ArticleObesity surgery2017
Modified thresholds for fibrosis risk scores in nonalcoholic fatty liver disease are necessary in the obese.
Article in Obesity surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Accuracy of Noninvasive Scoring Systems in Assessing Liver Fibrosis in Patients with Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis.Gut and liver · 2022Pooled it
- Visual Liver Score to Stratify Non-Alcoholic Steatohepatitis Risk and Determine Selective Intraoperative Liver Biopsy in Obesity.Obesity surgery · 2018Trial
- Derivation and internal validation of the enhanced liver fibrosis (ELF)-based prediction score for advanced liver fibrosis in obese patients undergoing bariatric surgery.Surgical endoscopy · 2026Article
- Integrated liver-secreted and plasma proteomics identify a predictive model that stratifies MASH.Cell reports. Medicine · 2025Article
- Deep proteome profiling of metabolic dysfunction-associated steatotic liver disease.Communications medicine · 2025Article
- Machine Learning Models for Predicting Significant Liver Fibrosis in Patients with Severe Obesity and Nonalcoholic Fatty Liver Disease.Obesity surgery · 2024Article
- Prospective Study to Analyze the Concordance Between a Standardized Visual Method With Pathology to stratify Nonalcoholic Fatty Liver Disease in Cadaveric Liver Grafts Evaluated for Transplantation.Transplantation direct · 2023Article
- Accuracy of FIB-4 to Detect Elevated Liver Stiffness Measurements in Patients with Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study in Referral Centers.International journal of molecular sciences · 2022Article
- The Utility and Diagnostic Accuracy of Transient Elastography in Adults with Morbid Obesity: A Prospective Study.Journal of clinical medicine · 2022Article
- Acoustic radiation force impulse elastography and liver fibrosis risk scores in severe obesity.Archives of endocrinology and metabolism · 2021Article
- Performance of non-invasive fibrosis scores in non-alcoholic fatty liver disease with and without morbid obesity.International journal of obesity (2005) · 2021Article
- Endoplasmic reticulum stress and autophagy are involved in adipocyte-induced fibrosis in hepatic stellate cells.Molecular and cellular biochemistry · 2021Article
- A prospective 5-year study on the use of transient elastography to monitor the improvement of non-alcoholic fatty liver disease following bariatric surgery.Scientific reports · 2021Observational
- Ectodysplasin A Is Increased in Non-Alcoholic Fatty Liver Disease, But Is Not Associated With Type 2 Diabetes.Frontiers in endocrinology · 2021Article
- Performance of Noninvasive Liver Fibrosis Scores in the Morbid Obese Patient, Same Scores but Different Thresholds.Obesity surgery · 2020Article
- Impact of using different biomarkers of liver fibrosis on hepatologic referral of individuals with severe obesity and NAFLD.Journal of endocrinological investigation · 2020Article
- Fibroscan-Based Score to Predict Significant Liver Fibrosis in Morbidly Obese Patients with Nonalcoholic Fatty Liver Disease.Obesity surgery · 2020Article
- Noninvasive Evaluation of Liver Function in Morbidly Obese Patients.Gastroenterology research and practice · 2019Article
- [Diagnostic application of serum GP73 and the relevant mechanism in the diagnosis of liver cirrhosis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2018Article
- EASL-EASD-EASO clinical practice guidelines for the management of non-alcoholic fatty liver disease in severely obese people: do they lead to over-referral?Diabetologia · 2017 · on this mapObservational
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundObesity and its related comorbidities are significant risk factors for nonalcoholic fatty liver disease (NAFLD). Liver fibrosis is the major determinant of long-term outcomes in NAFLD. A non-invasive tool that accurately identifies obese patients at elevated risk of liver fibrosis would be of significant value. Fibrosis risk scores in patients with NAFLD have been proposed but have not been validated in obese populations. We aimed to validate established simple fibrosis scores in bariatric surgical patients.
methodsWe conducted a prospective study of 107 consecutive high-risk obese patients undergoing primary bariatric surgery. Proposed fibrosis scores (NAFLD fibrosis score; body mass index (BMI), aspartate aminotransferase (AST)/alanine aminotransferase ratio (ALT), and diabetes (BARD); Fibrosis-4 (FIB-4); Forn; and AST to platelet ratio index) were calculated and compared hepatic fibrosis determined by histology of intraoperative liver biopsies. Accuracy was determined, and fibrosis score thresholds were optimized. These modified thresholds were then validated in an independent bariatric surgical population.
resultsLiver biopsies were available in 101 patients. Sixty-eight patients had some degree of fibrosis, with 23 patients (23 %) having significant fibrosis (F2-4). The Forn score best predicted significant fibrosis (area under the receiver operator characteristic curve (AUROC) 0.724, p = 0.001). With standard thresholds, the sensitivity for the Forn score for identification of significant fibrosis (F2-4) was 0 %. Using modified thresholds of 3.5, the sensitivity and negative predictive value increased to 85.7 and 94.7 %. This threshold was applied to an independent validation cohort with good accuracy.
conclusionsFibrosis risk scores using simple markers have moderate success at delineating obese patients with significant NAFLD-related fibrosis. Thresholds, however, need to be lowered to maximize diagnostic accuracy in this cohort.
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