ArticleObesity surgery2021
Performance of Noninvasive Liver Fibrosis Tests in Morbidly Obese Patients with Nonalcoholic Fatty Liver Disease.
Article in Obesity surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- 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
- Evolving B-mode ultrasound-based techniques for assessing metabolic dysfunction-associated steatotic liver disease: Now and beyond.Liver research (Beijing, China) · 2026Review
- Discordance Between FIB-4 and BAST Fibrosis Risk Classifications in Obese Patients with MASLD: Results from the OBREDI-TR Study.Diagnostics (Basel, Switzerland) · 2026Article
- Prevalence of Hepatic Fibrosis and Performance of Non-invasive Liver Fibrosis Scores in an Eastern Indian Diabetic Population with NAFLD.Journal of the ASEAN Federation of Endocrine Societies · 2025Observational
- Noninvasive Assessment of the Severity of Liver Fibrosis in MASLD Patients with Long-Standing Type 2 Diabetes.Journal of general internal medicine · 2025Article
- Comparing FIB-4, VCTE, pSWE, 2D-SWE, and MRE Thresholds and Diagnostic Accuracies for Detecting Hepatic Fibrosis in Patients with MASLD: A Systematic Review and Meta-Analysis.Diagnostics (Basel, Switzerland) · 2025Review
- Predictive performance of noninvasive factors for liver fibrosis in severe obesity: a screening based on machine learning models.Journal of diabetes and metabolic disorders · 2025Article
- The insight to history and trends of transient elastography for assessing liver fibrosis-a bibliometric analysis.Quantitative imaging in medicine and surgery · 2025Article
- Non-invasive liver fibrosis markers are increased in obese individuals with non-alcoholic fatty liver disease and the metabolic syndrome.Scientific reports · 2025Article
- Machine Learning Models for Predicting Significant Liver Fibrosis in Patients with Severe Obesity and Nonalcoholic Fatty Liver Disease.Obesity surgery · 2024Article
- Metabolic dysfunction-associated steatotic liver disease: The question of long-term high-normal alanine aminotransferase as a screening test.World journal of gastroenterology · 2024Article
- Poor Performance of Non-invasive Tests for Advanced Fibrosis in Nonalcoholic Fatty Liver Disease: A Multicentric Asian Study.Digestive diseases and sciences · 2023Article
- Benefits in routinely measured liver function tests following bariatric surgery: a retrospective cohort study.Journal of diabetes and metabolic disorders · 2023Article
- [Discussion from metabolism to fatty liver disease: rethinking the origin of disease and the endpoint of new drugs or metabolic dysfunction-associated steatotic liver disease].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2023Article
- A robust gene expression signature for NASH in liver expression data.Scientific reports · 2022Article
- FIB-4, APRI, and AST/ALT ratio compared to FibroScan for the assessment of hepatic fibrosis in patients with non-alcoholic fatty liver disease in Bandar Abbas, Iran.BMC gastroenterology · 2021Article
- Analysis of miRNAs Profiles in Serum of Patients With Steatosis and Steatohepatitis.Frontiers in cell and developmental biology · 2021Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNonalcoholic fatty liver disease (NAFLD) is highly prevalent in morbidly obese patients, and fibrosis is an independent predictor of mortality. Noninvasive tests (NITs) are being developed for the detection of advanced fibrosis (AF). PURPOSE: To assess the performance of three NITs (NAFLD fibrosis score, NFS, fibrosis-4 index, FIB-4, and aspartate aminotransferase-to-platelet ratio, APRI), in the identification of AF among morbidly obese patients. MATERIALS AND
methodsPatients, who underwent bariatric surgery between 2004 and 2009 and had liver biopsy, were included. Fibrosis stages ≥ F2 and ≥ F3 were defined as significant and AF, respectively. Published and optimal thresholds (Youden index) for NFS, FIB-4 and APRI, sensitivity, specificity, positive and negative predictive values (PPV-NPV), and area under the receiver operator curves (AUROC) were evaluated.
resultsAmong 584 patients (mean age 43.3 ± 11.3 years, 21.2% male, 75% white, mean BMI 45.5 ± 8.80), 31.7% had NASH. Stages distributions were F1 = 68.1%, F2 = 16.4%, F3 = 8%, and F4 = 3.2%. At published thresholds, all 3 NITs performed poorly for detection of AF, with AUROC < 0.62. Overall performance at optimal thresholds improved to 0.68, 0.72, and 0.74 for NFS, FIB-4, and APRI, respectively. At optimal thresholds, all tests had good NPV (94.4-95.9%) but low PPV (24.2-32.5%). Combinations of the tests did not improve their performance.
conclusionsNFS, FIB-4, and APRI fall short to detect advanced fibrosis but valuable for excluding advanced fibrosis. More research is needed to develop new NITs with high positive predictive value.
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