PMID- 38048934
OWN - NLM
STAT- MEDLINE
DCOM- 20240325
LR  - 20240325
IS  - 1542-7714 (Electronic)
IS  - 1542-3565 (Linking)
VI  - 22
IP  - 4
DP  - 2024 Apr
TI  - Accuracy of the Enhanced Liver Fibrosis Test in Patients With Type 2 Diabetes 
      Mellitus and Its Clinical Implications.
PG  - 789-797.e8
LID - S1542-3565(23)00961-8 [pii]
LID - 10.1016/j.cgh.2023.11.022 [doi]
AB  - BACKGROUND AND AIMS: The diagnostic performance of the Fibrosis-4 (FIB-4) index 
      and nonalcoholic fatty liver disease (NAFLD) fibrosis score (NFS) is poor in 
      patients with type 2 diabetes mellitus (T2DM). We determined the usefulness of 
      the Enhanced Liver Fibrosis (ELF) test in patients with T2DM. METHODS: A total of 
      1228 patients with biopsy-proven NAFLD were enrolled. The diagnostic performance 
      of the ELF test for predicting advanced fibrosis in participants with or without 
      T2DM was evaluated in comparison with the FIB-4 index and NFS. RESULTS: Overall, 
      the area under the curve of the ELF test for predicting advanced fibrosis was 
      greater (0.828) than that of the FIB-4 index (0.727) and NFS (0.733). The 
      diagnostic performance of the ELF test (area under the curve, 0.820) was also 
      superior to that of the FIB-4 index (0.698) and NFS (0.700) in patients with 
      T2DM. With the low cutoff values for each noninvasive test, the ELF test provided 
      an acceptable false negative rate (cutoff value 9.8, 6.7%) in this population, 
      unlike the FIB-4 index (1.30, 14.5%) and NFS (-1.455, 12.4%). After propensity 
      score matching to avoid selection bias including age, sex, body mass index, and 
      the prevalence of advanced fibrosis, the ELF test with a low cutoff value showed 
      a high sensitivity (>/=91.4%) and a high negative predictive value (>/=96.8%), 
      irrespective of the presence or absence of T2DM. CONCLUSIONS: The high diagnostic 
      performance of the ELF test for predicting advanced fibrosis in individuals with 
      or without T2DM could address an unmet medical need for accurate assessment of 
      liver fibrosis in patients with diabetes and NAFLD.
CI  - Copyright (c) 2024 AGA Institute. Published by Elsevier Inc. All rights reserved.
FAU - Arai, Taeang
AU  - Arai T
AD  - Division of Gastroenterology and Hepatology, Department of Internal Medicine, 
      Nippon Medical School, Tokyo, Japan.
FAU - Takahashi, Hirokazu
AU  - Takahashi H
AD  - Liver Center, Saga University Hospital, Saga, Japan. Electronic address: 
      takahas2@cc.saga-u.ac.jp.
FAU - Seko, Yuya
AU  - Seko Y
AD  - Department of Gastroenterology and Hepatology, Kyoto Prefectural University of 
      Medicine, Kyoto, Japan.
FAU - Toyoda, Hidenori
AU  - Toyoda H
AD  - Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, 
      Japan.
FAU - Hayashi, Hideki
AU  - Hayashi H
AD  - Department of Gastroenterology and Hepatology, Gifu Municipal Hospital, Gifu, 
      Japan.
FAU - Yamaguchi, Kanji
AU  - Yamaguchi K
AD  - Department of Gastroenterology and Hepatology, Kyoto Prefectural University of 
      Medicine, Kyoto, Japan.
FAU - Iwaki, Michihiro
AU  - Iwaki M
AD  - Department of Gastroenterology and Hepatology, Yokohama City University Graduate 
      School of Medicine, Yokohama, Japan.
FAU - Yoneda, Masato
AU  - Yoneda M
AD  - Department of Gastroenterology and Hepatology, Yokohama City University Graduate 
      School of Medicine, Yokohama, Japan.
FAU - Shima, Toshihide
AU  - Shima T
AD  - Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Osaka, 
      Japan.
FAU - Fujii, Hideki
AU  - Fujii H
AD  - Department of Hepatology, Osaka Metropolitan University, Osaka, Japan.
FAU - Morishita, Asahiro
AU  - Morishita A
AD  - Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa 
      University, Takamatsu, Japan.
FAU - Kawata, Kazuhito
AU  - Kawata K
AD  - Hepatology Division, Department of Internal Medicine II, Hamamatsu University 
      School of Medicine, Hamamatsu, Japan.
