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A Simple Index for Nonalcoholic Steatohepatitis-HUFA-Based on Routinely Performed Blood Tests

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2019
3260.pdf (428.0Kb)
Authors
Ćulafić, Milica
Vezmar-Kovačević, Sandra
Dopsaj, Violeta
Stulić, Miloš
Vlaisavljević, Željko
Miljković, Branislava
Ćulafić, Đorđe
Article (Published version)
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Abstract
Background and objectives: Data suggests that nearly 30% of the general population have steatosis and up to 5% of this population develops nonalcoholic steatohepatitis (NASH). Liver biopsy is still considered to be the gold standard for the diagnosis of NASH. Great effort is being made toward the identification of sensitive diagnostic tests that do not involve invasive procedures to address a common concern in patients with the nonalcoholic fatty liver disease-whether they have NASH or simple steatosis. We aimed to investigate the independent predictors and develop a non-invasive, easy-to-perform, low-cost set of parameters that may be used in clinical practice to differentiate simple steatosis from NASH. Methods: А cross-sectional study of nonalcoholic fatty liver disease (NAFLD) patients divided into two groups: group I-simple steatosis (SS) and group II-biopsy-proven NASH. Strict inclusion criteria and stepwise analysis allowed the evaluation of a vast number of measured/estimated p...arameters. Results: One hundred and eleven patients were included-82 with simple steatosis and 29 with biopsy-proven NASH. The probability of NASH was the highest when homeostatic model assessment of insulin resistance (HOMA-IR) was above 2.5, uric acid above 380 µmol/L, ferritin above 100 µg/L and ALT above 45 U/L. An acronym of using first letters was created and named the HUFA index. This combined model resulted in an area under the receiver operator characteristic curve (AUROC) of 0.94, provided sensitivity, specificity, positive predictive value and a negative predictive value for NASH of 70.3%, 95.1%, 83.1% and 90.0%, respectively. Conclusion: We suggest a simple non-invasive predictive index HUFA that encompasses four easily available parameters (HOMA-IR, uric acid, ferritin and ALT) to identify patients with NASH, which may reduce the need for a liver biopsy on a routine basis in patients with NAFLD.

Keywords:
fatty liver disease / identification / index / NAFLD / NASH
Source:
Medicina (Kaunas, Lithuania), 2019, 55, 6
Publisher:
  • NLM (Medline)

