Erschienen in:
07.04.2021 | Original Article
Predictive scoring system for advanced liver fibrosis in Japanese patients with severe obesity
verfasst von:
Haruka Nikai, Akira Sasaki, Akira Umemura, Naoto Takahashi, Hiroyuki Nitta, Risaburo Akasaka, Keisuke Kakisaka, Hidekatsu Kuroda, Kazuyuki Ishida, Yasuhiro Takikawa
Erschienen in:
Surgery Today
|
Ausgabe 9/2021
Einloggen, um Zugang zu erhalten
Abstract
Purpose
The aim of this study was to examine the predictive scoring system of advanced liver fibrosis in severely obese Japanese patients.
Methods
Seventy-two patients underwent laparoscopic sleeve gastrectomy and intraoperative liver biopsies. We classified these patients into two groups: Brunt stage ≥ 2 (advanced fibrosis) and 0/1 (none/mild fibrosis). A logistic regression analysis was performed to identify the predictors of advanced fibrosis.
Results
Sixteen patients had advanced fibrosis, while 56 had no/mild fibrosis. The prevalence of type 2 diabetes mellitus (T2DM) in advanced fibrosis group was significantly higher than in none/mild fibrosis. An univariate analysis of the factors predicting advanced fibrosis showed significant differences in AST/ALT ratio, serum insulin levels, HOMA-IR, and type IV collagen 7S in the T2DM group. According to a multivariate analysis, type IV collagen 7S was an independent predictor and the cutoff value was 5.6 ng/mL. We created a flow chart; high risk (T2DM and type IV collagen 7S ≥ 5.6 ng/mL), moderate risk (T2DM and type IV collagen 7S < 5.6 ng/mL), and low risk (non-DM). For those at high risk, the sensitivity, specificity, positive predictive value, and negative predictive value were 56.2%, 94.4%, 75.0%, and 87.9%, respectively.
Conclusion
This classification system has the potential to accurately categorize the risk of liver fibrosis.