Age as a confounding factor for the accurate non-invasive diagnosis of advanced NAFLD fibrosis
Open accessAbstract
OBJECTIVES: Non-invasive fibrosis scores are widely used to identify/exclude advanced fibrosis in patients with non-alcoholic fatty liver disease (NAFLD). However, these scores were principally developed and validated in patients aged between 35 and 65 years of age. The objective of this study was to assess the effect of age on the performance of non-invasive fibrosis tests in NAFLD. METHODS: Patients were recruited from European specialist hepatology clinics. The cohort was divided into five age-based groups: ≤35 (n=74), 36-45 (n=96), 46-55 (n=197), 56-64 (n=191), and ≥65 years (n=76), and the performance of the aspartate aminotransferase (AST)/alanine transaminase (ALT) ratio, fibrosis 4 (FIB-4), and NAFLD fibrosis score (NFS) for advanced fibrosis (stage F3-F4) for each group was assessed using liver biopsy as the standard. RESULTS: Six hundred and thirty-four patients were included. The diagnostic accuracy of the AST/ALT ratio was lower than NFS and FIB-4 in all the age groups. The AST/ALT ratio, NFS, and FIB-4 score performed poorly for a diagnosis of advanced fibrosis in those aged ≤35 years (area under the receiver operating characteristic curves (AUROCs 0.52, 0.52, and 0.60, respectively). For all groups >35 years, AUROCs for advanced fibrosis were similar for the NFS and FIB-4 score (range 0.77-0.84). However, the specificity for advanced fibrosis using the FIB-4 and NFS declined with age, becoming unacceptably low in those aged ≥65 years (35% for FIB-4 and 20% for NFS). New cutoffs were derived (and validated) for those aged ≥65 years, which improved specificity to 70% without adversely affecting sensitivity (FIB-4 2.0, sensitivity 77%; NFS 0.12, sensitivity 80%). CONCLUSIONS: The NFS and FIB-4 scores have similar accuracy for advanced fibrosis in patients aged >35 years. However, the specificity for advanced fibrosis is unacceptably low in patients aged ≥65 years, resulting in a high false positive rate. New thresholds for use in patients aged ≥65 years are proposed to address this issue.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Both FIB-4 and the NFS perform poorly in individuals younger than 35 years.
“Furthermore, both FIB-4 and the NFS perform poorly in individuals younger than 35 years.”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [141]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Diagnosis and Classification of Diabetes Mellitus
American Diabetes Association (2010) · Diabetes Care · doi:10.2337/dc11-s062 · Cited by 14,019 · see citing works
Design and validation of a histological scoring system for nonalcoholic fatty liver disease†
Kleiner, D. E., Brunt, E. M., Van Natta, M., Behling, C., Contos, M. J., Cummings, O. W., Ferrell, L. D., Liu, Y., Torbenson, M. S., Unalp‐Arida, A., et al. (2005) · Hepatology · doi:10.1002/hep.20701 · Cited by 10,791 · see citing works
Sterling, R. K., Lissen, E., Clumeck, N., Sola, R., Correa, M. C., Montaner, J., S. Sulkowski, M., Torriani, F. J., Dieterich, D. T., Thomas, D. L., et al. (2006) · Hepatology · doi:10.1002/hep.21178 · Cited by 5,021 · see citing works
Chalasani, N., Younossi, Z. M., Lavine, J. E., Diehl, A. M., Brunt, E. M., Cusi, K. J., Charlton, M., & Sanyal, A. J. (2012) · Hepatology · doi:10.1002/hep.25762 · Cited by 3,805 · see citing works
Prevalence of Hepatic Steatosis in An Urban Population in the United States: Impact of Ethnicity
Browning, J. D., Szczepaniak, L. S., Dobbins, R., Nuremberg, P., Horton, J. D., Cohen, J. C., Grundy, S. M., & Hobbs, H. H. (2004) · Hepatology · doi:10.1002/hep.20466 · Cited by 3,664 · see citing works
Angulo, P., Hui, J. M., Marchesini, G., Bugianesi, E., George, J., Farrell, G. C., Enders, F., Saksena, S., Burt, A. D., Bida, J. P., et al. (2007) · Hepatology · doi:10.1002/hep.21496 · Cited by 3,198 · see citing works
Self-citationAngulo, P., Kleiner, D. E., Dam-Larsen, S., Adams, L. A., Bjornsson, E. S., Charatcharoenwitthaya, P., Mills, P. R., Keach, J. C., Lafferty, H. D., Stahler, A., et al. (2015) · Gastroenterology · doi:10.1053/j.gastro.2015.04.043 · Cited by 2,987 · see citing works
Long-term follow-up of patients with NAFLD and elevated liver enzymes
Ekstedt, M., Franzén, L. E., Mathiesen, U. L., Thorelius, L., Holmqvist, M., Bodemar, G., & Kechagias, S. (2006) · Hepatology · doi:10.1002/hep.21327 · Cited by 2,302 · see citing works
Ekstedt, M., Hagström, H., Nasr, P., Fredrikson, M., Stål, P., Kechagias, S., & Hultcrantz, R. (2015) · Hepatology · doi:10.1002/hep.27368 · Cited by 2,287 · see citing works
Sampling Variability of Liver Biopsy in Nonalcoholic Fatty Liver Disease
Ratziu, V., Charlotte, F., Heurtier, A., Gombert, S., Giral, P., Bruckert, E., Grimaldi, A., Capron, F., & Poynard, T. (2005) · Gastroenterology · doi:10.1053/j.gastro.2005.03.084 · Cited by 2,106 · see citing works
Self-citationVallet‐Pichard, A., Mallet, V. O., Nalpas, B., Verkarre, V., Nalpas, A., Dhalluin-Venier, V., Fontaine, H., & Pol, S. (2007) · Hepatology · doi:10.1002/hep.21669 · Cited by 2,085 · see citing works
Progression of NAFLD to diabetes mellitus, cardiovascular disease or cirrhosis
Anstee, Q. M., Targher, G., & Day, C. P. (2013) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2013.41 · Cited by 1,747 · see citing works
Self-citationDiagnosis and Classification of Diabetes Mellitus
American Diabetes Association (2004) · Diabetes Care · doi:10.2337/diacare.27.2007.s5 · Cited by 1,668 · see citing works
Comparison of Noninvasive Markers of Fibrosis in Patients With Nonalcoholic Fatty Liver Disease
Shah, A. G., Lydecker, A. D., Murray, K. F., Tetri, B., Contos, M. J., & Sanyal, A. J. (2009) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2009.05.033 · Cited by 1,561 · see citing works
Wong, V. W.-S., Vergniol, J., Wong, G. L.-H., Foucher, J., Chan, H. L.-Y., Le Bail, B., Choi, P. C.-L., Kowo, M., Chan, A. W.-H., Merrouche, W., et al. (2010) · Hepatology · doi:10.1002/hep.23312 · Cited by 1,322 · see citing works
Pitfalls of Liver Stiffness Measurement: A 5-Year Prospective Study of 13,369 Examinations
Castéra, L., Foucher, J., Bernard, P., Carvalho, F., Allaix, D., Merrouche, W., Couzigou, P., & de Lédinghen, V. (2009) · Hepatology · doi:10.1002/hep.23425 · Cited by 1,157 · see citing works
McPherson, S., Hardy, T., Henderson, E., Burt, A. D., Day, C. P., & Anstee, Q. M. (2014) · Journal of Hepatology · doi:10.1016/j.jhep.2014.11.034 · Cited by 1,059 · see citing works
Self-citationA position statement on NAFLD/NASH based on the EASL 2009 special conference
Ratziu, V., Bellentani, S., Cortez‐Pinto, H., Day, C., & Marchesini, G. (2010) · Journal of Hepatology · doi:10.1016/j.jhep.2010.04.008 · Cited by 1,058 · see citing works
Self-citationMcPherson, S., Stewart, S. F., Henderson, E., Burt, A. D., & Day, C. P. (2010) · Gut · doi:10.1136/gut.2010.216077 · Cited by 946 · see citing works
Self-citationGuha, I. N., Parkes, J., Roderick, P. J., Chattopadhyay, D., Cross, R., Harris, S., Kaye, P., Burt, A. D., Ryder, S. D., Aithal, G. P., et al. (2007) · Hepatology · doi:10.1002/hep.21984 · Cited by 744 · see citing works
Self-citationWong, V. W.-S., Wong, G. L., Choi, P. C. L., Chan, A. W. H., Li, M. K.-P., Chan, H.-Y., Chim, A. M.-L., Yu, J. Q., Sung, J. J. �., & Chan, H. L. (2010) · Gut · doi:10.1136/gut.2009.205088 · Cited by 648 · see citing works
Williams, R. L., Aspinall, R., Bellis, M. A., Camps-Walsh, G., Cramp, M., Dhawan, A. K., Ferguson, J., Forton, D. M., Foster, G. R., Gilmore, S. I., et al. (2014) · The Lancet · doi:10.1016/s0140-6736(14)61838-9 · Cited by 601 · see citing works
Pais, R., Charlotte, F., Fedchuk, L., Bédossa, P., Lebray, P., Poynard, T., & Ratziu, V. (2013) · Journal of Hepatology · doi:10.1016/j.jhep.2013.04.027 · Cited by 520 · see citing works
Self-citationRatio of Serum Aspartate to Alanine Aminotransferase in Chronic Hepatitis Relationship to Cirrhosis
Williams, A. L. B., & Hoofnagle, J. H. (1988) · Gastroenterology · doi:10.1016/s0016-5085(88)80022-2 · Cited by 518 · see citing works
Ratziu, V., Massard, J., Charlotte, F., Messous, D., Imbert‐Bismut, F., Bonyhay, L., Tahiri, M., Munteanu, M., Thabut, D., Cadranel, J. F. D., et al. (2006) · BMC Gastroenterology · doi:10.1186/1471-230x-6-6 · Cited by 491 · see citing works
Self-citationBhala, N. B., Angulo, P., van der Poorten, D., Lee, E., Hui, J. M., Saracco, G. M., Adams, L. A., Charatcharoenwitthaya, P., Topping, J. H., Bugianesi, E., et al. (2011) · Hepatology · doi:10.1002/hep.24491 · Cited by 450 · see citing works
Self-citationNon-invasive diagnosis of non-alcoholic fatty liver disease. A critical appraisal
Machado, M. V., & Cortez‐Pinto, H. (2012) · Journal of Hepatology · doi:10.1016/j.jhep.2012.11.021 · Cited by 411 · see citing works
Non-alcoholic fatty liver disease: a practical approach to diagnosis and staging
Dyson, J. K., Anstee, Q. M., & McPherson, S. (2013) · Frontline Gastroenterology · doi:10.1136/flgastro-2013-100403 · Cited by 358 · see citing works
Self-citationPathological Features of Fatty Liver Disease
Yeh, M. M., & Brunt, E. M. (2014) · Gastroenterology · doi:10.1053/j.gastro.2014.07.056 · Cited by 339 · see citing works
Koehler, E. M., Plompen, E. P. C., Schouten, J. N. L., Hansen, B. E., Murad, S. D., Taimr, P., Leebeek, F. W. G., Albert Hofman, D., Stricker, B. H. C., Castéra, L., et al. (2015) · Hepatology · doi:10.1002/hep.27981 · Cited by 320 · see citing works
How big a problem is non-alcoholic fatty liver disease?
Anstee, Q. M., McPherson, S., & Day, C. (2011) · BMJ · doi:10.1136/bmj.d3897 · Cited by 200 · see citing works
Self-citationNoureddin, M., Yates, K. P., Vaughn, I. A., Neuschwander‐Tetri, B. A., Sanyal, A. J., McCullough, A. J., Merriman, R. B., Hameed, B., Doo, E. C., Kleiner, D. E., et al. (2013) · Hepatology · doi:10.1002/hep.26465 · Cited by 196 · see citing works
Adams, L. A., George, J., Bugianesi, E., Rossi, E., de Boer, W. B., van der Poorten, D., Ching, H. L., Bulsara, M. K., & Jeffrey, G. P. (2011) · Journal of Gastroenterology and Hepatology · doi:10.1111/j.1440-1746.2011.06774.x · Cited by 172 · see citing works
Self-citationAge‐related pseudocapillarization of the human liver
McLean, A. J., Cogger, V. C., Chong, G. C., Warren, A., Markus, A. M. A., Dahlstrom, J. E., & Couteur, D. G. L. (2003) · The Journal of Pathology · doi:10.1002/path.1328 · Cited by 170 · see citing works
Myers, R. P., Pomier–Layrargues, G., Kirsch, R., Pollett, A. F., Beaton, M. D., Levstik, M. A., Duarte‐Rojo, A., Wong, D., Crotty, P., & Elkashab, M. (2011) · Journal of Hepatology · doi:10.1016/j.jhep.2011.10.007 · Cited by 146 · see citing works
Diagnosis and Assessment of NAFLD: Definitions and Histopathological Classification
Lackner, C., TINIAKOS, D. G., & Burt, A. D. (2015) · Seminars in Liver Disease · doi:10.1055/s-0035-1562942 · Cited by 145 · see citing works
Self-citationPetta, S., Vanni, E., Bugianesi, E., Marco, V. D., Cammà, C., Cabibi, D., Mezzabotta, L., & Craxı̀, A. (2014) · Liver International · doi:10.1111/liv.12584 · Cited by 137 · see citing works
Self-citationBalduini, C. L., & Noris, P. (2014) · Haematologica · doi:10.3324/haematol.2014.106260 · Cited by 134 · see citing works
Serum Immunoglobulin Levels Predict Fibrosis in Patients With Non-Alcoholic Fatty Liver Disease
McPherson, S., Henderson, E., Burt, A. D., Day, C. P., & Anstee, Q. M. (2014) · Journal of Hepatology · doi:10.1016/j.jhep.2014.01.010 · Cited by 124 · see citing works
Self-citationAlanine Aminotransferase Decreases with Age: The Rancho Bernardo Study
Dong, M. H., Bettencourt, R., Barrett-Connor, E., & Loomba, R. (2010) · PLoS ONE · doi:10.1371/journal.pone.0014254 · Cited by 103 · see citing works
McPherson, S., Anstee, Q. M., Henderson, E., Day, C. P., & Burt, A. D. (2013) · European Journal of Gastroenterology & Hepatology · doi:10.1097/meg.0b013e32835d72cf · Cited by 98 · see citing works
Self-citationSerum Levels of Alanine Aminotransferase Decrease With Age in Longitudinal Analysis
Dong, M. H., Bettencourt, R., Brenner, D. A., Barrett-Connor, E. L., & Loomba, R. S. (2011) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2011.10.014 · Cited by 94 · see citing works
Epidemiology of fatty liver: an update.
Bedogni, G., Nobili, V., & Tiribelli, C. (2014) · PubMed Central · doi:10.3748/wjg.v20.i27.9050 · Cited by 87 · see citing works
Quantifying hepatic steatosis – more than meets the eye
Levene, A., Kudo, H., Armstrong, M. J., Thursz, M. R., Gedroyc, W. M. W., Anstee, Q. M., & Goldin, R. D. (2012) · Histopathology · doi:10.1111/j.1365-2559.2012.04193.x · Cited by 82 · see citing works
Self-citationNoninvasive Assessment of Nonalcoholic Fatty Liver Disease in Obese or Overweight Patients
Francque, S., Verrijken, A., Mertens, I. L., Hubens, G., Marck, E. V., Pelckmans, P. A., Michielsen, P. P., & Gaal, L. V. (2012) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2012.06.019 · Cited by 82 · see citing works
Self-citationNon-alcoholic fatty liver disease: non-invasive investigation and risk stratification
Dyson, J. K., McPherson, S., & Anstee, Q. M. (2013) · Journal of Clinical Pathology · doi:10.1136/jclinpath-2013-201620 · Cited by 78 · see citing works
