Practical diagnosis of cirrhosis in non-alcoholic fatty liver disease using currently available non-invasive fibrosis tests

AFEF group for the study of liver fibrosis; M118 study group

doi:10.1038/s41467-023-40328-4

Practical diagnosis of cirrhosis in non-alcoholic fatty liver disease using currently available non-invasive fibrosis tests

AFEF group for the study of liver fibrosis, M118 study group

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Abstract

Unlike for advanced liver fibrosis, the practical rules for the early non-invasive diagnosis of cirrhosis in NAFLD remain not well defined. Here, we report the derivation and validation of a stepwise diagnostic algorithm in 1568 patients with NAFLD and liver biopsy coming from four independent cohorts. The study algorithm, using first the elastography-based tests Agile3+ and Agile4 and then the specialized blood tests FibroMeterV3G and CirrhoMeterV3G, provides stratification in four groups, the last of which is enriched in cirrhosis (71% prevalence in the validation set). A risk prediction chart is also derived to allow estimation of the individual probability of cirrhosis. The predicted risk shows excellent calibration in the validation set, and mean difference with perfect prediction is only −2.9%. These tools improve the personalized non-invasive diagnosis of cirrhosis in NAFLD.

Original language	English
Article number	5219
Number of pages	11
Journal	Nature Communications
Volume	14
Issue number	1
DOIs	https://doi.org/10.1038/s41467-023-40328-4
Publication status	Published - 26 Aug 2023

Bibliographical note

Acknowledgements:
This work received grant support from Intercept, delivered to Angers University Hospital (JB). Philip N Newsome was supported by the Birmingham NIHR Biomedical Research Centre. This paper presents independent research supported in part by National institute for Health Research (NIHR) Birmingham Biomedical Research Centre at the University Hospitals Birmingham NHS foundation Trust and the University of Birmingham. (Grant reference number: BRC-1215-20009). The views expressed are those of author(s) and not necessarily those of NIHR or the department of Health and Social care. We thank Marc de Saint Loup, Sandra Girre, and Audrey Morisset for data collection and database construction.

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10.1038/s41467-023-40328-4Licence: Creative Commons: Attribution (CC BY)

BoursierJ2023PracticalFinal published version, 1.84 MBLicence: Creative Commons: Attribution (CC BY)

NIHR Biomedical Research Centre (BRC) - Core Theme
Barrett, T., Adams, D., Newsome, P., Kyte, D., Slade, A. & Calvert, M.
NIHR CENTRAL COMMISSIONING FACILITY
1/04/17 → 30/11/22
Project: Other Government Departments

Cite this

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title = "Practical diagnosis of cirrhosis in non-alcoholic fatty liver disease using currently available non-invasive fibrosis tests",

abstract = "Unlike for advanced liver fibrosis, the practical rules for the early non-invasive diagnosis of cirrhosis in NAFLD remain not well defined. Here, we report the derivation and validation of a stepwise diagnostic algorithm in 1568 patients with NAFLD and liver biopsy coming from four independent cohorts. The study algorithm, using first the elastography-based tests Agile3+ and Agile4 and then the specialized blood tests FibroMeterV3G and CirrhoMeterV3G, provides stratification in four groups, the last of which is enriched in cirrhosis (71% prevalence in the validation set). A risk prediction chart is also derived to allow estimation of the individual probability of cirrhosis. The predicted risk shows excellent calibration in the validation set, and mean difference with perfect prediction is only −2.9%. These tools improve the personalized non-invasive diagnosis of cirrhosis in NAFLD.",

author = "{AFEF group for the study of liver fibrosis} and {M118 study group} and J{\'e}r{\^o}me Boursier and Marine Roux and Charlotte Costentin and Julien Chaigneau and C{\'e}line Fournier-Poizat and Aldo Trylesinski and Canivet, {Cl{\'e}mence M.} and Sophie Michalak and {Le Bail}, Brigitte and Val{\'e}rie Paradis and Pierre Bedossa and Nathalie Sturm and {de Ledinghen}, Victor and Newsome, {Philip N.}",

