ArticleBMC gastroenterology2021
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.
Article in BMC gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 73 papers, 4 of them syntheses that pooled it.
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Who cites it
73 citing papers in PubMed, 4 syntheses or guidelines pooled it, 108 citations in OpenAlex.
- Silymarin for adults with metabolic dysfunction-associated steatotic liver disease.The Cochrane database of systematic reviews · 2025Pooled it
- Effect of different exercise modalities on nonalcoholic fatty liver disease: a systematic review and network meta-analysis.Scientific reports · 2024Pooled it
- Pegbelfermin for reducing transaminase levels in patients with non-alcoholic steatohepatitis: a dose-response meta-analysis of randomized controlled trials.Frontiers in medicine · 2024Pooled it
- Accuracy of prognostic serological biomarkers in predicting liver fibrosis severity in people with metabolic dysfunction-associated steatotic liver disease: a meta-analysis of over 40,000 participants.Frontiers in nutrition · 2024Pooled it
- Use of Noninvasive Biomarker Tests vs. FibroScan for Predicting Significant Fibrosis in Egyptian Pediatric Cancer Survivors with Chronic Hepatitis C Virus Infection.Pediatric gastroenterology, hepatology & nutrition · 2026Article
- MMP-9 and non-invasive markers in evaluating MASLD and atherosclerosis.Journal, genetic engineering & biotechnology · 2026Article
- Brazilian Green Propolis and Essential Oil Residues Improve Metabolic Dysfunction by Modulating Key Hepatic Lipogenic Genes in High-Fat Diet-Fed Mice.Journal of food science · 2026Article
- Glutamate dehydrogenase activity and non-ınvasive fibrosis ındices (APRI, AAR, FIB-4) compared to FibroScan in chronic hepatitis B and hepatocellular carcinoma.Irish journal of medical science · 2026Article
- Liver Fibrosis Screening in Childhood Acute Lymphoblastic Leukemia Survivors by Transient Elastography: A Case-Control Study.Indian pediatrics · 2026Article
- Diagnostic Value of Serum Fibroblast Growth Factor 21 Combined with Fibrosis-4 Index for Hepatic Fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2026Article
- The ALT/AST Ratio as a Predictor of MASLD in Obese Children: A Comparative Analysis with Metabolic Indices Including HOMA-IR and TyG.Journal of clinical medicine · 2026Article
- Dual-phase T1-mapping (DHR-MAP) for non-invasive assessment of advanced liver fibrosis and moderate hepatitis: a single-center validation study.BMC gastroenterology · 2026Article
- Pilot Study on the Use of Rheology and Low Field Nmr to Characterize the Liver of Obese Patients Undergoing Metabolic and Bariatric Surgery.International journal of molecular sciences · 2026Article
- Noninvasive Assessment of Hepatic Steatosis in Living Liver Donors.Diagnostics (Basel, Switzerland) · 2026Article
- Association of De Ritis ratio with mortality in ICU patients with sepsis-associated acute kidney injury: a retrospective multicenter cohort study.BMC infectious diseases · 2026Article
- Identification of dinner dietary patterns and their association with metabolic risk factors and anthropometric indices in adults with non-alcoholic fatty liver disease.BMC nutrition · 2026Article
- Blood markersWorld journal of hepatology · 2026Article
- Influence of Metabolic Dysfunction-Associated Steatotic Liver Disease on Pattern and Management of Acute Coronary Syndrome.Saudi medical journal · 2026Article
- Fortunellin Elevates the AMPK Pathway to Reduce Lipid Deposition and Immune Disorders in Young Non-Alcoholic Fatty Liver Disease RatsEndocrine, metabolic & immune disorders drug targets · 2026Article
- Association Between Iron Metabolism and Microalbuminuria in Patients With Type 2 Diabetes Mellitus and MASLD.International journal of endocrinology · 2026Article
13 more citing papers are in PubMed but not listed here.
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNon-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide. Researchers have tried to develop indices to assess liver fibrosis in NAFLD patients to avoid liver biopsy. In this study we aimed to compare fibrosis-4 (FIB-4), aspartate aminotransferase (AST) to platelet ratio index (APRI), and aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio with FibroScan for the assessment of hepatic fibrosis in patients with NAFLD.
methodsThis cross-sectional study included patients with NAFLD or non-alcoholic steatohepatitis (NASH) referred to the Gastroenterology Clinic of Shahid Mohammadi Hospital, Bandar Abbas, Iran, in 2019. Demographic features of the participants including age and gender were recorded. All participants underwent FibroScan and had their AST, ALT, and platelet count measured in a random blood sample, taken within 1 month of the FibroScan.
resultsOf the 205 NAFLD patients included in this study with a mean age of 42.95 ± 10.97 years, 144 (70.2%) were male. Fibroscan results revealed that 94 patients (45.9%) had F1, 67 (32.7%) F2, 29 (14.1%) F3, and 15 (7.3%) F4 liver fibrosis. A significant correlation was found between FibroScan score and FIB-4 (r = 0.572), APRI (r = 0.667), and AST/ALT (r = 0.251) (P < 0.001). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of APRI at the 0.702 cut-off for the differentiation of F3 and F4 from F2 and F1 were 84.1, 88.2, 66.1, 95.3, and 87.3%, FIB-4 at the 1.19 cut-off 97.7, 72.7, 49.4, 99.2 and 78%, and AST/ALT at the 0.94 cut-off 61.4, 77, 42.2, 87.9, and 73.7% respectively. Moreover, the area under the receiver operating curve of APRI, FIB-4, and AST/ALT for the differentiation of F3 and F4 from F2 and F1 was 0.923, 0.913, and 0.720, respectively.
conclusionsBased on these results, APRI appears to be the most appropriate substitute of FibroScan for the detection of significant fibrosis in NAFLD patients. FIB-4 was the second best, suggesting that in case of FibroScan unavailability, APRI and FIB-4 are the best indices to assess liver fibrosis in NAFLD patients.
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