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Development and Validation of a Score for Fibrotic Nonalcoholic Steatohepatitis
Tavaglione, Federica Jamialahmadi, Oveis De Vincentis, Antonio Qadri, Sami Mowlaei, Mohammad Erfan Mancina, Rosellina Margherita Ciociola, Ester Carotti, Simone Perrone, Giuseppe Bruni, Vincenzo
Tavaglione, Federica
Jamialahmadi, Oveis
De Vincentis, Antonio
Qadri, Sami
Mowlaei, Mohammad Erfan
Mancina, Rosellina Margherita
Ciociola, Ester
Carotti, Simone
Perrone, Giuseppe
Bruni, Vincenzo
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Journal article
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2023-05-23
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Computer & Information Sciences
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http://dx.doi.org/10.1016/j.cgh.2022.03.044
Abstract
Background & Aims: Noninvasive assessment of histological features of nonalcoholic fatty liver disease (NAFLD) has been an intensive research area over the last decade. Herein, we aimed to develop a simple noninvasive score using routine laboratory tests to identify, among individuals at high risk for NAFLD, those with fibrotic nonalcoholic steatohepatitis (NASH) defined as NASH, NAFLD activity score ≥4, and fibrosis stage ≥2. Methods: The derivation cohort included 264 morbidly obese individuals undergoing intraoperative liver biopsy in Rome, Italy. The best predictive model was developed and internally validated using a bootstrapping stepwise logistic regression analysis (2000 bootstrap samples). Performance was estimated by the area under the receiver operating characteristic curve (AUROC). External validation was assessed in 3 independent European cohorts (Finland, n = 370; Italy, n = 947; England, n = 5368) of individuals at high risk for NAFLD. Results: The final predictive model, designated as Fibrotic NASH Index (FNI), combined aspartate aminotransferase, high-density lipoprotein cholesterol, and hemoglobin A1c. The performance of FNI for fibrotic NASH was satisfactory in both derivation and external validation cohorts (AUROC = 0.78 and AUROC = 0.80–0.95, respectively). In the derivation cohort, rule-out and rule-in cutoffs were 0.10 for sensitivity ≥0.89 (negative predictive value, 0.93) and 0.33 for specificity ≥0.90 (positive predictive value, 0.57), respectively. In the external validation cohorts, sensitivity ranged from 0.87 to 1 (negative predictive value, 0.99-1) and specificity from 0.73 to 0.94 (positive predictive value, 0.12-0.49) for rule-out and rule-in cutoff, respectively. Conclusion: FNI is an accurate, simple, and affordable noninvasive score which can be used to screen for fibrotic NASH in individuals with dysmetabolism in primary health care.
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Federica Tavaglione, Oveis Jamialahmadi, Antonio De Vincentis, Sami Qadri, Mohammad Erfan Mowlaei, Rosellina Margherita Mancina, Ester Ciociola, Simone Carotti, Giuseppe Perrone, Vincenzo Bruni, Ida Francesca Gallo, Dario Tuccinardi, Cristiana Bianco, Daniele Prati, Silvia Manfrini, Paolo Pozzilli, Antonio Picardi, Marco Caricato, Hannele Yki-Järvinen, Luca Valenti, Umberto Vespasiani-Gentilucci, Stefano Romeo, Development and Validation of a Score for Fibrotic Nonalcoholic Steatohepatitis, Clinical Gastroenterology and Hepatology, Volume 21, Issue 6, 2023, Pages 1523-1532.e1, ISSN 1542-3565, https://doi.org/10.1016/j.cgh.2022.03.044.
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Elsevier
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Clinical Gastroenterology and Hepatology, Vol. 21, Iss. 6
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