Navegando por Palavras-chave "Non-Alcoholic Fatty"

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    Valor da elastografia hepática transitória isoladamente ou em associação a biomarcadores no estadiamento da doença hepática gordurosa não alcoólica
    (Universidade Federal de São Paulo (UNIFESP), 2019-09-26) Sammarco, Glauco Najas [UNIFESP]; Parise, Edison Roberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: The prevalence of non-alcoholic fatty liver disease (NAFLD) has significantly increased in the world, affecting up to 30% of the Western population. It is associated with hepatic and systemic complications, determining worse prognosis and higher mortality. Many non-invasive models for evaluation of hepatic fibrosis have been studied, with particular role in screening patients at risk for more advanced disease and unfavorable outcome. Objectives: To evaluate the diagnostic accuracy of transient elastography (TE), singly and in association with other non-invasive tests obtained through routine laboratory tests, in predicting liver fibrosis, having as standard reference the histological staging. Methods: An accuracy study was performed with patients with a histological diagnosis of NAFLD. The areas under receiver operating characteristics curves (AUROC) of Fibrosis-4 index (FIB-4), NAFLD fibrosis score (NFS) e TE (by FibroScan®) were compared for significant (≥ F2) and advanced (F3-F4) fibrosis, singly and serial combined each other. Results: The prevalence of significant and advanced fibrosis was 33,6% and 18,7%, respectively. The AUROC for significant fibrosis for TE, FIB-4 and NFS was 0,853, 0,729 e 0,639, respectively. For advanced fibrosis, the AUROC for TE, FIB-4 and NFS was 0,893, 0,810 e 0,746, respectively. The TE presented negative predictive value (NPV) of 84%, positive predictive value (PPV) of 90,6% for significant fibrosis diagnosis. For advanced fibrosis diagnosis, the TE showed NPV of 96%, PPV of 65,6% and high identification rate of sick individuals (84%). The serial combination generated accuracy ranging from 82,8% to 88% and identification rate of sick individuals ranging from 57% to 80%. Conclusions: The TE presented the better performance for advanced and significant fibrosis diagnostic in NAFLD than the other studied models. The methods association, in this study, did not increased diagnostic performance regarding the singly TE to significant or advanced fibrosis detection in NAFLD patients.