ArticleJournal of endocrinological investigation2020
Impact of using different biomarkers of liver fibrosis on hepatologic referral of individuals with severe obesity and NAFLD.
Article in Journal of endocrinological investigation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
7 citing papers in PubMed, 14 citations in OpenAlex.
- Nonalcoholic Fatty Liver Disease in Patients with Type 2 Diabetes: Screening, Diagnosis, and Treatment.Journal of clinical medicine · 2023Review
- Article
- Comparison of Pathway Referrals for Liver Fibrosis Risk Stratification Performed in Diabetology and Nutrition Clinics.Diabetes, metabolic syndrome and obesity : targets and therapy · 2023Article
- Patients with type 2 diabetes and elevated fibrosis-4 are under-referred to hepatology and have unrecognized hepatic decompensation.Journal of gastroenterology and hepatology · 2022Article
- Potential biomarkers in the fibrosis progression of nonalcoholic steatohepatitis (NASH).Journal of endocrinological investigation · 2022Article
- NAFLD: Mechanisms, Treatments, and Biomarkers.Biomolecules · 2022Review
- Prevalence of Elevated Liver Stiffness Among Potential Candidates for Bariatric Surgery in the United States.Obesity surgery · 2022Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this study was to estimate how many individuals with severe obesity and NAFLD should be referred to hepatologists according to the EASL-EASD-EASO guidelines and whether the choice of specific indicators of liver fibrosis would significantly impact the number of referrals.
methodsThis was a single-center retrospective study of 495 individuals with severe obesity screened at our institution between 2012 and 2018 for a bariatric surgery intervention. The guidelines were applied using the NAFLD Liver Fat Score (NLFS) to assess the presence of steatosis and the NAFLD fibrosis score (NFS), Fibrosis-4 (FIB-4) and Hepamet Fibrosis Score (HFS) to assess the risk of advanced fibrosis.
resultsThree hundred and seventy-nine patients (76.6%) had evidence of liver steatosis. The application of the guidelines would lead to referral of 66.3% of patients using NFS, 31.7% using FIB-4 and 34.2% using HFS. When referrals due to abnormal liver function tests were excluded, these percentages dropped to 55.8%, 7.3% and 12.1%, respectively. The strongest inter-biomarker agreement was found between FIB-4 and HFS (κ = 0.86, 95% CI 0.815-0.910).
conclusionStrict application of the guidelines in individuals with severe obesity would probably lead to over-referral, although a great variability exists among the different scores.
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