Clinical predictors of advanced non-alcoholic fatty liver disease (NAFLD) are needed to guide diagnostic evaluation and treatment.
Dr Harrison and colleagues from Texas, USA assessed the demographics of non-alcoholic liver disease and risk factors for advanced disease.
The research team analyzed 827 patients with non-alcoholic liver disease at 2 geographically separate tertiary medical centers.
The researchers noted that the cohort was 51% female, of which 3% had a normal body mass index.
Common co-morbidities included hypertension in 60% and diabetes in 35%.
The team observed that insulin resistance was present in 91%, and advanced fibrosis in 24% of patients.
|Diabetes mellitus was associated with odds ratios of 2.4 for advanced fibrosis|
When comparing patients with no fibrosis or mild fibrosis to those with advanced fibrosis, body mass index 28 kg/m2, and age over 50 years were associated with advanced fibrosis.
Aspartate transaminase/alanine aminotransferase ratio 0.8, a quantitative assessment check index score less than 0.3 were associated with advanced fibrosis.
The presence of diabetes mellitus was associated by univariate analysis with an odds ratio of 2.4 for advanced fibrosis.
Based on the results of forced entry logistic regression analysis, 3 variables were combined in a weighted sum to form an easily calculated composite score for predicting advanced fibrosis called the BARD score.
A score of 2 to 4 was associated with an odds ratios for advanced fibrosis of 17 and a negative predictive value of 96%.
Dr Harrison’s team concluded, “Insulin resistance and its co-morbidities are often present in patients with non-alcoholic liver disease.”
“An easily calculated score based on readily available clinical data can reliably exclude the presence of advanced fibrosis in these patients, particularly among non-diabetics.”