Diagnostic performance of FibroTest, SteatoTest and ActiTest in patients with NAFLD using the SAF score as histological reference

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorMUNTEANU, M.
dc.contributor.authorTINIAKOS, D.
dc.contributor.authorANSTEE, Q.
dc.contributor.authorCHARLOTTE, F.
dc.contributor.authorMARCHESINI, G.
dc.contributor.authorBUGIANESI, E.
dc.contributor.authorTRAUNER, M.
dc.contributor.authorGOMEZ, M. Romero
dc.contributor.authorOLIVEIRA, C.
dc.contributor.authorDAY, C.
dc.contributor.authorDUFOUR, J. -F.
dc.contributor.authorBELLENTANI, S.
dc.contributor.authorNGO, Y.
dc.contributor.authorTRAUSSNIG, S.
dc.contributor.authorPERAZZO, H.
dc.contributor.authorDECKMYN, O.
dc.contributor.authorBEDOSSA, P.
dc.contributor.authorRATZIU, V.
dc.contributor.authorPOYNARD, T.
dc.date.accessioned2016-12-20T16:37:47Z
dc.date.available2016-12-20T16:37:47Z
dc.date.issued2016
dc.description.abstractBackground Blood tests of liver injury are less well validated in non-alcoholic fatty liver disease (NAFLD) than in patients with chronic viral hepatitis. Aims To improve the validation of three blood tests used in NAFLD patients, FibroTest for fibrosis staging, SteatoTest for steatosis grading and ActiTest for inflammation activity grading. Methods We pre-included new NAFLD patients with biopsy and blood tests from a single-centre cohort (FibroFrance) and from the multicentre FLIP consortium. Contemporaneous biopsies were blindly assessed using the new steatosis, activity and fibrosis (SAF) score, which provides a reliable and reproducible diagnosis and grading/staging of the three elementary features of NAFLD (steatosis, inflammatory activity) and fibrosis with reduced interobserver variability. We used nonbinary-ROC (NonBinAUROC) as the main endpoint to prevent spectrum effect and multiple testing. Results A total of 600 patients with reliable tests and biopsies were included. The mean NonBinAUROCs (95% CI) of tests were all significant (P < 0.0001): 0.878 (0.864-0.892) for FibroTest and fibrosis stages, 0.846 (0.830-0.862) for ActiTest and activity grades, and 0.822 (0.804-0.840) for SteatoTest and steatosis grades. FibroTest had a higher NonBinAUROC than BARD (0.836; 0.820-0.852; P = 0.0001), FIB4 (0.845; 0.829-0.861; P = 0.007) but not significantly different than the NAFLD score (0.866; 0.850-0.882; P = 0.26). FibroTest had a significant difference in median values between adjacent stage F2 and stage F1 contrarily to BARD, FIB4 and NAFLD scores (Bonferroni test P < 0.05). Conclusions In patients with NAFLD, SteatoTest, ActiTest and FibroTest are non-invasive tests that offer an alternative to biopsy, and they correlate with the simple grading/staging of the SAF scoring system across the three elementary features of NAFLD: steatosis, inflammatory activity and fibrosis.
