ArticleDiabetes/metabolism research and reviews2021
Advanced liver fibrosis and the metabolic syndrome in a primary care setting.
Article in Diabetes/metabolism research and reviews, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 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
17 citing papers in PubMed, 31 citations in OpenAlex.
- A novel model for detecting advanced fibrosis in patients with nonalcoholic fatty liver disease.Diabetes/metabolism research and reviews · 2022Trial
- Implications of Expanded Advanced Fibrosis Screening Strategies for Metabolic Dysfunction-Associated Steatotic Liver Disease in Primary Care.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2026Article
- Prognostic value of the fibrosis-4 index for predicting in-hospital mortality in sepsis patients: evidence from MIMIC-IV and eICU databases.Scientific reports · 2026Article
- Impact of Levothyroxine on Progression to and Complications of Cirrhosis in MASH.Digestive diseases and sciences · 2025Article
- Association between fibrosis-4 index (FIB-4) and gallstones: an analysis of the NHANES 2017-2020 cross-sectional study.BMC gastroenterology · 2025Article
- Patterns of gastroenterology specialty referral for primary care patients with metabolic dysfunction-associated steatotic liver disease.The American journal of the medical sciences · 2024Article
- Objective Measures of Cardiometabolic Risk and Advanced Fibrosis Risk Progression in Primary Care Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2024Article
- Article
- Hepatic Fibrosis Risk Assessment in Primary Care: Opportunities and Challenges.Digestive diseases and sciences · 2024Article
- Article
- Metabolic syndrome and transaminases: systematic review and meta-analysis.Diabetology & metabolic syndrome · 2023Review
- Metabolic Dysfunction-Associated Steatotic Liver Disease and Metabolic Dysfunction-Associated Steatohepatitis: The Patient and Physician Perspective.Journal of clinical medicine · 2023Review
- Gaps in Confirmatory Fibrosis Risk Assessment in Primary Care Patients with Nonalcoholic Fatty Liver Disease.Digestive diseases and sciences · 2023Article
- Accurate Identification of Patients with Cirrhosis and Its Complications in the Electronic Health Record.Digestive diseases and sciences · 2023Review
- Letter: Hepatic Fibrosis and Steatosis in Metabolic Syndrome (J Obes Metab Syndr 2022;31:61-9).Journal of obesity & metabolic syndrome · 2022Article
- Liver Fibrosis and Hearing Loss in an Older Mediterranean Population: Results from the Salus in Apulia Study.Journal of clinical medicine · 2022Article
- The Association of Fibrosis-4 Index Scores with Severe Liver Outcomes in Primary Care.Journal of general internal medicine · 2022Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
aimsThe fibrosis-4 index (FIB-4) and NAFLD fibrosis score (NFS) are noninvasive and accessible methods for assessing advanced liver fibrosis risk in primary care. We evaluated the distribution of FIB-4 and NFS scores in primary care patients with clinical signals for nonalcoholic fatty liver disease (NAFLD). MATERIALS AND
methodsThis retrospective cohort study of electronic record data between 2007 and 2018 included adults with at least one abnormal aminotransferase and no known (non-NAFLD) liver disease. We calculated patient-level FIB-4 and NFS scores, the proportion of patients with mean values exceeding advanced fibrosis thresholds (indeterminate risk: FIB-4 > 1.3, NFS > -1.455; high-risk: FIB-4 > 2.67, NFS > 0.676), and the proportion of patients with a NAFLD International Classification of Diseases-9/10 code. Logistic regression models evaluated the associations of metabolic syndrome (MetS) components with elevated FIB-4 and NFS scores.
resultsThe cohort included 6506 patients with a median of 6 (interquartile range: 3-13) FIB-4 and NFS scores per patient. Of these patients, 81% had at least two components of MetS, 29% had mean FIB-4 and NFS scores for indeterminate fibrosis risk, and 11% had either mean FIB-4 or NFS scores exceeding the high advanced fibrosis risk thresholds. Regression models identified associations of low high-density lipoprotein, hyperglycemia, Black race and male gender with high-risk FIB-4 and NFS values. Only 5% of patients had existing diagnoses for NAFLD identified.
conclusionsMany primary care patients have FIB-4 and NFS scores concerning for advanced fibrosis, but rarely a diagnosis of NAFLD. Elevated FIB-4 and NFS scores may provide signals for further clinical evaluation of liver disease in primary care settings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.