Blood-Based Non-Invasive Tests of Hepatic Fibrosis in Autoimmune Hepatitis: Application among Selected Patients Leads to Higher Accuracy
Background. Assessment of liver fibrosis is essential to guide treatment in autoimmune hepatitis (AIH), but non-invasive tests (NITs) showed poor accuracy. Our study aims to evaluate the performance of NITs among different AIH presentations. Methods. Monocentric retrospective study among 122 AIH pat...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-09-01
|
| Series: | Gastroenterology Insights |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2036-7422/13/3/29 |
| _version_ | 1797488093302882304 |
|---|---|
| author | Marco Ferronato Marco Lenzi Paolo Muratori Luigi Muratori |
| author_facet | Marco Ferronato Marco Lenzi Paolo Muratori Luigi Muratori |
| author_sort | Marco Ferronato |
| collection | DOAJ |
| description | Background. Assessment of liver fibrosis is essential to guide treatment in autoimmune hepatitis (AIH), but non-invasive tests (NITs) showed poor accuracy. Our study aims to evaluate the performance of NITs among different AIH presentations. Methods. Monocentric retrospective study among 122 AIH patients. NITs were compared to histological grading of liver fibrosis. We performed an accuracy analysis among acute (jaundice and/or transaminases > 10 times upper limit of normal) and non-acute patients. Results. A significant difference in the distribution of NIT values for each Ishak stage was found for spleen-diameter-to-platelet-count ratio (SD/PC) (<i>p</i> < 0.001), fibrosis-4-score (FIB-4) (<i>p</i> = 0.002), AST-to-ALT ratio (AAR) (<i>p</i> = 0.002), red-blood-cell-width-distribution-to-platelet-count ratio (RDW/PC) (<i>p</i> = 0.008) and AST-to-platelet-count ratio (APRI) (<i>p</i> = 0.029). The AUC for advanced fibrosis of SD/PC, FIB-4, RDW/PC, APRI and AAR were, respectively, 0.814, 0.770, 0.768, 0.708 and 0.694. The AUC of SD/PC, FIB-4 and APRI in non-acute subgroup were 0.902, 0.834 and 0.758, while in acute patients they were 0.754, 0.724 and 0.716. RDW/PC and AAR weren’t different among the two subgroups. Conclusions. For SD/PC, FIB-4 and APRI, diagnostic accuracy is higher in patients with non-acute presentation. In this context, SD/PC and FIB-4 showed an overall performance that could be of interest in clinical practice alongside other non-invasive techniques. |
| first_indexed | 2024-03-09T23:58:10Z |
| format | Article |
| id | doaj.art-2dff419d93f0420ab9a4d29e5024cae4 |
| institution | Directory Open Access Journal |
| issn | 2036-7414 2036-7422 |
| language | English |
| last_indexed | 2024-03-09T23:58:10Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Gastroenterology Insights |
| spelling | doaj.art-2dff419d93f0420ab9a4d29e5024cae42023-11-23T16:21:16ZengMDPI AGGastroenterology Insights2036-74142036-74222022-09-0113328629510.3390/gastroent13030029Blood-Based Non-Invasive Tests of Hepatic Fibrosis in Autoimmune Hepatitis: Application among Selected Patients Leads to Higher AccuracyMarco Ferronato0Marco Lenzi1Paolo Muratori2Luigi Muratori3Center for the Study and Treatment of Autoimmune Diseases of the Liver and Biliary System, Policlinico di Sant’Orsola, Istituto di Ricovero e Cura a Carattere, Scientifico Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, 40138 Bologna, ItalyCenter for the Study and Treatment of Autoimmune Diseases of the Liver and Biliary System, Policlinico di Sant’Orsola, Istituto di Ricovero e Cura a Carattere, Scientifico Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, 40138 Bologna, ItalyDepartment for the Science of the Quality of Life (QUVI), University of Bologna, 40138 Bologna, ItalyCenter for the Study and Treatment of Autoimmune Diseases of the Liver and Biliary