Diagnostic performance of FibroTest, SteatoTest and ActiTest in patients with NAFLD using the SAF score as histological reference. Issue 8 (23rd August 2016)

• Record Type: Journal Article
• Authors: Munteanu, M.; Tiniakos, D.; Anstee, Q.; Charlotte, F.; Marchesini, G.; Bugianesi, E.; Trauner, M.; Romero Gomez, M.; Oliveira, C.; Day, C.; Dufour, J.‐F.; Bellentani, S.; Ngo, Y.; Traussnig, S.; Perazzo, H.; Deckmyn, O.; Bedossa, P.; Ratziu, V.; Poynard, T.
• Other Names: Ratziu Vlad investigator.; Poynard Thierry investigator.; Castille Jean‐Marie investigator.; Ngo Yen investigator.; Langon Tania investigator.; Day Chris investigator.; Tiniakos Dina investigator.; Lawlor Debbie investigator.; Marchesini Giulio investigator.; Marra Fabio investigator.; Bugianesi Elisabetta investigator.; Bellentani Stefano investigator.; Dufour Jean‐François investigator.; Romero Gomez Manuel investigator.; Sørensen Thorkild investigator.; Tribelli Claudio investigator.; De Minicis Samuele investigator.; Trauner Michael investigator.; Oliveira Claudia investigator.; Bedossa Pierre investigator.; Burt Alastair D. investigator.; Gouw Annette S.H. investigator.; Lackner Carolin investigator.; Schirmacher Peter investigator.; Terracciano Luigi investigator.; Tiniakos Dina investigator.; Brain J. investigator.; Bury Yvonne investigator.; Cabibi Daniela investigator.; Charlotte Frederic investigator.; David Ezio investigator.; Losi Luisa investigator.; Montani Matteo investigator.; Pareja Marıa Jesus investigator.; Wendum Dominique investigator.; Wrba Fritz investigator.; Ziol Marianne investigator.; Ratziu Vlad investigator.; Poynard Thierry investigator.; Ratziu Vlad investigator.; Thabut Dominique investigator.; Moussalli Joseph investigator.; Lebray Pascal investigator.; Rudler Marika investigator.; Bismuth Françoise Imbert investigator.; Charlotte Frederic investigator.; Rosmorduc Olivier investigator.; Calmus Yvon investigator.; Hartemann Agnes investigator.; Jacqueminet Sophie investigator.; Bruckert Eric investigator.; Giral Philippe investigator.; Naveau Sylvie investigator.; Perlemuter Gabriel investigator.; Varsat Brigitte investigator.; Mercadier Anne investigator.;
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 44:Issue 8(2016)
• Page Start: 877
• Page End: 889
• Publication Date: 2016-08-23
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.13770
• Languages: English
• ISSNs: 0269-2813

Abstract

Summary: Background: Blood tests of liver injury are less well validated in non‐alcoholic fatty liver disease (NAFLD) than in patients with chronic viral hepatitis. Aims: To improve the validation of three blood tests used in NAFLD patients, FibroTest for fibrosis staging, SteatoTest for steatosis grading and ActiTest for inflammation activity grading. Methods: We pre‐included new NAFLD patients with biopsy and blood tests from a single‐centre cohort (FibroFrance) and from the multicentre FLIP consortium. Contemporaneous biopsies were blindly assessed using the new steatosis, activity and fibrosis (SAF) score, which provides a reliable and reproducible diagnosis and grading/staging of the three elementary features of NAFLD (steatosis, inflammatory activity) and fibrosis with reduced interobserver variability. We used nonbinary‐ROC (NonBinAUROC) as the main endpoint to prevent spectrum effect and multiple testing. Results: A total of 600 patients with reliable tests and biopsies were included. The mean NonBinAUROCs (95% CI) of tests were all significant ( P < 0.0001): 0.878 (0.864–0.892) for FibroTest and fibrosis stages, 0.846 (0.830–0.862) for ActiTest and activity grades, and 0.822 (0.804–0.840) for SteatoTest and steatosis grades. FibroTest had a higher NonBinAUROC than BARD (0.836; 0.820–0.852; P = 0.0001), FIB4 (0.845; 0.829–0.861; P = 0.007) but not significantly different than the NAFLD score (0.866; 0.850–0.882; P = 0.26). FibroTest had a significant difference in median values between adjacent stage F2 and stage F1 contrarily to BARD, FIB4 and NAFLD scores (Bonferroni test P < 0.05). Conclusions: In patients with NAFLD, SteatoTest, ActiTest and FibroTest are non‐invasive tests that offer an alternative to biopsy, and they correlate with the simple grading/staging of the SAF scoring system across the three elementary features of NAFLD: steatosis, inflammatory activity and fibrosis.