title: The BARD score and the NAFLD fibrosis score in the assessment of advanced liver fibrosis in nonalcoholic fatty liver disease.
abstract: BACKGROUND
  Non-alcoholic fatty liver disease (NAFLD) refers to a very wide clinical spectrum. Advanced fibrosis that accompanies disease leads to the development of cirrhosis and hepatocellular carcinoma. Thus, identification of patients with advanced fibrosis is essential. The aim of the present study was to compare the usefulness of NAFLD fibrosis and BARD scores in predicting fibrosis in NAFLD and to determine the risk factors of advanced fibrosis.
  
  
  METHODS
  The study included 126 patients with NAFLD. Fibrosis in liver biopsy was scored on a 5-point scale. The BARD and the NAFLD fibrosis scores were compared with the biopsy findings.
  
  
  RESULTS
  Liver biopsy revealed 27 patients with advanced and 99 with mild/moderate fibrosis. Advanced fibrosis was statistically significantly more common in older patients with obesity, AST/ALT ratio ≥0.8, diabetes mellitus, and thrombocytes ≤200 × 10³/L. Positive predictive value, negative predictive value and AUROC curve for BARD score, and NAFLD fibrosis score were 68.57%, 96.70%, 0.865 and 70.59%, 98.11%, 0.919, respectively.
  
  
  CONCLUSIONS
  Both scores are capable of ruling out advanced fibrosis and markedly reducing the need for liver biopsies in patients with NAFLD. Obesity, diabetes mellitus, thrombocytes ≤200 × 10³/L, advanced age and AST/ALT ratio ≥0.8 are the risk factors of advanced fibrosis.
authors.affiliation: Department of Gastroenterology, Medical University of Lublin, Lublin, Poland.
authors.forename: Halina
authors.initials: H
authors.lastname: Cichoż-Lach
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Celiński
authors.forename: Beata
authors.initials: B
authors.lastname: Prozorow-Król
authors.forename: Jarosław
authors.initials: J
authors.lastname: Swatek
authors.forename: Maria
authors.initials: M
authors.lastname: Słomka
authors.forename: Tomasz
authors.initials: T
authors.lastname: Lach
mesh_terms: D000328:Adult; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005234:Fatty Liver / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease; D012307:Risk Factors