dc.description.indexMEDLINE
dc.description.sponsorshipEuropean Community [HEALTH-F2-2009-241762]
dc.identifier.citationALIMENTARY PHARMACOLOGY & THERAPEUTICS, v.44, n.8, p.877-889, 2016
dc.identifier.doi10.1111/apt.13770
dc.identifier.eissn1365-2036
dc.identifier.issn0269-2813
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/17075
dc.language.isoeng
dc.publisherWILEY-BLACKWELL
dc.relation.ispartofAlimentary Pharmacology & Therapeutics
dc.rightsrestrictedAccess
dc.rights.holderCopyright WILEY-BLACKWELL
dc.subject.otherfatty liver-disease
dc.subject.otherchronic hepatitis-c
dc.subject.othernoninvasive biomarkers fibrotest
dc.subject.otherfibrosis progression
dc.subject.otherbiochemical markers
dc.subject.othernonalcoholic steatohepatitis
dc.subject.otherelastography fibroscan(r)
dc.subject.otherlarge population
dc.subject.other7 categories
dc.subject.othervariability
dc.subject.wosGastroenterology & Hepatology
dc.subject.wosPharmacology & Pharmacy
dc.titleDiagnostic performance of FibroTest, SteatoTest and ActiTest in patients with NAFLD using the SAF score as histological reference
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.affiliation.countryInglaterra
hcfmusp.affiliation.countryGrécia
hcfmusp.affiliation.countryFrança
hcfmusp.affiliation.countrySuíça
hcfmusp.affiliation.countryEspanha
hcfmusp.affiliation.countryÁustria
hcfmusp.affiliation.countryItália
hcfmusp.affiliation.countryisofr
hcfmusp.affiliation.countryisogr
hcfmusp.affiliation.countryisogb
hcfmusp.affiliation.countryisoit
hcfmusp.affiliation.countryisoat
hcfmusp.affiliation.countryisoes
hcfmusp.affiliation.countryisoch
hcfmusp.author.externalMUNTEANU, M.:BioPredictive, Paris, France
hcfmusp.author.externalTINIAKOS, D.:Newcastle Univ, Liver Res Grp, Inst Cellular Med, Newcastle Upon Tyne, Tyne & Wear, England; Univ Athens, Sch Med, Lab Histol & Embryol, Athens, Greece
hcfmusp.author.externalANSTEE, Q.:Newcastle Univ, Liver Res Grp, Inst Cellular Med, Newcastle Upon Tyne, Tyne & Wear, England
hcfmusp.author.externalCHARLOTTE, F.:UPMC Univ Paris 06, Sorbonne Univ, Grp Hosp Pitie Salpetriere APHP, INSERM,UMR S 938, Paris, France; Inst Cardiometab & Nutr ICAN, Paris, France
hcfmusp.author.externalMARCHESINI, G.:Univ Bologna, Bologna, Italy
hcfmusp.author.externalBUGIANESI, E.:Univ Turin, Turin, Italy
hcfmusp.author.externalTRAUNER, M.:Med Univ Wien, Vienna, Austria
hcfmusp.author.externalGOMEZ, M. Romero:Univ Seville, Valme Univ Hosp, Seville, Spain
hcfmusp.author.externalDAY, C.:Newcastle Univ, Liver Res Grp, Inst Cellular Med, Newcastle Upon Tyne, Tyne & Wear, England
hcfmusp.author.externalDUFOUR, J. -F.:Univ Bern, Bern, Switzerland
hcfmusp.author.externalBELLENTANI, S.:Azienda USL Modena Reggio Emilia, Gastroenterol, Modena, Italy
hcfmusp.author.externalNGO, Y.:BioPredictive, Paris, France
hcfmusp.author.externalTRAUSSNIG, S.:Med Univ Wien, Vienna, Austria
hcfmusp.author.externalPERAZZO, H.:APHP UPMC Liver Ctr, Paris, France
hcfmusp.author.externalDECKMYN, O.:BioPredictive, Paris, France
hcfmusp.author.externalBEDOSSA, P.:Inst Cardiometab & Nutr ICAN, Paris, France; Univ Paris Diderot, Hop Beaujon, Assistance Publ Hop Paris, Paris, France
hcfmusp.author.externalRATZIU, V.:UPMC Univ Paris 06, Sorbonne Univ, Grp Hosp Pitie Salpetriere APHP, INSERM,UMR S 938, Paris, France; Inst Cardiometab & Nutr ICAN, Paris, France
hcfmusp.author.externalPOYNARD, T.:UPMC Univ Paris 06, Sorbonne Univ, Grp Hosp Pitie Salpetriere APHP, INSERM,UMR S 938, Paris, France
hcfmusp.citation.scopus72
hcfmusp.contributor.author-fmusphcCLAUDIA PINTO MARQUES SOUZA DE OLIVEIRA
hcfmusp.description.beginpage877
hcfmusp.description.endpage889
hcfmusp.description.issue8
hcfmusp.description.volume44
hcfmusp.origemWOS
hcfmusp.origem.pubmed27549244
hcfmusp.origem.scopus2-s2.0-84987800464
hcfmusp.origem.wosWOS:000387151700010
hcfmusp.publisher.cityHOBOKEN
hcfmusp.publisher.countryUSA
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