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标题: 南亚人后裔的脂肪肝疾病中肝纤维化的非侵入性标记是不可 [打印本页]
作者: StephenW    时间: 2017-11-17 07:54     标题: 南亚人后裔的脂肪肝疾病中肝纤维化的非侵入性标记是不可

                Liver


  
   
                Research


  
   
                      Non-invasive markers of liver fibrosis in fatty liver disease are unreliable in people of South Asian descent
         
  
   
                                      Author affiliations



  
   
               
Abstract

Objective Liver biopsy is the most accurate method for determining stage and grade of injury in non-alcoholic fatty liver disease (NAFLD). Given risks and limitations of biopsy, non-invasive tests such as NAFLD fibrosis score, aspartate transaminase (AST) to platelet ratio index, Fib-4, AST/alanine transaminase ratio and BARD are used. Prevalence and severity of NAFLD and metabolic syndrome vary by ethnicity, yet tests have been developed in largely white populations. We tested our hypothesis that non-invasive tests that include metabolic parameters are less accurate in South Asian compared with white patients.


Design Retrospective cross-sectional.


Setting Specialist liver centre.


Patients Patients with histologically confirmed NAFLD.


Interventions Scores calculated using clinical data taken within 1 week and compared with histology (Kleiner).


Main outcome measures Diagnostic test characteristics.


Results 175 patients were identified. South Asians (n=90) were younger, had lower body mass index and lower proportion of obesity compared with white patients (n=79), with comparable rates of diabetes and liver injury. Tests are less sensitive at detecting advanced fibrosis in South Asian compared with white patients. Relative risk of correct diagnosis in white patients compared with South Asians is 1.86 (95% CI 1.4 to 2.6). In binary logistic regression models, ethnicity and platelet count predicted accuracy. Transient elastography was equally and highly accurate in both ethnicities.


Conclusions Blood test-based non-invasive scores are less accurate in South Asian patients, irrespective of metabolic parameters. Ethnicity should be considered when devising risk-stratification algorithms for NAFLD.



This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/






  
   
                          

  
   
                http://dx.doi.org/10.1136/flgastro-2017-100865
  
   
作者: StephenW    时间: 2017-11-17 07:55

肝
研究
南亚人后裔的脂肪肝疾病中肝纤维化的非侵入性标记是不可靠的

Sampath De Silva1李文浩1 Polychronis Kemos1 James H Brindley1 Jibran Mecci1 Salma Samsuddin1 Joanne Chin-Aleong2 Roger M Feakins2 Graham R Foster1 Wing-Kin Syn1,3,4 William Alazawi1

作者从属关系

英国伦敦伦敦玛丽皇后大学Blizard研究所肝脏研究所
英国伦敦Bart健康NHS信托组织病理学系
美国查尔斯顿Ralph H Johnson退伍军人医疗中心消化科
美国南卡罗来纳州医科大学胃肠病学和肝病学系，美国查尔斯顿

伦敦E1 2AT伦敦大学玛丽女王学院Blizard Institute肝脏单位William Alazawi博士的信函; [email protected]

抽象

使用活检的客观风险和局限性，非侵入性检查如NAFLD纤维化评分，天门冬氨酸转氨酶（AST）与血小板比值指数，Fib-4，AST /丙氨酸转氨酶比值和BARD。 NAFLD和代谢综合征的患病率和严重程度因种族而异，但在大部分白种人群中已经开发了测试。我们测试了我们的假设，即包括代谢参数的非侵入性测试在南亚地区与白人患者相比较不准确。

设计回顾横断面。

设置专科肝脏中心。

患者经组织学证实的NAFLD患者。

干预使用1周内获得的临床数据计算得分并与组织学（Kleiner）进行比较。

主要结果测量诊断测试特征。

与白人患者（n = 79）相比，南亚人（n = 90）年轻，体重指数较低，肥胖比例较低，糖尿病和肝损伤发生率相当。与白人患者相比，南亚地区检测到的晚期纤维化患者的检测不太敏感。与南亚人相比，白种人正确诊断的相对风险是1.86（95％CI 1.4至2.6）。在二元logistic回归模型中，种族和血小板计数预测的准确性。同样和高度准确的两个民族

结论无论代谢参数如何，南亚患者的基于血液检查的无创评分都不太准确。在设计NAFLD的风险分层算法时应考虑种族。

这是根据知识共享署名（CC BY 4.0）许可条款分发的开放获取文章，允许他人分发，混合，修改和构建本作品，商业用途，前提是原创作品适当。 ：http://creativecommons.org/licenses/by/4.0/

http://dx.doi.org/10.1136/flgastro-2017-100865
作者: StephenW    时间: 2017-11-17 07:55

http://fg.bmj.com/content/early/ ... 2017-100865?papetoc



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