RT Journal Article
T1 Development and Validation of Hepamet Fibrosis Scoring System-A Simple, Noninvasive Test to Identify Patients With Nonalcoholic Fatty Liver Disease With Advanced Fibrosis.
A1 Ampuero, Javier
A1 Pais, Raluca
A1 Aller, Rocío
A1 Gallego-Durán, Rocío
A1 Crespo, Javier
A1 García-Monzón, Carmelo
A1 Boursier, Jerome
A1 Vilar, Eduardo
A1 Petta, Salvatore
A1 Zheng, Ming-Hua
A1 Escudero, Desamparados
A1 Calleja, Jose Luis
A1 Aspichueta, Patricia
A1 Diago, Moisés
A1 Rosales, Jose Miguel
A1 Caballería, Joan
A1 Gómez-Camarero, Judith
A1 Lo Iacono, Oreste
A1 Benlloch, Salvador
A1 Albillos, Agustín
A1 Turnes, Juan
A1 Banales, Jesus M
A1 Ratziu, Vlad
A1 Romero-Gómez, Manuel
A1 HEPAmet Registry, 
K1 Cirrhosis
K1 Diagnostic Tool
K1 HOMA
K1 Prognostic Factor
K1 Steatosis
AB Fibrosis affects prognoses for patients with nonalcoholic fatty liver disease (NAFLD). Several non-invasive scoring systems have aimed to identify patients at risk for advanced fibrosis, but inconclusive results and variations in features of patients (diabetes, obesity and older age) reduce their diagnostic accuracy. We sought to develop a scoring system based on serum markers to identify patients with NAFLD at risk for advanced fibrosis. We collected data from 2452 patients with NAFLD at medical centers in Italy, France, Cuba, and China. We developed the Hepamet fibrosis scoring system using demographic, anthropometric, and laboratory test data, collected at time of liver biopsy, from a training cohort of patients from Spain (n = 768) and validated the system using patients from Cuba (n = 344), Italy (n = 288), France (n = 830), and China (n = 232). Hepamet fibrosis score (HFS) were compared with those of previously developed fibrosis scoring systems (the NAFLD fibrosis score [NFS] and FIB-4). The diagnostic accuracy of the Hepamet fibrosis scoring system was assessed based on area under the receiver operating characteristic (AUROC) curve, sensitivity, specificity, diagnostic odds ratio, and positive and negative predictive values and likelihood ratios. Variables used to determine HFS were patient sex, age, homeostatic model assessment score, presence of diabetes, levels of aspartate aminotransferase, and albumin, and platelet counts; these were independently associated with advanced fibrosis. HFS discriminated between patients with and without advanced fibrosis with an AUROC curve value of 0.85 whereas NFS or FIB-4 did so with AUROC values of 0.80 (P = .0001). In the validation set, cut-off HFS of 0.12 and 0.47 identified patients with and without advanced fibrosis with 97.2% specificity, 74% sensitivity, a 92% negative predictive value, a 76.3% positive predictive value, a 13.22 positive likelihood ratio, and a 0.31 negative likelihood ratio. HFS were not affected by patient age, body mass index, hypertransaminasemia, or diabetes. The Hepamet fibrosis scoring system had the greatest net benefit in identifying patients who should undergo liver biopsy analysis and led to significant improvements in reclassification, reducing the number of patients with undetermined results to 20% from 30% for the FIB-4 and NFS systems (P  Using clinical and laboratory data from patients with NAFLD, we developed and validated the Hepamet fibrosis scoring system, which identified patients with advanced fibrosis with greater accuracy than the FIB-4 and NFS systems. the Hepamet system provides a greater net benefit for the decision-making process to identify patients who should undergo liver biopsy analysis.
YR 2019
FD 2019-06-11
LK http://hdl.handle.net/10668/14108
UL http://hdl.handle.net/10668/14108
LA en
DS RISalud
RD Apr 18, 2025