB-4 ≥1.3, but the sensitivity (54.5%) did not show adequate diagnostic capability as a noninvasive test for diagnosing VCTE-derived LSM ≥8 kPa.

Conclusions: Acknowledging the selection bias in hepatology centers, we undertook this prospective health check-up study. Although the FIB-4 index proves to be a convenient marker, it might not perform well as a primary screening tool for liver fibrosis in the general population (UMIN Clinical Trials Registry No. UMIN000035188).

Keywords: Fibrosis‐4 index; health check‐up; metabolic dysfunction‐associated steatotic liver disease; vibration‐controlled transient elastography.

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References

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Distribution of Fibrosis-4 index and vibration-controlled transient elastography-derived liver stiffness measurement for patients with metabolic dysfunction-associated steatotic liver disease in health check-up

Affiliations

Distribution of Fibrosis-4 index and vibration-controlled transient elastography-derived liver stiffness measurement for patients with metabolic dysfunction-associated steatotic liver disease in health check-up

Authors

Affiliations

Abstract

References

REFERENCES

Grants and funding

LinkOut - more resources

Full Text Sources