FIB-4 Index should Guide the Referral of Patients with Metabolic Syndrome to Gastroenterology: The Perspective of a Portuguese Cohort

• Type: Article in National Scientific Journal
• Date: 2023

Authors

Borges Canha, M (Author) Other; Liberal, R (Author) Other; Leite, AR (Author) Other; Correia Chaves, J (Author) Other; Lourenco, IM (Author) Other; von Hafe, M (Author) Other; Neves, JS (Author) Other; Fragao Marques, M (Author) Other; Vale, C (Author) FMUP; Pedro Pimentel-Nunes (Author) FMUP; Leite-Moreira AF (Author) FMUP; Carvalho, Davide (Author) FMUP; Freitas, P (Author) Other

Journal

Title: Revista Portuguesa de Endocrinologia, Diabetes e Metabolismo

ISSN: 1646-3439

Indexing

ISI Web of Knowledge - 0 Citations

Other information

Authenticus ID: P-00Z-JPV

DOI: 10.26497/ao230023

Abstract (EN): Introduction: Data regarding the referral of patients with metabolic syndrome (MetS) to hepatologists is scarce. Most authors agree that at-risk patients (including the ones with diabetes or MetS) should be screened for non-alcoholic fatty liver disease (NAFLD) and referred to hepatologists when needed. Existing data highlights that referral of patients with NAFLD to specialists remain low among endocrinologists. Our aim was to evaluate a Portuguese cohort of patients with MetS followed in Endocrinology outpatient setting regarding their need to referral to hepatologists. Methods: Secondary analysis including the patients from microDHNA cohort (adult patients with MetS followed for any cause in Endocrinology outpatient setting). The recruitment includes anamnesis, physical examination, blood drawing for several predefined analyses and hepatic elastography. Our main outcome was referral to gastroenterology due to hepatic fibrosis (every patient with a median value on elastography (3)7kPa was referred). We tested the discriminatory accuracy of hepatic biochemical parameters and indexes [FLI (Fatty Liver Index) score, a predictor of hepatic steatosis; and BARD (Body Mass Index, AST/ALT Ratio, and Diabetes), APRI (Aspartate Aminotransferase to Platelet Ratio Index), NFS (NAFLD Fibrosis Score) and FIB-4 (Fibrosis-4 Index) scores, predictors of hepatic fibrosis] for the need to referral of patients using ROC curve analyses. Results: We included a total of 65 participants; of those, 53.8% were female and the average age was 61.2 +/- 9.6 years old. Eight patients (12.3%) were referred to gastroenterology after performing hepatic elastography, none of which was already referred. Our analysis showed that the best parameter in this cohort was FIB-4 index. A cut-off value of 2.11 associates to an area under the curve of 0.80 and has a sensitivity of 62% and specificity of 98% for predicting the need for referral. Conclusion: Our results highlight that the use of scores as the FIB-4 index should be included in the evaluation of patients with MetS in the Endocrinology outpatient setting. Further studies are needed to validate FIB-4 best cut-off value in our population.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 5