Background and aims Steatotic liver disease(SLD)is a growing global concern.The Chronic Liver Disease(CLivD)risk score predicts liver-related outcomes in the general population using easily accessible variables with o...Background and aims Steatotic liver disease(SLD)is a growing global concern.The Chronic Liver Disease(CLivD)risk score predicts liver-related outcomes in the general population using easily accessible variables with or without laboratory tests(CLivDlab and CLivDnon-lab).We assessed CLivD’s associations with liver steatosis,fibrosis and its combined performance with fibrosis-4(FIB-4)for advanced fibrosis detection.Methods Using the National Health and Nutrition Examination Survey data(2017–2020),3603 participants aged 40–70 years with valid liver stiffness measurements(LSMs)were included.Advanced fibrosis was defined as LSM≥12 kPa,and SLD as controlled attenuation parameter≥288 dB/m.Results Significant associations were found between CLivD and SLD and advanced fibrosis.CLivDlab had an area under the curve(AUC)for advanced fibrosis of 0.72(95%CI 0.68 to 0.77),while CLivDnon-lab had an AUC of 0.68(95%CI 0.64 to 0.72),both slightly higher than FIB-4(AUC 0.66,95%CI 0.60 to 0.72).Among participants without obesity,AUC of CLivDlab was 0.82(95%CI 0.76 to 0.88)and AUC of CLivDnon-lab was 0.72(95%CI 0.65 to 0.79).The CLivD score improved FIB-4’s AUC for advanced fibrosis detection from<0.5 at minimal CLivD scores to>0.8 at high CLivD scores.A sequential CLivD→FIB-4 strategy outperformed universal FIB-4 testing,enhancing specificity from 72%to 83%,with sensitivity at 51%–53%.This strategy identified a subgroup with a 55%prevalence of advanced fibrosis,while 47%had minimal-risk CLivD scores,eliminating the need for FIB-4 testing.Conclusions The CLivD score,designed for predicting liver-related outcomes,effectively identifies liver steatosis and advanced fibrosis in the general population.Combining CLivD with FIB-4 enhances advanced fibrosis detection accuracy.The CLivD score could enhance population-based liver fibrosis screening,optimising resource allocation.展开更多
基金F.was supported by Finska L.kares.llskapet,Academy of Finland(#338544),Sigrid Jusélius Foundation,Mary and Georg Ehrnrooth Foundation,Medicinska Underst.dsf.rening Liv&H.lsaWilhelm and Else Stockmann Foundation.ML was supported by Finnish State Research Funding and Mary and Georg Ehrnrooth Foundation.The researchers are independent of the funders.
文摘Background and aims Steatotic liver disease(SLD)is a growing global concern.The Chronic Liver Disease(CLivD)risk score predicts liver-related outcomes in the general population using easily accessible variables with or without laboratory tests(CLivDlab and CLivDnon-lab).We assessed CLivD’s associations with liver steatosis,fibrosis and its combined performance with fibrosis-4(FIB-4)for advanced fibrosis detection.Methods Using the National Health and Nutrition Examination Survey data(2017–2020),3603 participants aged 40–70 years with valid liver stiffness measurements(LSMs)were included.Advanced fibrosis was defined as LSM≥12 kPa,and SLD as controlled attenuation parameter≥288 dB/m.Results Significant associations were found between CLivD and SLD and advanced fibrosis.CLivDlab had an area under the curve(AUC)for advanced fibrosis of 0.72(95%CI 0.68 to 0.77),while CLivDnon-lab had an AUC of 0.68(95%CI 0.64 to 0.72),both slightly higher than FIB-4(AUC 0.66,95%CI 0.60 to 0.72).Among participants without obesity,AUC of CLivDlab was 0.82(95%CI 0.76 to 0.88)and AUC of CLivDnon-lab was 0.72(95%CI 0.65 to 0.79).The CLivD score improved FIB-4’s AUC for advanced fibrosis detection from<0.5 at minimal CLivD scores to>0.8 at high CLivD scores.A sequential CLivD→FIB-4 strategy outperformed universal FIB-4 testing,enhancing specificity from 72%to 83%,with sensitivity at 51%–53%.This strategy identified a subgroup with a 55%prevalence of advanced fibrosis,while 47%had minimal-risk CLivD scores,eliminating the need for FIB-4 testing.Conclusions The CLivD score,designed for predicting liver-related outcomes,effectively identifies liver steatosis and advanced fibrosis in the general population.Combining CLivD with FIB-4 enhances advanced fibrosis detection accuracy.The CLivD score could enhance population-based liver fibrosis screening,optimising resource allocation.