Self-citationFagan, K. J., Pretorius, C. J., Horsfall, L. U., Irvine, K. M., Wilgen, U., Choi, K., Fletcher, L. M., Tate, J. R., Melino, M., Nusrat, S., et al. (2014) · Liver International · doi:10.1111/liv.12760 · Cited by 74 · see citing works
Jansen, P. L. M. (2002) · Best Practice & Research Clinical Gastroenterology · doi:10.1053/bega.2002.0271 · Cited by 64 · see citing works
Pérez-Gutiérrez, O. Z., Hernández-Rocha, C., Cândia, R., Arrese, M. A., Benítez, C., Brizuela-Alcántara, D. C., Méndez‐Sánchez, N., Uribe, M., & Chávez-Tapia, N. C. (2013) · Annals of Hepatology · doi:10.1016/s1665-2681(19)31004-x · Cited by 47 · see citing works
Xun, Y., Fan, J., Zang, G. Q., Liu, H., Jiang, Y., Xiang, J., Huang, Q., & Shi, J. (2012) · Journal of Digestive Diseases · doi:10.1111/j.1751-2980.2012.00631.x · Cited by 42 · see citing works
Demir, M., Lang, S., Nierhoff, D., Drebber, U., Hardt, A., Wedemeyer, I., Schulte, S., Quasdorff, M., Goeser, T., Töx, U., et al. (2013) · Journal of Clinical Gastroenterology · doi:10.1097/mcg.0b013e3182819a89 · Cited by 42 · see citing works
Fiel, M. I., Denız, K., Elmalı, F., & Schiano, T. D. (2011) · Journal of Hepatology · doi:10.1016/j.jhep.2010.12.018 · Cited by 35 · see citing works
Goh, G. B., Pagadala, M. R., Dasarathy, J., Ünalp–Arida, A., Pai, R. K., Yerian, L. M., Khiyami, A., Sourianarayanane, A., Sargent, R., Hawkins, C., et al. (2015) · Digestive Diseases and Sciences · doi:10.1007/s10620-015-3529-8 · Cited by 31 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Vallet-Pichard A, Mallet V, Nalpas B et al. FIB-4: an inexpensive and accurate marker of fibrosis in HCV infection. comparison with liver biopsy and fibrotest. Hepatology 2007; 46: 32–36. 17567829
Cited by
Sorted by citations
MAFLD: a consensus-driven proposed nomenclature for metabolic associated fatty liver disease
Eslam, M., Sanyal, A. J., George, J., Sanyal, A., Neuschwander-Tetri, B., Tiribelli, C., Kleiner, D. E., Brunt, E., Bugianesi, E., Yki-Järvinen, H., et al. (2020) · Gastroenterology · doi:10.1053/j.gastro.2019.11.312 · Cited by 3,286 · see citing works
Self-citationRinella, M. E., Neuschwander-Tetri, B. A., Siddiqui, M. S., Abdelmalek, M. F., Caldwell, S., Barb, D., Kleiner, D. E., & Loomba, R. (2023) · Hepatology · doi:10.1097/hep.0000000000000323 · Cited by 2,667 · see citing works
Tacke, F., Horn, P., Wai-Sun Wong, V., Ratziu, V., Bugianesi, E., Francque, S., Zelber-Sagi, S., Valenti, L., Roden, M., Schick, F., et al. (2024) · Journal of Hepatology · doi:10.1016/j.jhep.2024.04.031 · Cited by 2,210 · see citing works
Self-citationNoninvasive assessment of liver disease in patients with nonalcoholic fatty liver disease
Castera, L., Friedrich-Rust, M., & Loomba, R. (2019) · Gastroenterology · doi:10.1053/j.gastro.2018.12.036 · Cited by 1,494 · see citing works
Cusi, K., Isaacs, S., Barb, D., Basu, R., Caprio, S., Garvey, W. T., Kashyap, S., Mechanick, J. I., Mouzaki, M., Nadolsky, K., et al. (2022) · Endocrine Practice · doi:10.1016/j.eprac.2022.03.010 · Cited by 1,021 · see citing works
Xiao, G., Zhu, S., Xiao, X., Yan, L., Yang, J., & Wu, G. (2017) · Hepatology · doi:10.1002/hep.29302 · Cited by 895 · see citing works
Metabolic dysfunction-associated steatotic liver disease (MASLD): a state-of-the-art review
Chan, W.-K., Chuah, K.-H., Rajaram, R. B., Lim, L.-L., Ratnasingam, J., & Vethakkan, S. R. (2023) · Journal of Obesity & Metabolic Syndrome · doi:10.7570/jomes23052 · Cited by 776 · see citing works
Advancing the global public health agenda for NAFLD: a consensus statement
