Hepamet Fibrosis Score in Nonalcoholic Fatty Liver Disease Patients in Mexico: Lower than Expected Positive Predictive Value (original) (raw)

Abstract

Background

Nonalcoholic fatty liver disease (NAFLD) has been associated with different negative outcomes in the presence of advanced fibrosis. The Hepamet Fibrosis Score (HFS), a recently described noninvasive score, has shown excellent performance for the detection of advanced fibrosis. The aim of this study was to assess its performance in a Mexican population with NAFLD.

Methods

This was a retrospective cross-sectional study performed in 222 patients with biopsy-proven NAFLD, of whom 33(14%) had advanced fibrosis. We retrieved clinical data from each patient’s medical record to compute the HFS, the NAFLD Fibrosis Score (NFS), and the Fibrosis-4 (FIB-4), and assess their performance.

Results

When considering the models as continuous variables, the area under the receiving operating characteristics curve of the HFS(0.758) was not different from that of the NFS(0.669, p = 0.09) or FIB-4(0.796, p = 0.1). The HFS had a sensitivity, specificity, positive and negative predictive values of 76.7% (95% CI 57.7–90.1), 90.1% (95% CI 85–93.9), 36.7% (95% CI 19.9–56.1), and 94.3% (95% CI 88.5–97.7), respectively. Indeterminate results (i.e., gray area) were more common with FIB-4 and HFS when compared with NFS [139(63%) and 122(55%) vs 80(36%), p < 0.001]. The variables that were associated with misclassification using the HFS were diabetes [OR 3.40 (95% CI 1.42–8.10), p = 0.006] and age [OR 1.06 (95% CI 1.01–1.11), p = 0.01].

Conclusion

The HFS showed sensitivity and specificity similar to that reported in the original publication; however, the positive predictive value was 36.7% at a pretest probability of 14%. The role of the HFS in prospective studies and in combination with other methods should be further explored.

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Authors and Affiliations

1. Department of Gastroenterology, Hospital General de México Dr. Eduardo Liceaga, Dr. Balmis 148, Colonia Doctores, Alcaldía Cuauhtémoc, 06720, Mexico City, Mexico
   Fátima Higuera-de-la-Tijera
2. Hepatology Division, Hospital General “Dr. Manuel GEA González”, Calz. de Tlalpan 4800, Colonia Belisario Domínguez Secc 16, Alcaldía Tlalpan, 14080, Mexico City, Mexico
   Jacqueline Córdova-Gallardo
3. Departamento de Gastroenterología, Centro Médico Nacional 20 de Noviembre, Félix Cuevas 540, Colonia del Valle Sur, Alcaldía Benito Juárez, 03229, Mexico City, Mexico
   Elizabeth Buganza-Torio & Beatriz Barranco-Fragoso
4. Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Vasco de Quiroga 15, Colonia Belisario Domínguez Secc 16, Alcaldía Tlalpan, 14080, Mexico City, Mexico
   Aldo Torre, Graciela Castro-Narro & Carlos Moctezuma-Velazquez
5. Pathology Division, Hospital General “Dr. Manuel GEA González”, Calz. de Tlalpan 4800, Colonia Belisario Domínguez Secc 16, Alcaldía Tlalpan, 14080, Mexico City, Mexico
   Sara Parraguirre-Martínez
6. Bariatric Surgery Division, Surgery Service, Hospital General “Dr. Manuel GEA González”, Calz. de Tlalpan 4800, Colonia Belisario Domínguez Secc 16, Alcaldía Tlalpan, 14080, Mexico City, Mexico
   Martin Edgardo Rojano-Rodríguez
7. Department of Pathology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
   Gabriel Quintero-Bustos

Authors

1. Fátima Higuera-de-la-Tijera
2. Jacqueline Córdova-Gallardo
3. Elizabeth Buganza-Torio
4. Beatriz Barranco-Fragoso
5. Aldo Torre
6. Sara Parraguirre-Martínez
7. Martin Edgardo Rojano-Rodríguez
8. Gabriel Quintero-Bustos
9. Graciela Castro-Narro
10. Carlos Moctezuma-Velazquez

Corresponding author

Correspondence toCarlos Moctezuma-Velazquez.

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Higuera-de-la-Tijera, F., Córdova-Gallardo, J., Buganza-Torio, E. et al. Hepamet Fibrosis Score in Nonalcoholic Fatty Liver Disease Patients in Mexico: Lower than Expected Positive Predictive Value.Dig Dis Sci 66, 4501–4507 (2021). https://doi.org/10.1007/s10620-020-06821-2

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• Received: 01 October 2020
• Accepted: 31 December 2020
• Published: 11 January 2021
• Version of record: 11 January 2021
• Issue date: December 2021
• DOI: https://doi.org/10.1007/s10620-020-06821-2

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