PMID- 36926233
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230318
IS  - 1948-5182 (Print)
IS  - 1948-5182 (Electronic)
VI  - 15
IP  - 2
DP  - 2023 Feb 27
TI  - Progressive changes in platelet counts and Fib-4 scores precede the diagnosis of 
      advanced fibrosis in NASH patients.
PG  - 225-236
LID - 10.4254/wjh.v15.i2.225 [doi]
AB  - BACKGROUND: Cirrhosis and its complications develop in a subgroup of patients 
      with non-alcoholic fatty liver disease (NASH). Early detection of liver fibrosis 
      represents an important goal of clinical care. AIM: To test the hypothesis that 
      the development of cirrhosis in nonalcoholic fatty liver disease patients is 
      preceded by the long-term trends of platelet counts and Fib-4 scores. METHODS: We 
      identified all patients in our healthcare system who had undergone fibrosis 
      staging by liver biopsy or magnetic resonance elastography (MRE) for 
      non-alcoholic fatty liver disease during the past decade (n = 310). Platelet 
      counts, serum glutamic-pyruvic transaminase and serum glutamic oxalacetic 
      transaminase values preceding the staging tests were extracted from the 
      electronic medical record system, and Fib-4 scores were calculated. Potential 
      predictors of advanced fibrosis were evaluated using multivariate regression 
      analysis. RESULTS: Significant decreases in platelet counts and increases in 
      Fib-4 scores were observed in all fibrosis stages, particularly in patients with 
      cirrhosis. In the liver biopsy group, the presence of cirrhosis was best 
      predicted by the combination of the Fib-4 score at the time closest to staging (P 
      < 0.0001), the presence of diabetes (P = 0.0001), and the correlation coefficient 
      of the preceding time-dependent drop in platelet count (P = 0.044). In the MRE 
      group, Fib4 score (P = 0.0025) and platelet drop (P = 0.0373) were significant 
      predictors. In comparison, the time-dependent rise of the Fib-4 score did not 
      contribute in a statistically significant way. CONCLUSION: Time-dependent changes 
      in platelet counts and Fib-4 scores contribute to the prediction of cirrhosis in 
      NASH patients with biopsy- or MRE-staged fibrosis. Their incorporation into 
      predictive algorithms may assist in the earlier identification of high-risk 
      patients.
CI  - (c)The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights 
      reserved.
FAU - Zijlstra, Michael K
AU  - Zijlstra MK
AD  - Department of Internal Medicine, NorthShore University Health System, Evanston, 
      IL 60201, United States.
FAU - Gampa, Anuhya
AU  - Gampa A
AD  - Division of Gastroenterology and Hepatology, University of Chicago Pritzker 
      School of Medicine, Chicago, IL 60637, United States.
FAU - Joseph, Nora
AU  - Joseph N
AD  - Department of Pathology, NorthShore University Health System, Evanston, IL 60201, 
      United States.
FAU - Sonnenberg, Amnon
AU  - Sonnenberg A
AD  - Portland VA Medical Center, Portland, OR 97239, United States.
AD  - Department of Gastroenterology, Oregon Health Sciences University, Portland, OR 
      97201, United States.
FAU - Fimmel, Claus J
AU  - Fimmel CJ
AD  - Division of Gastroenterology, Department of Internal Medicine, NorthShore 
      University Health System, Evanston, IL 60201, United States. clausfimmel@att.net.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - World J Hepatol
JT  - World journal of hepatology
JID - 101532469
PMC - PMC10011908
OTO - NOTNLM
OT  - Liver biopsy
OT  - Liver fibrosis
OT  - Magnetic resonance elastography
OT  - Non-alcoholic fatty liver disease
OT  - Prediction
OT  - cirrhosis
COIS- Conflict-of-interest statement: All authors have no conflict of interest to 
      report.
EDAT- 2023/03/18 06:00
MHDA- 2023/03/18 06:01
PMCR- 2023/02/27
CRDT- 2023/03/17 02:45
PHST- 2022/06/27 00:00 [received]
PHST- 2022/08/02 00:00 [revised]
PHST- 2023/01/13 00:00 [accepted]
PHST- 2023/03/17 02:45 [entrez]
PHST- 2023/03/18 06:00 [pubmed]
PHST- 2023/03/18 06:01 [medline]
PHST- 2023/02/27 00:00 [pmc-release]
AID - 10.4254/wjh.v15.i2.225 [doi]
PST - ppublish
SO  - World J Hepatol. 2023 Feb 27;15(2):225-236. doi: 10.4254/wjh.v15.i2.225.