Lazarus, J. V., Mark, H. E., Anstee, Q. M., Arab, J. P., Batterham, R. L., Castera, L., Cortez-Pinto, H., Crespo, J., Cusi, K., Dirac, M. A., et al. (2022) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-021-00523-4 · Cited by 757 · see citing works
Self-citationKanwal, F., Shubrook, J. H., Adams, L. A., Pfotenhauer, K., Wai-Sun Wong, V., Wright, E., Abdelmalek, M. F., Harrison, S. A., Loomba, R., Mantzoros, C. S., et al. (2021) · Gastroenterology · doi:10.1053/j.gastro.2021.07.049 · Cited by 618 · see citing works
Self-citationDaniels, S. J., Leeming, D. J., Eslam, M., Hashem, A. M., Nielsen, M. J., Krag, A., Karsdal, M. A., Grove, J. I., Neil Guha, I., Kawaguchi, T., et al. (2019) · Hepatology · doi:10.1002/hep.30163 · Cited by 273 · see citing works
Lin, H., Lee, H. W., Yip, T. C.-F., Tsochatzis, E., Petta, S., Bugianesi, E., Yoneda, M., Zheng, M.-H., Hagström, H., Boursier, J., et al. (2024) · JAMA · doi:10.1001/jama.2024.1447 · Cited by 250 · see citing works
Self-citationImpact of non-invasive biomarkers on hepatology practice: past, present and future
Anstee, Q. M., Castera, L., & Loomba, R. (2022) · Journal of Hepatology · doi:10.1016/j.jhep.2022.03.026 · Cited by 224 · see citing works
Self-citationRepeated FIB-4 measurements can help identify individuals at risk of severe liver disease
Hagström, H., Talbäck, M., Andreasson, A., Walldius, G., & Hammar, N. (2020) · Journal of Hepatology · doi:10.1016/j.jhep.2020.06.007 · Cited by 199 · see citing works
Newsome, P., Francque, S., Harrison, S., Ratziu, V., Van Gaal, L., Calanna, S., Hansen, M., Linder, M., & Sanyal, A. (2019) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.15316 · Cited by 186 · see citing works
Self-citationHagström, H., Talbäck, M., Andreasson, A., Walldius, G., & Hammar, N. (2020) · Gastroenterology · doi:10.1053/j.gastro.2019.09.008 · Cited by 182 · see citing works
Hagström, H., Nasr, P., Ekstedt, M., Stål, P., Hultcrantz, R., & Kechagias, S. (2019) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2018.11.030 · Cited by 132 · see citing works
Younossi, Z. M., Anstee, Q. M., Wai-Sun Wong, V., Trauner, M., Lawitz, E. J., Harrison, S. A., Camargo, M., Kersey, K., Subramanian, G. M., Myers, R. P., et al. (2021) · Gastroenterology · doi:10.1053/j.gastro.2020.12.003 · Cited by 118 · see citing works
Self-citationCholankeril, G., Kramer, J. R., Chu, J., Yu, X., Balakrishnan, M., Li, L., El-Serag, H. B., & Kanwal, F. (2023) · Journal of Hepatology · doi:10.1016/j.jhep.2022.10.035 · Cited by 119 · see citing works
Corey, K. E., Pitts, R., Lai, M., Loureiro, J., Masia, R., Osganian, S. A., Gustafson, J. L., Hutter, M. M., Gee, D. W., Meireles, O. R., et al. (2022) · Journal of Hepatology · doi:10.1016/j.jhep.2021.09.026 · Cited by 88 · see citing works
Implementation of a liver health check in people with type 2 diabetes
Abeysekera, K. W. M., Valenti, L., Younossi, Z., Dillon, J. F., Allen, A. M., Noureddin, M., Rinella, M. E., Tacke, F., Francque, S., Ginès, P., et al. (2024) · The Lancet Gastroenterology & Hepatology · doi:10.1016/s2468-1253(23)00270-4 · Cited by 63 · see citing works
Self-citationZhang, X., Yip, T. C.-F., Wong, G. L.-H., Leow, W.-X., Liang, L. Y., Lim, L.-L., Li, G., Ibrahim, L., Lin, H., Lai, J. C. T., et al. (2023) · Gut · doi:10.1136/gutjnl-2023-330269 · Cited by 55 · see citing works
Eslam, M., Wong, G. L.-H., Hashem, A. M., Chan, H. L.-Y., Nielsen, M. J., Leeming, D. J., Chan, A. W.-H., Chen, Y., Duffin, K. L., Karsdal, M., et al. (2021) · American Journal of Gastroenterology · doi:10.14309/ajg.0000000000001059 · Cited by 53 · see citing works
