The FIB-4 Index Predicts the Development of Liver-Related Events, Extrahepatic Cancers, and Coronary Vascular Disease in Patients with NAFLD
(This article belongs to the Section Nutrition and Metabolism)
Abstract
:1. Introduction
2. Patients and Methods
2.1. Ethical Committee Approval
2.2. Biopsy-Confirmed NAFLD Patients and Histological Evaluation
2.3. Definition of LREs (HCC, Decompensation, and Bleeding Gastroesophageal varices) and MACEs
2.4. Anthropometry and Laboratory Measurements
2.5. Statistical Analysis
3. Results
3.1. Characteristics of the Study Subjects
3.2. Follow-Up Evaluation
3.3. Incidence of LREs
3.4. Incidence of Extrahepatic Cancers
3.5. Incidence of MACEs
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | FIB4 Low (<1.255) | FIB4 Hi (≥1.255) | p Value * |
---|---|---|---|
Number | 176 | 177 | |
Age (y) | 43.5 ± 11.7 | 60.6 ± 8.5 | <0.0001 |
Sex (F/M) | 91/85 | 93/84 | 0.875 |
BMI (kg/m2) | 28.1 ± 5.0 | 27.0 ± 4.6 | 0.041 |
AST (U/L) | 44.1 ± 33.8 | 72.2 ± 44.1 | <0.0001 |
ALT (U/L) | 86.1 ± 73.2 | 96.7 ± 65.5 | 0.0037 |
AST/ALT ratio | 0.580 ± 0.174 | 0.802 ± 0.242 | <0.0001 |
GGT (U/L) | 92.3 ± 99.8 | 79.1 ± 69.2 | 0.390 |
ALP (U/L) | 238.5 ± 102.0 | 281.3 ± 112.4 | <0.0001 |
T-Chol (mg/dL) | 205.1 ± 35.9 | 205.4 ± 38.6 | 0.734 |
TG (mg/dL) | 135.5 ± 75.0 | 133.7 ± 54.2 | 0.504 |
HDL-C (mg/dL) | 52.1 ± 12.5 | 48.8 ± 11.4 | 0.190 |
FBS (mg/dL) | 107.0 ± 17.9 | 104.4 ± 20.0 | 0.192 |
IRI (mU/mL) | 14.4 ± 9.2 | 11.5 ± 5.8 | 0.281 |
Albumin (g/dL) | 4.54 ± 0.39 | 4.36 ± 0.44 | <0.0001 |
Ferritin (ng/mL) | 231.1 ± 214.1 | 312.5 ± 324.1 | 0.023 |
Hyaluronic acid (ng/mL) | 26.6 ± 15.9 | 130.9 ± 244.0 | <0.0001 |
Platelet count (×104/μL) | 26.2 ± 20.7 | 18.9 ± 5.2 | <0.0001 |
FIB4-index | 0.82 ± 0.27 | 2.52 ± 1.24 | <0.0001 |
Stage (0/1/2/3/4) | 45/57/28/13/0 | 19/37/62/53/5 | <0.0001 |
FIB4 Low | FIB4 Hi | Odds Ratio (95% CI) | p Value * | |
---|---|---|---|---|
Death (n) | 1.67 (2) | 5.59 (8) | 4.12 (0.86–19.67) | 0.131 |
HCC (n) | 0.84 (1) | 4.89 (7) | 7.21 (0.88–59.19) | 0.071 |
Decompensation (n) | 0.00 (0) | 7.68 (11) | Incalculable ** | 0.0049 |
Varices(n) | 0.00 (0) | 5.59 (8) | Incalculable ** | 0.015 |
Liver-related disease (n) | 0.84 (1) | 11.87 (17) | 18.59 (2.44–141.31) | 0.0009 |
MACEs (n) | 1.67 (2) | 7.68 (10) | 5.76 (1.26–26.40) | 0.041 |
Extrahepatic cancers (n) | 6.70 (4) | 16.76 (20) | 3.29 (1.44–7.55) | 0.0095 |
Colorectal cancer (n) | 0.00 (0) | 3.49 (5) | Incalculable ** | 0.059 |
FIB4 Low | FIB4 Hi | p Value * | |
---|---|---|---|
HCC | |||
early stage (F0–2) | 0/163 | 0/119 | Incalculable ** |
advanced stage (F3–4) | 1/13 | 7/58 | 0.64 |
Decompensation | |||
early stage (F0–2) | 0/163 | 2/119 | 0.063 |
advanced stage (F3–4) | 0/13 | 9/58 | 0.048 |
Varices | |||
early stage (F0–2) | 0/163 | 1/119 | 0.19 |
advanced stage (F3–4) | 0/13 | 7/58 | 0.083 |
LREs | |||
early stage (F0–2) | 0/163 | 3/119 | 0.022 |
advanced stage (F3–4) | 1/13 | 14/58 | 0.15 |
Extrahepatic cancers | |||
early stage (F0–2) | 3/163 | 13/119 | 0.0057 |
advanced stage (F3–4) | 1/13 | 7/58 | 0.53 |
Colorectal cancer | |||
early stage (F0–2) | 0/163 | 1/119 | 0.19 |
advanced stage (F3–4) | 0/13 | 4/58 | 0.20 |
MACEs | |||
early stage (F0–2) | 2/163 | 8/119 | 0.013 |
advanced stage (F3–4) | 0/13 | 3/58 | 0.26 |
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Kamada, Y.; Munekage, K.; Nakahara, T.; Fujii, H.; Sawai, Y.; Doi, Y.; Hyogo, H.; Sumida, Y.; Imai, Y.; Miyoshi, E.; et al. The FIB-4 Index Predicts the Development of Liver-Related Events, Extrahepatic Cancers, and Coronary Vascular Disease in Patients with NAFLD. Nutrients 2023, 15, 66. https://doi.org/10.3390/nu15010066
Kamada Y, Munekage K, Nakahara T, Fujii H, Sawai Y, Doi Y, Hyogo H, Sumida Y, Imai Y, Miyoshi E, et al. The FIB-4 Index Predicts the Development of Liver-Related Events, Extrahepatic Cancers, and Coronary Vascular Disease in Patients with NAFLD. Nutrients. 2023; 15(1):66. https://doi.org/10.3390/nu15010066
Chicago/Turabian StyleKamada, Yoshihiro, Kensuke Munekage, Takashi Nakahara, Hideki Fujii, Yoshiyuki Sawai, Yoshinori Doi, Hideyuki Hyogo, Yoshio Sumida, Yasuharu Imai, Eiji Miyoshi, and et al. 2023. "The FIB-4 Index Predicts the Development of Liver-Related Events, Extrahepatic Cancers, and Coronary Vascular Disease in Patients with NAFLD" Nutrients 15, no. 1: 66. https://doi.org/10.3390/nu15010066