File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Sequential algorithm to stratify liver fibrosis risk in overweight/obese metabolic dysfunction-associated fatty liver disease

TitleSequential algorithm to stratify liver fibrosis risk in overweight/obese metabolic dysfunction-associated fatty liver disease
Authors
Keywordsfatty liver disease
MAFLD (metabolic associated fatty liver disease)
obesity
overweight
population based study
Issue Date6-Jan-2023
PublisherFrontiers Media
Citation
Frontiers in Endocrinology, 2023, v. 13 How to Cite?
Abstract

Background: Non-diabetic overweight/obese metabolic dysfunction-associated fatty liver disease (MAFLD) represents the largest subgroup with heterogeneous liver fibrosis risk. Metabolic dysfunction promotes liver fibrosis. Here, we investigated whether incorporating additional metabolic risk factors into clinical evaluation improved liver fibrosis risk stratification among individuals with non-diabetic overweight/obese MAFLD.

Materials and methods: Comprehensive metabolic evaluation including 75-gram oral glucose tolerance test was performed in over 1000 participants from the New Hong Kong Cardiovascular Risk Factor Prevalence Study (HK-NCRISPS), a contemporary population-based study of HK Chinese. Hepatic steatosis and fibrosis were evaluated based on controlled attenuation parameter and liver stiffness (LS) measured using vibration-controlled transient elastography, respectively. Clinically significant liver fibrosis was defined as LS ≥8.0 kPa. Our findings were validated in an independent pooled cohort comprising individuals with obesity and/or polycystic ovarian syndrome.

Results: Of the 1020 recruited community-dwelling individuals, 312 (30.6%) had non-diabetic overweight/obese MAFLD. Among them, 6.4% had LS ≥8.0 kPa. In multivariable stepwise logistic regression analysis, abnormal serum aspartate aminotransferase (AST) (OR 7.95, p<0.001) and homeostasis model assessment of insulin resistance (HOMA-IR) ≥2.5 (OR 5.01, p=0.008) were independently associated with LS ≥8.0 kPa, in a model also consisting of other metabolic risk factors including central adiposity, hypertension, dyslipidaemia and prediabetes. A sequential screening algorithm using abnormal AST, followed by elevated HOMA-IR, was developed to identify individuals with LS ≥8.0 kPa, and externally validated with satisfactory sensitivity (>80%) and negative predictive value (>90%).

Conclusion: A sequential algorithm incorporating AST and HOMA-IR levels improves fibrosis risk stratification among non-diabetic overweight/obese MAFLD individuals.

Keywords: MAFLD (metabolic associated fatty liver disease); fatty liver disease; obesity; overweight; population based study.


Persistent Identifierhttp://hdl.handle.net/10722/330959
ISSN
2023 Impact Factor: 3.9
2023 SCImago Journal Rankings: 1.240
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLee, Chi Ho-
dc.contributor.authorLui, David Tak Wai-
dc.contributor.authorLi, Raymond Hang Wun-
dc.contributor.authorYuen, Michele Mae Ann-
dc.contributor.authorFong, Carol Ho Yi-
dc.contributor.authorLeung, Ambrose Pak Wah-
dc.contributor.authorChu, Justin Chiu Man-
dc.contributor.authorMak, Loey Lung Yi-
dc.contributor.authorLam, Tai Hing-
dc.contributor.authorWoo, Jean-
dc.contributor.authorWoo, Yu Cho-
dc.contributor.authorXu, Aimin-
dc.contributor.authorTse, Hung Fat-
dc.contributor.authorTan, Kathryn Choon Beng-
dc.contributor.authorCheung, Bernard Man Yung-
dc.contributor.authorYuen, Man Fung-
dc.contributor.authorLam, Karen Siu Ling-
dc.date.accessioned2023-09-21T06:51:31Z-
dc.date.available2023-09-21T06:51:31Z-
dc.date.issued2023-01-06-
dc.identifier.citationFrontiers in Endocrinology, 2023, v. 13-
dc.identifier.issn1664-2392-
dc.identifier.urihttp://hdl.handle.net/10722/330959-
dc.description.abstract<p><strong>Background: </strong>Non-diabetic overweight/obese metabolic dysfunction-associated fatty liver disease (MAFLD) represents the largest subgroup with heterogeneous liver fibrosis risk. Metabolic dysfunction promotes liver fibrosis. Here, we investigated whether incorporating additional metabolic risk factors into clinical evaluation improved liver fibrosis risk stratification among individuals with non-diabetic overweight/obese MAFLD.</p><p><strong>Materials and methods: </strong>Comprehensive metabolic evaluation including 75-gram oral glucose tolerance test was performed in over 1000 participants from the New Hong Kong Cardiovascular Risk Factor Prevalence Study (HK-NCRISPS), a contemporary population-based study of HK Chinese. Hepatic steatosis and fibrosis were evaluated based on controlled attenuation parameter and liver stiffness (LS) measured using vibration-controlled transient elastography, respectively. Clinically significant liver fibrosis was defined as LS ≥8.0 kPa. Our findings were validated in an independent pooled cohort comprising individuals with obesity and/or polycystic ovarian syndrome.</p><p><strong>Results: </strong>Of the 1020 recruited community-dwelling individuals, 312 (30.6%) had non-diabetic overweight/obese MAFLD. Among them, 6.4% had LS ≥8.0 kPa. In multivariable stepwise logistic regression analysis, abnormal serum aspartate aminotransferase (AST) (OR 7.95, p<0.001) and homeostasis model assessment of insulin resistance (HOMA-IR) ≥2.5 (OR 5.01, p=0.008) were independently associated with LS ≥8.0 kPa, in a model also consisting of other metabolic risk factors including central adiposity, hypertension, dyslipidaemia and prediabetes. A sequential screening algorithm using abnormal AST, followed by elevated HOMA-IR, was developed to identify individuals with LS ≥8.0 kPa, and externally validated with satisfactory sensitivity (>80%) and negative predictive value (>90%).</p><p><strong>Conclusion: </strong>A sequential algorithm incorporating AST and HOMA-IR levels improves fibrosis risk stratification among non-diabetic overweight/obese MAFLD individuals.</p><p><strong>Keywords: </strong>MAFLD (metabolic associated fatty liver disease); fatty liver disease; obesity; overweight; population based study.</p>-
dc.languageeng-
dc.publisherFrontiers Media-
dc.relation.ispartofFrontiers in Endocrinology-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectfatty liver disease-
dc.subjectMAFLD (metabolic associated fatty liver disease)-
dc.subjectobesity-
dc.subjectoverweight-
dc.subjectpopulation based study-
dc.titleSequential algorithm to stratify liver fibrosis risk in overweight/obese metabolic dysfunction-associated fatty liver disease-
dc.typeArticle-
dc.identifier.doi10.3389/fendo.2022.1056562-
dc.identifier.pmid36686469-
dc.identifier.scopuseid_2-s2.0-85146525884-
dc.identifier.volume13-
dc.identifier.eissn1664-2392-
dc.identifier.isiWOS:000913903700001-
dc.publisher.placeLAUSANNE-
dc.identifier.issnl1664-2392-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats