Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Prognostic performance of 7 biomarkers compared to liver biopsy in early alcohol-related liver disease

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Bacterial infections in patients with acute variceal bleeding in the era of antibiotic prophylaxis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. PREDICT identifies precipitating events associated with the clinical course of acutely decompensated cirrhosis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. rs641738C>T near MBOAT7 is associated with liver fat, ALT and fibrosis in NAFLD: A meta-analysis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Rebleeding and mortality risk are increased by ACLF but reduced by pre-emptive TIPS

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. The power of genetic diversity in genome-wide association studies of lipids

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Abnormal brain cholesterol homeostasis in Alzheimer’s disease—a targeted metabolomic and transcriptomic study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Distinct Molecular Signatures of Clinical Clusters in People with Type 2 Diabetes: an IMI-RHAPSODY Study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Essential Branched-Chain Amino Acids and Ribonic Acid Are Associated with Cardiorenal Events in Type 1 Diabetes

    Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

  • MicrobLiver consortia
Vis graf over relationer

Background & Aims: Alcohol is the most common cause of liver-related mortality and morbidity. We therefore aimed to assess and compare the prognostic performance of elastography and blood-based markers to predict time to the first liver-related event, severe infection, and all-cause mortality in patients with a history of excess drinking. Methods: We performed a prospective cohort study in patients with early, compensated alcohol-related liver disease. At baseline, we obtained a liver biopsy, transient elastography (TE), 2-dimensional shear-wave elastography (2D-SWE), enhanced liver fibrosis test (ELF), FibroTest, fibrosis-4 index (FIB-4), non-alcoholic fatty liver fibrosis score (NFS) and Forns index. We compared C-statistics and time-dependent AUC for prognostication. We used validated cut-off points to create 3 risk groups for each test: low, intermediate and high risk. Results: We followed 462 patients for a median of 49 months (IQR 31–70). Median age was 57 years, 76% were males, 20% had advanced fibrosis. Eighty-four patients (18%) developed a liver-related event after a median of 18 months (7-34). TE had the highest prognostic accuracy, with a C-statistic of 0.876, and time-dependent AUC at 5 years of 0.889, comparable to 2D-SWE and ELF. TE, ELF and 2D-SWE outperformed FibroTest, FIB4, NFS, Forns index and biopsy-verified fibrosis stage. Compared to patients with TE <10 kPa, the hazard ratios for liver-related events for TE 10–15 kPa were 8.1 (3.2–20.4), and 27.9 (13.8–56.8) for TE >15 kPa. Periods of excessive drinking during follow-up increased the risk of progressing to liver-related events, except for patients in the low-risk groups. Conclusion: TE, ELF and 2D-SWE are highly accurate prognostic markers in patients with alcohol-related liver disease. Easy-to-use cut-offs can distinguish between substantially different risk profiles. Lay summary: Alcohol is the leading cause of death and illness due to liver disease. In this study, we assessed the ability of biomarkers to predict the risk of developing symptomatic liver disease in patients with early stages of alcohol-related liver disease. We found that several tests accurately predicted the risk of liver-related events such as ascites, esophageal varices and hepatic encephalopathy during an average follow-up of 4.1 years. Liver stiffness measurements by ultrasound elastography and the enhanced liver fibrosis test performed best. By using them, we were able to stratify patients into 3 groups with significantly different risks.

OriginalsprogEngelsk
TidsskriftJournal of Hepatology
Vol/bind75
Udgave nummer5
Sider (fra-til)1017-1025
Antal sider9
ISSN0168-8278
DOI
StatusUdgivet - nov. 2021

Bibliografisk note

Publisher Copyright:
© 2021 The Authors

ID: 69206392