System, Policlinico di Sant’Orsola, Istituto di Ricovero e Cura a Carattere, Scientifico Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, 40138 Bologna, ItalyBackground. Assessment of liver fibrosis is essential to guide treatment in autoimmune hepatitis (AIH), but non-invasive tests (NITs) showed poor accuracy. Our study aims to evaluate the performance of NITs among different AIH presentations. Methods. Monocentric retrospective study among 122 AIH patients. NITs were compared to histological grading of liver fibrosis. We performed an accuracy analysis among acute (jaundice and/or transaminases > 10 times upper limit of normal) and non-acute patients. Results. A significant difference in the distribution of NIT values for each Ishak stage was found for spleen-diameter-to-platelet-count ratio (SD/PC) (<i>p</i> < 0.001), fibrosis-4-score (FIB-4) (<i>p</i> = 0.002), AST-to-ALT ratio (AAR) (<i>p</i> = 0.002), red-blood-cell-width-distribution-to-platelet-count ratio (RDW/PC) (<i>p</i> = 0.008) and AST-to-platelet-count ratio (APRI) (<i>p</i> = 0.029). The AUC for advanced fibrosis of SD/PC, FIB-4, RDW/PC, APRI and AAR were, respectively, 0.814, 0.770, 0.768, 0.708 and 0.694. The AUC of SD/PC, FIB-4 and APRI in non-acute subgroup were 0.902, 0.834 and 0.758, while in acute patients they were 0.754, 0.724 and 0.716. RDW/PC and AAR weren’t different among the two subgroups. Conclusions. For SD/PC, FIB-4 and APRI, diagnostic accuracy is higher in patients with non-acute presentation. In this context, SD/PC and FIB-4 showed an overall performance that could be of interest in clinical practice alongside other non-invasive techniques.https://www.mdpi.com/2036-7422/13/3/29autoimmune hepatitisfibrosisnon-invasive testFIB-4spleen diameterplatelet count |
| spellingShingle | Marco Ferronato Marco Lenzi Paolo Muratori Luigi Muratori Blood-Based Non-Invasive Tests of Hepatic Fibrosis in Autoimmune Hepatitis: Application among Selected Patients Leads to Higher Accuracy Gastroenterology Insights autoimmune hepatitis fibrosis non-invasive test FIB-4 spleen diameter platelet count |
| title | Blood-Based Non-Invasive Tests of Hepatic Fibrosis in Autoimmune Hepatitis: Application among Selected Patients Leads to Higher Accuracy |
| title_full | Blood-Based Non-Invasive Tests of Hepatic Fibrosis in Autoimmune Hepatitis: Application among Selected Patients Leads to Higher Accuracy |
| title_fullStr | Blood-Based Non-Invasive Tests of Hepatic Fibrosis in Autoimmune Hepatitis: Application among Selected Patients Leads to Higher Accuracy |
| title_full_unstemmed | Blood-Based Non-Invasive Tests of Hepatic Fibrosis in Autoimmune Hepatitis: Application among Selected Patients Leads to Higher Accuracy |
| title_short | Blood-Based Non-Invasive Tests of Hepatic Fibrosis in Autoimmune Hepatitis: Application among Selected Patients Leads to Higher Accuracy |
| title_sort | blood based non invasive tests of hepatic fibrosis in autoimmune hepatitis application among selected patients leads to higher accuracy |
| topic | autoimmune hepatitis fibrosis non-invasive test FIB-4 spleen diameter platelet count |
| url | https://www.mdpi.com/2036-7422/13/3/29 |
| work_keys_str_mv | AT marcoferronato bloodbasednoninvasivetestsofhepaticfibrosisinautoimmunehepatitisapplicationamongselectedpatientsleadstohigheraccuracy AT marcolenzi bloodbasednoninvasivetestsofhepaticfibrosisinautoimmunehepatitisapplicationamongselectedpatientsleadstohigheraccuracy AT paolomuratori bloodbasednoninvasivetestsofhepaticfibrosisinautoimmunehepatitisapplicationamongselectedpatientsleadstohigheraccuracy AT luigimuratori bloodbasednoninvasivetestsofhepaticfibrosisinautoimmunehepatitisapplicationamongselectedpatientsleadstohigheraccuracy |