Distribution of FIB-4 index in the general population: analysis of 75,666 residents who underwent health checkups
Abstract Background Fatty liver is frequently found in a general population, and it is critical to detect advanced fibrosis. FIB-4 index is considered a useful marker for evaluating liver fibrosis but the distribution of FIB-4 index in the general population remains unknown. Methods This cross-secti...
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| Format: | Article |
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BMC
2022-05-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-022-02290-1 |
| _version_ | 1818206812622553088 |
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| author | Aya Sugiyama Akemi Kurisu Bunthen E Serge Ouoba Ko Ko Anvarjon Rakhimov Tomoyuki Akita Takayuki Harakawa Toru Sako Makoto Koshiyama Takashi Kumada Junko Tanaka |
| author_facet | Aya Sugiyama Akemi Kurisu Bunthen E Serge Ouoba Ko Ko Anvarjon Rakhimov Tomoyuki Akita Takayuki Harakawa Toru Sako Makoto Koshiyama Takashi Kumada Junko Tanaka |
| author_sort | Aya Sugiyama |
| collection | DOAJ |
| description | Abstract Background Fatty liver is frequently found in a general population, and it is critical to detect advanced fibrosis. FIB-4 index is considered a useful marker for evaluating liver fibrosis but the distribution of FIB-4 index in the general population remains unknown. Methods This cross-sectional study included residents who underwent ultrasonography at health checkups in Hiroshima or Iwate prefectures. The distribution of FIB-4 index in the total study population (N = 75,666) as well as in non-alcoholic fatty liver disease (NAFLD) populations (N = 17,968) and non-drinkers without fatty liver populations (N = 47,222) was evaluated. The distribution of aspartate aminotransferase (AST) levels, alanine aminotransferase (ALT) levels was also evaluated. Results The mean FIB-4 index in the total study population was 1.20 ± 0.63. FIB-4 index ≥ 2.67, which indicates a high risk of liver fibrosis, was found in 16.4% of those aged ≥ 70 years. In the NAFLD population, 58.1% of those in their 60 s and 88.1% of those ≥ 70 years met the criteria for referral to hepatologists by using the recommended FIB-4 index cutoff value (≥ 1.3). The mean FIB-4 index in the NAFLD population (1.12 ± 0.58) was significantly lower than in the non-drinkers without fatty liver (1.23 ± 0.63, p < 0.0001). The non-drinkers without fatty liver tended to have higher AST relative to ALT levels (60.0% with AST/ALT > 1.0), whereas the results in the NAFLD population were opposite (14.8% with AST/ALT > 1.0). AST > ALT resulted in a higher FIB-4 index in non-drinkers without fatty liver due to the nature of FIB-4 index formula. Conclusions The cutoff value of FIB-4 index (≥ 1.3) for triaging the elderly people with fatty liver for referral to hepatologists should be reconsidered to avoid over-referral. Due to the impact of age and characteristics of AST/ALT ratios, there is no prospect of using FIB-4 index for primary screening for liver fibrosis in a general population of unknown presence or absence of liver disease, even though it can be easily calculated using routine clinical indices. It is desired to develop a non-invasive method for picking up cases with advanced fibrosis latent in the general population. |
| first_indexed | 2024-12-12T04:18:59Z |
| format | Article |
| id | doaj.art-1fc12c1872ae4b6796e8f4ff9a3764f6 |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-12T04:18:59Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
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| series | BMC Gastroenterology |
| spelling | doaj.art-1fc12c1872ae4b6796e8f4ff9a3764f62022-12-22T00:38:22ZengBMCBMC Gastroenterology1471-230X2022-05-0122111010.1186/s12876-022-02290-1Distribution of FIB-4 index in the general population: analysis of 75,666 residents who underwent health checkupsAya Sugiyama0Akemi Kurisu1Bunthen E2Serge Ouoba3Ko Ko4Anvarjon Rakhimov5Tomoyuki Akita6Takayuki Harakawa7Toru Sako8Makoto Koshiyama9Takashi Kumada10Junko Tanaka11Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityDepartment of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityDepartment of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityDepartment of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityDepartment of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityDepartment of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityDepartment of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityGeneral Affairs, Foundation for Community Health and Medicine Promotion in Hiroshima PrefectureGeneral Affairs, Foundation for Community Health and Medicine Promotion in Hiroshima PrefectureIwate Prefectural Preventive Medicine AssociationDepartment of Nursing, Faculty of Nursing, Gifu Kyoritsu UniversityDepartment of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityAbstract Background Fatty liver is frequently found in a general population, and it is critical to detect advanced fibrosis. FIB-4 index is considered a useful marker for evaluating liver fibrosis but the distribution of FIB-4 index in the general population remains unknown. Methods This cross-sectional study included residents who underwent ultrasonography at health checkups in Hiroshima or Iwate prefectures. The distribution of FIB-4 index in the total study population (N = 75,666) as well as in non-alcoholic fatty liver disease (NAFLD) populations (N = 17,968) and non-drinkers without fatty liver populations (N = 47,222) was evaluated. The distribution of aspartate aminotransferase (AST) levels, alanine aminotransferase (ALT) levels was also evaluated. Results The mean FIB-4 index in the total study population was 1.20 ± 0.63. FIB-4 index ≥ 2.67, which indicates a high risk of liver fibrosis, was found in 16.4% of those aged ≥ 70 years. In the NAFLD population, 58.1% of those in their 60 s and 88.1% of those ≥ 70 years met the criteria for referral to hepatologists by using the recommended FIB-4 index cutoff value (≥ 1.3). The mean FIB-4 index in the NAFLD population (1.12 ± 0.58) was significantly lower than in the non-drinkers without fatty liver (1.23 ± 0.63, p < 0.0001). The non-drinkers without fatty liver tended to have higher AST relative to ALT levels (60.0% with AST/ALT > 1.0), whereas the results in the NAFLD population were opposite (14.8% with AST/ALT > 1.0). AST > ALT resulted in a higher FIB-4 index in non-drinkers without fatty liver due to the nature of FIB-4 index formula. Conclusions The cutoff value of FIB-4 index (≥ 1.3) for triaging the elderly people with fatty liver for referral to hepatologists should be reconsidered to avoid over-referral. Due to the impact of age and characteristics of AST/ALT ratios, there is no prospect of using FIB-4 index for primary screening for liver fibrosis in a general population of unknown presence or absence of liver disease, even though it can be easily calculated using routine clinical indices. It is desired to develop a non-invasive method for picking up cases with advanced fibrosis latent in the general population.https://doi.org/10.1186/s12876-022-02290-1Fatty liverNon-alcoholic fatty liver diseaseLiver fibrosisIndirect biomarkerScoring systemUltrasonography |
| spellingShingle | Aya Sugiyama Akemi Kurisu Bunthen E Serge Ouoba Ko Ko Anvarjon Rakhimov Tomoyuki Akita Takayuki Harakawa Toru Sako Makoto Koshiyama Takashi Kumada Junko Tanaka Distribution of FIB-4 index in the general population: analysis of 75,666 residents who underwent health checkups BMC Gastroenterology Fatty liver Non-alcoholic fatty liver disease Liver fibrosis Indirect biomarker Scoring system Ultrasonography |
| title | Distribution of FIB-4 index in the general population: analysis of 75,666 residents who underwent health checkups |
| title_full | Distribution of FIB-4 index in the general population: analysis of 75,666 residents who underwent health checkups |
| title_fullStr | Distribution of FIB-4 index in the general population: analysis of 75,666 residents who underwent health checkups |
| title_full_unstemmed | Distribution of FIB-4 index in the general population: analysis of 75,666 residents who underwent health checkups |
| title_short | Distribution of FIB-4 index in the general population: analysis of 75,666 residents who underwent health checkups |
| title_sort | distribution of fib 4 index in the general population analysis of 75 666 residents who underwent health checkups |
| topic | Fatty liver Non-alcoholic fatty liver disease Liver fibrosis Indirect biomarker Scoring system Ultrasonography |
| url | https://doi.org/10.1186/s12876-022-02290-1 |
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