FAU - Tomita, Kengo
AU  - Tomita K
AD  - Department of Internal Medicine, National Defense Medical College, Tokorozawa, 
      Japan.
FAU - Kawanaka, Miwa
AU  - Kawanaka M
AD  - Department of General Internal Medicine 2, Kawasaki General Medical Center, 
      Kawasaki Medical School, Okayama, Japan.
FAU - Yoshida, Yuichi
AU  - Yoshida Y
AD  - Department of Gastroenterology and Hepatology, Suita Municipal Hospital, Osaka, 
      Japan.
FAU - Ikegami, Tadashi
AU  - Ikegami T
AD  - Department of Gastroenterology and Hepatology, Tokyo Medical University Ibaraki 
      Medical Center, Ibaraki, Japan.
FAU - Notsumata, Kazuo
AU  - Notsumata K
AD  - Department of General Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, 
      Japan.
FAU - Oeda, Satoshi
AU  - Oeda S
AD  - Liver Center, Saga University Hospital, Saga, Japan.
FAU - Atsukawa, Masanori
AU  - Atsukawa M
AD  - Division of Gastroenterology and Hepatology, Department of Internal Medicine, 
      Nippon Medical School, Tokyo, Japan.
FAU - Kamada, Yoshihiro
AU  - Kamada Y
AD  - Department of Advanced Metabolic Hepatology, Osaka University Graduate School of 
      Medicine, Osaka, Japan.
FAU - Sumida, Yoshio
AU  - Sumida Y
AD  - Division of Hepatology and Pancreatology, Department of Internal Medicine, Aichi 
      Medical University, Aichi, Japan.
FAU - Fukushima, Hideaki
AU  - Fukushima H
AD  - Diagnostics Business Area, Siemens Healthcare Diagnostics K.K., Tokyo, Japan.
FAU - Miyoshi, Eiji
AU  - Miyoshi E
AD  - Department of Molecular Biochemistry & Clinical Investigation, Osaka University 
      Graduate School of Medicine, Osaka, Japan.
FAU - Aishima, Shinichi
AU  - Aishima S
AD  - Department of Pathology and Microbiology, Faculty of Medicine, Saga University, 
      Saga, Japan.
FAU - Okanoue, Takeshi
AU  - Okanoue T
AD  - Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Osaka, 
      Japan.
FAU - Itoh, Yoshito
AU  - Itoh Y
AD  - Department of Gastroenterology and Hepatology, Kyoto Prefectural University of 
      Medicine, Kyoto, Japan.
FAU - Nakajima, Atsushi
AU  - Nakajima A
AD  - Department of Gastroenterology and Hepatology, Yokohama City University Graduate 
      School of Medicine, Yokohama, Japan.
CN  - Japan Study Group of Nonalcoholic Fatty Liver Disease (JSG-NAFLD)
LA  - eng
PT  - Journal Article
DEP - 20231202
PL  - United States
TA  - Clin Gastroenterol Hepatol
JT  - Clinical gastroenterology and hepatology : the official clinical practice journal 
      of the American Gastroenterological Association
JID - 101160775
RN  - EC 2.6.1.2 (Alanine Transaminase)
RN  - EC 2.6.1.1 (Aspartate Aminotransferases)
SB  - IM
MH  - Humans
MH  - *Non-alcoholic Fatty Liver Disease/complications/diagnosis/epidemiology
MH  - *Diabetes Mellitus, Type 2/complications
MH  - Alanine Transaminase
MH  - Aspartate Aminotransferases
MH  - Liver Cirrhosis/pathology
MH  - Biopsy
MH  - Liver/pathology
MH  - Severity of Illness Index
OTO - NOTNLM
OT  - Diabetes
OT  - ELF
OT  - Fibrosis
OT  - NAFLD
OT  - Noninvasive Tests
EDAT- 2023/12/05 00:42
MHDA- 2024/03/25 06:43
CRDT- 2023/12/04 19:24
PHST- 2023/05/31 00:00 [received]
PHST- 2023/10/05 00:00 [revised]
PHST- 2023/11/20 00:00 [accepted]
PHST- 2024/03/25 06:43 [medline]
PHST- 2023/12/05 00:42 [pubmed]
PHST- 2023/12/04 19:24 [entrez]
AID - S1542-3565(23)00961-8 [pii]
AID - 10.1016/j.cgh.2023.11.022 [doi]
PST - ppublish
SO  - Clin Gastroenterol Hepatol. 2024 Apr;22(4):789-797.e8. doi: 
      10.1016/j.cgh.2023.11.022. Epub 2023 Dec 2.