Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

FIB-4 First in Diagnostic Algorithm of MAFLD at the Era of “Global Metabodemic “

Yoshio Sumida
* ORCID logo ,
Masashi Yoneda
,
Katsutoshi Tokushige
,
Miwa Kawanaka
,
Hideki Fujii
ORCID logo ,
Masato Yoneda
,
Kento Imajo
ORCID logo ,
Hirokazu Takahashi
,
Yuichiro Eguchi
,
Masafumi Ono
,
Yuichi Nozaki
,
Hideyuki Hyogo
,
Masahiro Koseki
,
Yuichi Yoshida
,
Takumi Kawaguchi
ORCID logo ,
Yoshihiro Kamada
ORCID logo ,
Takeshi Okanoue
,
Atsushi Nakajima
ORCID logo
Version 1 : Received: 18 August 2020 / Approved: 19 August 2020 / Online: 19 August 2020 (13:00:28 CEST)

How to cite: Sumida, Y.; Yoneda, M.; Tokushige, K.; Kawanaka, M.; Fujii, H.; Yoneda, M.; Imajo, K.; Takahashi, H.; Eguchi, Y.; Ono, M.; Nozaki, Y.; Hyogo, H.; Koseki, M.; Yoshida, Y.; Kawaguchi, T.; Kamada, Y.; Okanoue, T.; Nakajima, A. FIB-4 First in Diagnostic Algorithm of MAFLD at the Era of “Global Metabodemic “. Preprints 2020, 2020080417. https://doi.org/10.20944/preprints202008.0417.v1 Sumida, Y.; Yoneda, M.; Tokushige, K.; Kawanaka, M.; Fujii, H.; Yoneda, M.; Imajo, K.; Takahashi, H.; Eguchi, Y.; Ono, M.; Nozaki, Y.; Hyogo, H.; Koseki, M.; Yoshida, Y.; Kawaguchi, T.; Kamada, Y.; Okanoue, T.; Nakajima, A. FIB-4 First in Diagnostic Algorithm of MAFLD at the Era of “Global Metabodemic “. Preprints 2020, 2020080417. https://doi.org/10.20944/preprints202008.0417.v1

Abstract

The prevalence of obesity or metabolic syndrome is increasing worldwide (“Globally metabodemic”). Approximately 25% of adult general population is suffering from nonalcoholic fatty liver disease (NAFLD) which has become serious health problem. Hepatic fibrosis is the most significant determinant of all cause and liver -related mortality in NAFLD. Noninvasive test (NIT) should be urgently required to evaluate hepatic fibrosis in NAFLD. Fibrosis-4 (FIB-4) index is the 1st triaging tool for excluding advanced fibrosis because of its accuracy, simplicity, and cheapness especially for general physicians or endocrinologists, although FIB-4 index has several drawbacks. Accumulating evidence has suggested that vibration controlled transient elastography (VCTE) and the enhanced liver fibrosis (ELF) test may become useful as the 2nd step after triaging by FIB-4 index. The leading cause of mortality in NAFLD is cardiovascular disease (CVD), extrahepatic malignancy, and liver-related diseases. NAFLD often complicates chronic kidney disease (CKD), resulting in increased simultaneous liver kidney transplantation (SLKT). FIB-4 index could be a predictor of not only liver-related mortality and incident hepatocullar carcinoma (HCC) but also prevalent and incident CKD, CVD, and extrahepatic malignancy. Although NITs as milestones for evaluating treatment efficacy have never been established, FIB- 4 index is expected to reflect histological hepatic fibrosis after treatment in several longitudinal studies. We here review the role of FIB-4 index as 1st step NIT in management of NAFLD.

Keywords

hepatic fibrosis; hepatocullar carcinoma; vibration controlled transient elastography

Subject

Biology and Life Sciences, Endocrinology and Metabolism

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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