DOI: 10.3390/medicina55060243

ISSN: 1648-9144

WoS: 000475303800028

Scopus: 2-s2.0-85067442310
[ Google Scholar ]
6
5
URI
https://farfar.pharmacy.bg.ac.rs/handle/123456789/3262
Collections
  • Radovi istraživača / Researchers’ publications
Institution/Community
Pharmacy
TY  - JOUR
AU  - Ćulafić, Milica
AU  - Vezmar-Kovačević, Sandra
AU  - Dopsaj, Violeta
AU  - Stulić, Miloš
AU  - Vlaisavljević, Željko
AU  - Miljković, Branislava
AU  - Ćulafić, Đorđe
PY  - 2019
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/3262
AB  - Background and objectives: Data suggests that nearly 30% of the general population have steatosis and up to 5% of this population develops nonalcoholic steatohepatitis (NASH). Liver biopsy is still considered to be the gold standard for the diagnosis of NASH. Great effort is being made toward the identification of sensitive diagnostic tests that do not involve invasive procedures to address a common concern in patients with the nonalcoholic fatty liver disease-whether they have NASH or simple steatosis. We aimed to investigate the independent predictors and develop a non-invasive, easy-to-perform, low-cost set of parameters that may be used in clinical practice to differentiate simple steatosis from NASH. Methods: А cross-sectional study of nonalcoholic fatty liver disease (NAFLD) patients divided into two groups: group I-simple steatosis (SS) and group II-biopsy-proven NASH. Strict inclusion criteria and stepwise analysis allowed the evaluation of a vast number of measured/estimated parameters. Results: One hundred and eleven patients were included-82 with simple steatosis and 29 with biopsy-proven NASH. The probability of NASH was the highest when homeostatic model assessment of insulin resistance (HOMA-IR) was above 2.5, uric acid above 380 µmol/L, ferritin above 100 µg/L and ALT above 45 U/L. An acronym of using first letters was created and named the HUFA index. This combined model resulted in an area under the receiver operator characteristic curve (AUROC) of 0.94, provided sensitivity, specificity, positive predictive value and a negative predictive value for NASH of 70.3%, 95.1%, 83.1% and 90.0%, respectively. Conclusion: We suggest a simple non-invasive predictive index HUFA that encompasses four easily available parameters (HOMA-IR, uric acid, ferritin and ALT) to identify patients with NASH, which may reduce the need for a liver biopsy on a routine basis in patients with NAFLD.
PB  - NLM (Medline)
T2  - Medicina (Kaunas, Lithuania)
T1  - A Simple Index for Nonalcoholic Steatohepatitis-HUFA-Based on Routinely Performed Blood Tests
VL  - 55
IS  - 6
DO  - 10.3390/medicina55060243
ER  - 
@article{
author = "Ćulafić, Milica and Vezmar-Kovačević, Sandra and Dopsaj, Violeta and Stulić, Miloš and Vlaisavljević, Željko and Miljković, Branislava and Ćulafić, Đorđe",
year = "2019",
abstract = "Background and objectives: Data suggests that nearly 30% of the general population have steatosis and up to 5% of this population develops nonalcoholic steatohepatitis (NASH). Liver biopsy is still considered to be the gold standard for the diagnosis of NASH. Great effort is being made toward the identification of sensitive diagnostic tests that do not involve invasive procedures to address a common concern in patients with the nonalcoholic fatty liver disease-whether they have NASH or simple steatosis. We aimed to investigate the independent predictors and develop a non-invasive, easy-to-perform, low-cost set of parameters that may be used in clinical practice to differentiate simple steatosis from NASH. Methods: А cross-sectional study of nonalcoholic fatty liver disease (NAFLD) patients divided into two groups: group I-simple steatosis (SS) and group II-biopsy-proven NASH. Strict inclusion criteria and stepwise analysis allowed the evaluation of a vast number of measured/estimated parameters. Results: One hundred and eleven patients were included-82 with simple steatosis and 29 with biopsy-proven NASH. The probability of NASH was the highest when homeostatic model assessment of insulin resistance (HOMA-IR) was above 2.5, uric acid above 380 µmol/L, ferritin above 100 µg/L and ALT above 45 U/L. An acronym of using first letters was created and named the HUFA index. This combined model resulted in an area under the receiver operator characteristic curve (AUROC) of 0.94, provided sensitivity, specificity, positive predictive value and a negative predictive value for NASH of 70.3%, 95.1%, 83.1% and 90.0%, respectively. Conclusion: We suggest a simple non-invasive predictive index HUFA that encompasses four easily available parameters (HOMA-IR, uric acid, ferritin and ALT) to identify patients with NASH, which may reduce the need for a liver biopsy on a routine basis in patients with NAFLD.",
publisher = "NLM (Medline)",
journal = "Medicina (Kaunas, Lithuania)",
title = "A Simple Index for Nonalcoholic Steatohepatitis-HUFA-Based on Routinely Performed Blood Tests",
volume = "55",
number = "6",
doi = "10.3390/medicina55060243"
}
Ćulafić, M., Vezmar-Kovačević, S., Dopsaj, V., Stulić, M., Vlaisavljević, Ž., Miljković, B.,& Ćulafić, Đ.. (2019). A Simple Index for Nonalcoholic Steatohepatitis-HUFA-Based on Routinely Performed Blood Tests. in Medicina (Kaunas, Lithuania)
NLM (Medline)., 55(6).
https://doi.org/10.3390/medicina55060243
Ćulafić M, Vezmar-Kovačević S, Dopsaj V, Stulić M, Vlaisavljević Ž, Miljković B, Ćulafić Đ. A Simple Index for Nonalcoholic Steatohepatitis-HUFA-Based on Routinely Performed Blood Tests. in Medicina (Kaunas, Lithuania). 2019;55(6).
doi:10.3390/medicina55060243 .
Ćulafić, Milica, Vezmar-Kovačević, Sandra, Dopsaj, Violeta, Stulić, Miloš, Vlaisavljević, Željko, Miljković, Branislava, Ćulafić, Đorđe, "A Simple Index for Nonalcoholic Steatohepatitis-HUFA-Based on Routinely Performed Blood Tests" in Medicina (Kaunas, Lithuania), 55, no. 6 (2019),
https://doi.org/10.3390/medicina55060243 . .

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