Non-alcoholic fatty liver disease (NAFLD) has become a major public health issue with an increasing prevalence worldwide. Accurate diagnosis and staging of the disease is important in determining the long-term management and follow-up of these patients. The aim of our study is to investigate the correlation between non-invasive tests and different stages of liver fibrosis in NAFLD.Methods
905 patients with NAFLD underwent Fibroscan at Aberdeen Royal Infirmary from March 2013 to November 2016. 417 patients with liver stiffness measurement >7 kPa underwent electronic medical record reviews to identify patients who had liver biopsies within a year from the date of their Fibroscan. 54 out of 417 patients underwent liver biopsies. 42 of the 54 patients were identified to have biopsy-proven NAFLD. The histological reports of the liver biopsies were reviewed and different stages of fibrosis were recorded. Liver fibrosis was classified as no fibrosis (F0), mild fibrosis (F1), moderate fibrosis (F2), severe/bridging fibrosis (F3) and cirrhosis (F4). Clinical, radiological and biochemical data of these patients were also analysed, provided they were within 1 year from the dates of liver biopsies.Results
Out of the 42 patients identified, the mean age was 56 (±14) with a male preponderance (55%). 1 patient had no fibrosis (F0), 14 patients had mild fibrosis (F1), 1 patient had moderate fibrosis (F2), 14 patients had severe fibrosis (F3) and 12 patients had cirrhosis (F4). Correlation between different variables and stages of fibrosis were tested using the non-parametric Spearman’s correlation coefficient. Data are summarised in the table 1 below and are expressed as median ±IQR.Conclusions
Our study indicated that there were statistically significant positive correlations between LSM, NALFD score and FIB-4 score with different stages of fibrosis in patients with NAFLD. However, the correlations between AST to Platelet Ratio Index (APRI), United Kingdom Model for End-Stage Liver Disease (UKELD) score and different stages of fibrosis were not statistically significant. The difference may be due to the inclusion of clinical variables in the NAFLD score. The addition of LSM to the NAFLD score could potentially improve the diagnostic accuracy of fibrosis in NAFLD patients.