Self-citationChow, J. C., Wong, G. L., Chan, A. W., Shu, S. S., Chan, C. K., Leung, J. K., Choi, P. C., Chim, A. M., Chan, H. L., & Wong, V. W. (2019) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.14311 · Cited by 46 · see citing works
Udompap, P., Therneau, T. M., Canning, R. E., Benson, J. T., & Allen, A. M. (2023) · Hepatology · doi:10.1002/hep.32739 · Cited by 37 · see citing works
Behari, J., Gougol, A., Wang, R., Luu, H. N., Paragomi, P., Yu, Y.-C., Molinari, M., Chopra, K., Malik, S. M., Geller, D., et al. (2023) · Hepatology Communications · doi:10.1097/hc9.0000000000000183 · Cited by 35 · see citing works
Authors, & Collaborators: (2022) · Zeitschrift für Gastroenterologie · doi:10.1055/a-1880-2388 · Cited by 30 · see citing works
Wong, V. W.-S., Tak, W. Y., Goh, G. B. B., Cheng, P.-N., Lawitz, E. J., Younossi, Z. M., Vuppalanchi, R., Younes, Z., Alkhouri, N., Wang, L., et al. (2023) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2022.01.015 · Cited by 31 · see citing works
Self-citationRutledge, S. M., Soper, E. R., Ma, N., Pejaver, V., Friedman, S. L., Branch, A. D., Kenny, E. E., Belbin, G. M., & Abul-Husn, N. S. (2023) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2022.12.025 · Cited by 22 · see citing works
- Authors
- McPherson, S., Hardy, T., Dufour, J.-F., Petta, S., Romero-Gomez, M., Allison, M., Oliveira, C. P., Francque, S., Van Gaal, L., Schattenberg, J. M., Tiniakos, D., Burt, A., Bugianesi, E., Ratziu, V., Day, C. P., & Anstee, Q. M.
- Affiliations
- Freeman Hospital (GB)
- University of Palermo (IT)
- Addenbrooke's Hospital (GB)
- Universidade de São Paulo (BR)
- Antwerp University Hospital (BE)
- University Medical Center of the Johannes Gutenberg University Mainz (DE)
- The University of Adelaide (AU)
- Azienda Ospedaliera Citta' della Salute e della Scienza di Torino (IT)
- Pitié-Salpêtrière Hospital (FR)
- Corresponding author
- Anstee, Quentin M
- ORCID
- Venue
- American Journal of Gastroenterology
- Published
- 2017-05
- Volume
- 112
- Issue
- 5
- Pages
- 740-751
- ISSN
- 0002-9270 (ISSN-L)
- PMC
- PMC5418560
- OpenAlex
- W2529917894
- Cited by
- 945
- References
- 53
- Citations by year
- 2026: 129 · 2025: 150 · 2024: 123 · 2023: 126 · 2022: 108 · 2021: 125 · 2020: 79 · 2019: 49 · 2018: 24 · 2017: 22 · 2016: 1 · 2015: 3
- FWCI
- 30.01
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- cc-by-nc-sa
- Locations
- The American Journal of Gastroenterology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- RISalud Institutional Health Repository of Andalucía (submittedVersion, cc-by-nc-sa)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion, other-oa)
- Bern Open Repository and Information System (University of Bern) (submittedVersion, cc-by-nc-sa)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by-nc-sa)
- Nova Science Publishers (Nova Science Publishers, Inc.) (submittedVersion, other-oa)
- Newcastle University ePrints (Newcastle Univesity) (cc-by-nc-sa)
- Open Access CRIS of the University of Bern
- Funders
- European Commission (634413, HORIZON2020)
- European Association for the Study of the Liver
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Keywords
- non-alcoholic fatty liver disease, liver fibrosis, advanced fibrosis, non-invasive fibrosis scores, NAFLD fibrosis score, FIB-4, AST/ALT ratio, elderly patients, false positive rate, confounding factor, transient elastography
- MeSH terms
- Adult, Age Factors, Aged, Alanine Transaminase, Aspartate Aminotransferases, Biopsy, False Positive Reactions, Female, Humans, Liver, Liver Cirrhosis, Male, Middle Aged, Platelet Count, Predictive Value of Tests, Reference Values, ROC Curve, Area Under Curve, Non-alcoholic Fatty Liver Disease
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
