Περίληψη:
Objectives: In cystic fibrosis (CF), liver disease (LD) is the third leading cause of mortality. As liver biopsy was considered inconsistent in CFLD diagnosis, a combination of modalities were utilized in the conventional Debray criteria (DC). More recently, noninvasive liver fibrosis biomarkers were applied by Koh et al (New criteria-NC). In the current study, we aimed to evaluate noninvasive biomarkers for the CFLD diagnosis. Methods: Longitudinal data were collected from a cohort of genetically confirmed CF patients. CFLD was diagnosed by both DC and NC. Apart from transient elastography (TE) > 6.8 kPa, biomarkers incorporated in the NC included AST/ALT-ratio (AAR) ≥ 1, FIB-4 index ≥3.25 and APRI >0.50. Results: 62 patients with CF, [56.5% male, age at enrollment 25 (22–31) years], were prospectively followed-up for 33 (28–36) months. Sixteen (25.8%) and 27 (43.5%) patients met DC and NC, respectively. Twenty-four fulfilling NC had at least one positive biomarker (6 TE, 7 AAR, 6 both TE and AAR, 2 both APRI and AAR and 3 both APRI and TE). Thirteen (48.1%) had diffuse LD/cirrhosis by the NC and all had at least one additional parameter classifying them as CFLD. From the 14 (51.8%) with no-diffuse-LD, 64.3%, 14.3% and 21.4% had 2, 3 and 4 of the necessary modalities incorporated in NC, respectively, confirming their classification as CFLD. TE was 100% specific to rule in CFLD but had a moderate sensitivity. Conclusions: NC were able to identify 17.7% more CFLD patients compared to DC. The multiple biomarkers incorporated in NC may enhance the ability to detect CFLD. © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group.
Συγγραφείς:
Alexopoulou, A.
Pouriki, S.
Vasilieva, L.
Alexopoulos, T.
Filaditaki, V.
Gioka, M.
Diamantea, F.
Dourakis, S.P.
Λέξεις-κλειδιά:
alanine aminotransferase; alkaline phosphatase; aspartate aminotransferase; biological marker; gamma glutamyltransferase; ursodeoxycholic acid; biological marker, adult; alanine aminotransferase blood level; alkaline phosphatase blood level; Article; aspartate aminotransferase blood level; body mass; cohort analysis; comparative study; controlled study; cystic fibrosis; diagnostic test accuracy study; female; follow up; gamma glutamyl transferase blood level; human; liver disease; liver stiffness; longitudinal study; major clinical study; male; observational study; predictive value; priority journal; transient elastography; blood; complication; cystic fibrosis; elastography; liver cirrhosis; liver function test; platelet count; prospective study; severity of illness index; young adult, Adult; Biomarkers; Cystic Fibrosis; Elasticity Imaging Techniques; Female; Humans; Liver Cirrhosis; Liver Function Tests; Male; Platelet Count; Prospective Studies; Severity of Illness Index; Young Adult
