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Kalaiyarasi K, Sanchalika A, Hsien Min L, Wei Ming Y, Vishalkumar S, Kuo Chao Y, Jee Keem L, Sameer J, Terence HCW, Yen Ping T. Transient Elastography Is the Best-Performing Non-Invasive Test of Liver Fibrosis in Obese Asian Patients with Non-Alcoholic Fatty Liver Disease: A Pilot, Cross-Sectional Study. Medicina (Kaunas) 2024; 60:169. [PMID: 38256429 PMCID: PMC10819647 DOI: 10.3390/medicina60010169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/13/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024]
Abstract
Background and Objectives: The prevalence of NAFLD (non-alcoholic fatty liver disease) is increasing, and up to 64% of Asian patients with NAFLD are obese. Non-invasive tests (NITs) for the assessment of liver fibrosis are increasingly being used, but data on their performance in obese Asian patients are lacking. In this pilot cross-sectional study, we aim to compare the distribution of serum and radiological markers of fibrosis between obese Asian biopsy-proven NAFLD patients with and without fibrosis and estimate the diagnostic accuracies of these indices. Materials and Methods: Obese Asian patients with NAFLD and who had undergone a liver biopsy showing histological evidence of NAFLD were invited to participate. Liver fibrosis was assessed using laboratory (APRI, AAR, BARD, FIB4, NFS, and Asia-Pacific NAFLD advanced fibrosis score) and imaging modalities (TE: transient elastography, MRE: magnetic resonance elastography, and SWU: shear wave ultrasonography). Results: A total of 16 patients were included in the final analysis. On liver biopsy, nine patients (56.3%) had significant fibrosis (F2 or higher), and six of these patients had advanced fibrosis (F3 or higher). F4 fibrosis was present in one patient (6.3%). For the laboratory markers, we found that the BARD score correctly identified five out of six patients with advanced fibrosis (83.4%, p value 0.045). Among all the NITs studied, liver stiffness measured by TE had the highest accuracy of 87.5% in its established threshold of 8.5 kPa for the detection of advanced fibrosis. MRE also performed well (81.2% in 3.64 kPa). Conclusions: In conclusion, TE has performed well in the detection of advanced fibrosis in obese Asian patients with biopsy-proven NAFLD in our pilot study. Further large-scale definitive studies are needed to validate the results of our findings.
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Affiliation(s)
- Kaliyaperumal Kalaiyarasi
- Division of Hepatology and Gastroenterology, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore 308433, Singapore;
| | - Acharyya Sanchalika
- Clinical Research & Innovation Office, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore 308433, Singapore;
| | - Low Hsien Min
- Division of Radiology, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore 308433, Singapore;
| | - Yap Wei Ming
- Division of Pathology, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore 308433, Singapore;
| | - Shelat Vishalkumar
- Division of General Surgery, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore 308433, Singapore; (L.J.K.); (J.S.); (H.C.W.T.); (T.Y.P.)
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
| | - Yew Kuo Chao
- Division of Hepatology and Gastroenterology, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore 308433, Singapore;
| | - Low Jee Keem
- Division of General Surgery, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore 308433, Singapore; (L.J.K.); (J.S.); (H.C.W.T.); (T.Y.P.)
| | - Junnarkar Sameer
- Division of General Surgery, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore 308433, Singapore; (L.J.K.); (J.S.); (H.C.W.T.); (T.Y.P.)
| | - Huey Cheong Wei Terence
- Division of General Surgery, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore 308433, Singapore; (L.J.K.); (J.S.); (H.C.W.T.); (T.Y.P.)
| | - Tan Yen Ping
- Division of General Surgery, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore 308433, Singapore; (L.J.K.); (J.S.); (H.C.W.T.); (T.Y.P.)
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