title: New discriminant score to predict the fibrotic stage of non-alcoholic steatohepatitis in Japan.
abstract: OBJECTIVE
  Currently, non-alcoholic steatohepatitis (NASH) can only be diagnosed histopathologically. Our objective was to establish a new scoring system for the fibrotic stage of NASH.
  
  
  METHODS
  We enrolled 139 patients with histologically proven NASH and divided them into two groups to construct (n = 90) and validate (n = 49) a fibrotic score for NASH (FSN). We used 17 variables and their natural logarithmic transformations in the multivariate analysis. To assess the accuracy of the FSN in determining NASH advanced fibrosis (stages 3-4), we compared various fibrotic scores for NASH.
  
  
  RESULTS
  In the construct group, multivariate regression analysis ultimately obtained the following function: z = 1.022 × ln (type IV collagen 7S) (ng/mL) - 0.00680 × (platelet count) (×10(9)/L) + 1.925 × ln (AST) (IU/L) - 1.239 × ln (ALT) (IU/L) + 0.249. Median values of the FSN for stages 1, 2, 3 and 4 were 1.87, 2.14, 3.26 and 3.89, respectively. The multiple regression coefficient and coefficient of determination were 0.70 and 0.46, respectively. In the validation group, the median value was 2.00, 2.83, 3.08 and 4.37 in each stage. With regard to the utility of the FSN for predicting advanced fibrosis of NASH (stage ≥3), the area under the receiver operating characteristic curves (AUROC), 0.909 (95% CI 0.847-0.970, p < 0.001), was higher than that for the other fibrotic scores (APRI, NAFLD fibrosis score, FIB-4 index, BARD score, NIKEI) in the construct group.
  
  
  CONCLUSIONS
  This simple scoring system accurately predicts fibrotic stage and discriminates patients with advanced fibrosis of NASH.
authors: Department of Hepatology, Toranomon Hospital, 2-2-2, Toranomon, Minato-ku, Tokyo, 105-8470, Japan, k-yusuke@toranomon.gr.jp.
authors: Yusuke
authors: Y
authors: Kawamura
authors: Kenji
authors: K
authors: Ikeda
authors: Yasuji
authors: Y
authors: Arase
authors: Yushi
authors: Y
authors: Sorin
authors: Taito
authors: T
authors: Fukushima
authors: Hideo
authors: H
authors: Kunimoto
authors: Tetsuya
authors: T
authors: Hosaka
authors: Masahiro
authors: M
authors: Kobayashi
authors: Satoshi
authors: S
authors: Saitoh
authors: Hitomi
authors: H
authors: Sezaki
authors: Norio
authors: N
authors: Akuta
authors: Fumitaka
authors: F
authors: Suzuki
authors: Yoshiyuki
authors: Y
authors: Suzuki
authors: Hiromitsu
authors: H
authors: Kumada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D019540:Area Under Curve; D001219:Aspartate Aminotransferases / Q000097:blood; D024141:Collagen Type IV / Q000097:blood; D005260:Female; D006801:Humans; D007564:Japan; D008103:Liver Cirrhosis / Q000097:blood / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000473:pathology*; D010976:Platelet Count; D011237:Predictive Value of Tests; D012372:ROC Curve; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D024141:Collagen Type IV; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase