title: Prediction of liver fibrosis in patients with features of the metabolic syndrome regardless of alcohol consumption.
abstract: The aim of this study was to determine noninvasive predictive factors of significant liver fibrosis in patients with increased serum aminotransferases associated with features of metabolic syndrome (abdominal obesity, systemic hypertension, fasting hyperglycemia, and dyslipidemia). One hundred seventy-three patients were prospectively examined, regardless of alcohol consumption. Biometric, metabolic, and hepatic biochemical variables were tested for association with fibrosis assessed on liver biopsy according to the Metavir score system. Significant fibrosis, defined as Metavir scores F2, F3, or F4, was observed in 42 of 173 patients (24%). A logistic regression model and receiver operating characteristic curve were used to construct a simple index predictive of significant fibrosis. None of the patients with serum hyaluronate levels of 35 microg/L or less had significant fibrosis. In patients with serum hyaluronate levels >35 microg/L, no case of fibrosis stage F3 or F4 was found when serum carbohydrate-deficient transferrin/transferrin ratio was less than 0.9. In conclusion, in patients with increased serum aminotransferases associated with features of metabolic syndrome, a simple algorithm, including serum hyaluronate and serum carbohydrate-deficient transferrin/transferrin ratio, allows the exclusion of clinically relevant hepatic fibrosis, regardless of current or past alcohol consumption.
authors.affiliation: Centre d'Investigation Clinique INSERM 0203, CHU Pontchaillou, Rennes, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Lainé
authors.forename: Claude
authors.initials: C
authors.lastname: Bendavid
authors.forename: Romain
authors.initials: R
authors.lastname: Moirand
authors.forename: Sabrina
authors.initials: S
authors.lastname: Tessier
authors.forename: Michèle
authors.initials: M
authors.lastname: Perrin
authors.forename: Anne
authors.initials: A
authors.lastname: Guillygomarc'h
authors.forename: Dominique
authors.initials: D
authors.lastname: Guyader
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Calon
authors.forename: Alain
authors.initials: A
authors.lastname: Renault
authors.forename: Pierre
authors.initials: P
authors.lastname: Brissot
authors.forename: Bruno
authors.initials: B
authors.lastname: Turlin
authors.forename: Yves
authors.initials: Y
authors.lastname: Deugnier
mesh_terms: D000428:Alcohol Drinking; D000465:Algorithms; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity