Hepatology research : the official journal of the Japan Society of Hepatology · 2019
Profiles of advanced hepatic fibrosis evaluated by FIB-4 index and shear wave elastography in health checkup examinees.
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Yamamura Sakura, Kawaguchi Takumi, Nakano Dan, Tomiyasu Yoshiko, Yoshinaga Shinobu, Doi Yumi, Takahashi Hirokazu, Anzai Keizo, Eguchi Yuichiro, Torimura Takuji, Shiba Naoto
Аннотация
AIM: Advanced hepatic fibrosis is seen in individuals with potential hepatocellular carcinoma and cardiovascular disease. Hepatic fibrosis can be assessed using a combination of the FIB-4 index and imaging modalities, including shear wave elastography. We aimed to investigate the prevalence of advanced fibrosis in the general population and the profiles associated with advanced fibrosis using a data-mining analysis.
METHODS: We enrolled 1155 health checkup examinees (median age 53 years, 685 women, 470 male). Advanced fibrosis was defined by FIB-4 index ≥1.3 and liver stiffness ≥8.07 kPa using shear wave elastography. Participants were classified as normal-mild fibrosis (n = 1035) or advanced fibrosis (n = 120). Factors associated with advanced fibrosis were analyzed by logistic regression and decision-tree analyses.
RESULTS: Advanced fibrosis was observed in 10.4% of participants (120/1155). In the logistic regression analysis, independent factors for advanced fibrosis were age (≥75 years; OR 2.12, 95% CI 1.021-4.415; P = 0.0419) and the presence of metabolic syndrome (OR 2.51, 95% CI 1.416-4.462; P = 0.0017). The decision-tree analysis showed two profiles associated with advanced fibrosis: profile 1 - individuals aged ≥65 years with metabolic syndrome and mild-to-moderate alcohol consumption (prevalence of advanced fibrosis 73.3%); and profile 2 - individuals without metabolic syndrome, aged ≥75 years, with no exercise habit (prevalence of advanced fibrosis 56.3%).
CONCLUSIONS: Advanced fibrosis was observed in 10.4% of health checkup examinees. Furthermore, we showed that aging, metabolic syndrome with mild-to-moderate alcohol consumption, and physical inactivity were associated with advanced fibrosis. Thus, prevention of metabolic syndrome and alcohol withdrawal, as well as exercise habits, might inhibit the progression of hepatic fibrosis.
METHODS: We enrolled 1155 health checkup examinees (median age 53 years, 685 women, 470 male). Advanced fibrosis was defined by FIB-4 index ≥1.3 and liver stiffness ≥8.07 kPa using shear wave elastography. Participants were classified as normal-mild fibrosis (n = 1035) or advanced fibrosis (n = 120). Factors associated with advanced fibrosis were analyzed by logistic regression and decision-tree analyses.
RESULTS: Advanced fibrosis was observed in 10.4% of participants (120/1155). In the logistic regression analysis, independent factors for advanced fibrosis were age (≥75 years; OR 2.12, 95% CI 1.021-4.415; P = 0.0419) and the presence of metabolic syndrome (OR 2.51, 95% CI 1.416-4.462; P = 0.0017). The decision-tree analysis showed two profiles associated with advanced fibrosis: profile 1 - individuals aged ≥65 years with metabolic syndrome and mild-to-moderate alcohol consumption (prevalence of advanced fibrosis 73.3%); and profile 2 - individuals without metabolic syndrome, aged ≥75 years, with no exercise habit (prevalence of advanced fibrosis 56.3%).
CONCLUSIONS: Advanced fibrosis was observed in 10.4% of health checkup examinees. Furthermore, we showed that aging, metabolic syndrome with mild-to-moderate alcohol consumption, and physical inactivity were associated with advanced fibrosis. Thus, prevention of metabolic syndrome and alcohol withdrawal, as well as exercise habits, might inhibit the progression of hepatic fibrosis.