note = "Acknowledgements: This work received grant support from Intercept, delivered to Angers University Hospital (JB). Philip N Newsome was supported by the Birmingham NIHR Biomedical Research Centre. This paper presents independent research supported in part by National institute for Health Research (NIHR) Birmingham Biomedical Research Centre at the University Hospitals Birmingham NHS foundation Trust and the University of Birmingham. (Grant reference number: BRC-1215-20009). The views expressed are those of author(s) and not necessarily those of NIHR or the department of Health and Social care. We thank Marc de Saint Loup, Sandra Girre, and Audrey Morisset for data collection and database construction.",

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AU - AFEF group for the study of liver fibrosis

AU - M118 study group

AU - Boursier, Jérôme

AU - Roux, Marine

AU - Costentin, Charlotte

AU - Chaigneau, Julien

AU - Fournier-Poizat, Céline

AU - Trylesinski, Aldo

AU - Canivet, Clémence M.

AU - Michalak, Sophie

AU - Le Bail, Brigitte

AU - Paradis, Valérie

AU - Bedossa, Pierre

AU - Sturm, Nathalie

AU - de Ledinghen, Victor

AU - Newsome, Philip N.

N1 - Acknowledgements: This work received grant support from Intercept, delivered to Angers University Hospital (JB). Philip N Newsome was supported by the Birmingham NIHR Biomedical Research Centre. This paper presents independent research supported in part by National institute for Health Research (NIHR) Birmingham Biomedical Research Centre at the University Hospitals Birmingham NHS foundation Trust and the University of Birmingham. (Grant reference number: BRC-1215-20009). The views expressed are those of author(s) and not necessarily those of NIHR or the department of Health and Social care. We thank Marc de Saint Loup, Sandra Girre, and Audrey Morisset for data collection and database construction.

PY - 2023/8/26

Y1 - 2023/8/26

N2 - Unlike for advanced liver fibrosis, the practical rules for the early non-invasive diagnosis of cirrhosis in NAFLD remain not well defined. Here, we report the derivation and validation of a stepwise diagnostic algorithm in 1568 patients with NAFLD and liver biopsy coming from four independent cohorts. The study algorithm, using first the elastography-based tests Agile3+ and Agile4 and then the specialized blood tests FibroMeterV3G and CirrhoMeterV3G, provides stratification in four groups, the last of which is enriched in cirrhosis (71% prevalence in the validation set). A risk prediction chart is also derived to allow estimation of the individual probability of cirrhosis. The predicted risk shows excellent calibration in the validation set, and mean difference with perfect prediction is only −2.9%. These tools improve the personalized non-invasive diagnosis of cirrhosis in NAFLD.

AB - Unlike for advanced liver fibrosis, the practical rules for the early non-invasive diagnosis of cirrhosis in NAFLD remain not well defined. Here, we report the derivation and validation of a stepwise diagnostic algorithm in 1568 patients with NAFLD and liver biopsy coming from four independent cohorts. The study algorithm, using first the elastography-based tests Agile3+ and Agile4 and then the specialized blood tests FibroMeterV3G and CirrhoMeterV3G, provides stratification in four groups, the last of which is enriched in cirrhosis (71% prevalence in the validation set). A risk prediction chart is also derived to allow estimation of the individual probability of cirrhosis. The predicted risk shows excellent calibration in the validation set, and mean difference with perfect prediction is only −2.9%. These tools improve the personalized non-invasive diagnosis of cirrhosis in NAFLD.

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DO - 10.1038/s41467-023-40328-4

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JO - Nature Communications

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ER -

Practical diagnosis of cirrhosis in non-alcoholic fatty liver disease using currently available non-invasive fibrosis tests

Abstract

Bibliographical note

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NIHR Biomedical Research Centre (BRC) - Core Theme

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