Validation of the NAFLD fibrosis score in a Chinese population with low prevalence of advanced fibrosis.
OBJECTIVE
Nonalcoholic fatty liver disease (NAFLD) is increasing in prevalence worldwide. This study aimed to validate the NAFLD fibrosis score in the Chinese population.


METHODS
NAFLD patients were prospectively recruited for liver biopsy and blood tests. The NAFLD fibrosis score was calculated as -1.675 + 0.037 x age (yr) + 0.094 x BMI (kg/m(2)) + 1.13 x impaired fasting glucose/diabetes (yes = 1, no = 0) + 0.99 x AST/ALT ratio-0.013 x platelet (x10(9)/L)-0.66 x albumin (g/dL). Advanced fibrosis was defined as stage 3 to 4 fibrosis.


RESULTS
One hundred sixty-two patients (age 46 +/- 10 yr, male 59%) were included in the study. Advanced fibrosis was found in 18 (11%) patients. Only 11 of 128 patients with the NAFLD fibrosis score below the proposed low cutoff point (<-1.455) were under-staged, resulting in a high negative predictive value of 91%. Only two patients exceeded the proposed high cutoff point (>0.676), but neither had advanced fibrosis. If the NAFLD fibrosis score was implemented in the Chinese population, 79% of liver biopsies could be avoided.


CONCLUSIONS
The NAFLD fibrosis score has high negative predictive value in excluding advanced fibrosis in the Chinese population, and can reduce the burden of liver biopsy in the vast majority of cases. Since there were few cases of advanced fibrosis in this cohort, this study had limited power in validating the high cutoff point.
Wong
Vincent Wai-Sun
VW
Institute of Digestive Disease and Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.
Wong
Grace Lai-Hung
GL
Chim
Angel Mei-Ling
AM
Tse
Ada Mei-Ling
AM
Tsang
Steven Woon-Choy
SW
Hui
Alex Yui
AY
Choi
Paul Cheung-Lung
PC
Chan
Anthony Wing-Hung
AW
So
Wing-Yee
WY
Chan
Francis Ka-Leung
FK
Sung
Joseph Jao-Yao
JJ
Chan
Henry Lik-Yuen
HL
D002681:China / Q000453:epidemiology; D005234:Fatty Liver / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies