The FIB-4 Index Predicts the Development of Liver-Related Events, Extrahepatic Cancers, and Coronary Vascular Disease in Patients with NAFLD

• Published in: Nutrients Vol. 15; no. 1; p. 66
• Main Authors: Kamada, Yoshihiro, Munekage, Kensuke, Nakahara, Takashi, Fujii, Hideki, Sawai, Yoshiyuki, Doi, Yoshinori, Hyogo, Hideyuki, Sumida, Yoshio, Imai, Yasuharu, Miyoshi, Eiji, Ono, Masafumi
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 23.12.2022; MDPI
• Subjects: Angina pectoris; Ascites; biomarkers; Biopsy; Blood circulation disorders; Body mass index; Cancer; Carcinoma, Hepatocellular - complications; Carcinoma, Hepatocellular - diagnosis; Carcinoma, Hepatocellular - epidemiology; Cardiac patients; Cardiovascular diseases; Complications and side effects; Coronary Artery Disease - complications; Development and progression; Evaluation; Fatty liver; Fibrosis; Heart attacks; Heart failure; hepatoma; Hospitals; Humans; Hyaluronic acid; Japan; Liver; Liver cancer; liver cirrhosis; Liver Cirrhosis - diagnosis; Liver Cirrhosis - epidemiology; Liver Cirrhosis - etiology; Liver diseases; Liver Neoplasms - diagnosis; Liver Neoplasms - epidemiology; Magnetic resonance imaging; Medical research; Medicine, Experimental; Non-alcoholic Fatty Liver Disease - complications; Non-alcoholic Fatty Liver Disease - diagnosis; Non-alcoholic Fatty Liver Disease - epidemiology; Prognosis; Risk factors; ROC Curve; Statistical analysis; Type 2 diabetes; vascular diseases; Japan; Asia; Taiwan; United States > US; major adverse cardiovascular events (MACEs); noninvasive test (NIT); biomarker; biopsy-confirmed NAFLD
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu15010066

The prognosis of nonalcoholic fatty liver disease (NAFLD) patients depends on liver-related events (LREs), extrahepatic cancers, and major adverse cardiovascular events (MACEs). The fibrosis-4 (FIB-4) index is one of the most reliable and useful predictors of the degree of liver fibrosis. Recent studies have reported that the FIB-4 index is also useful for predicting LREs and MACEs in NAFLD patients. In the present study, we investigated the prognostic value of the FIB-4 index in NAFLD patients. A total of 506 biopsy-confirmed NAFLD patients from six hepatology centers in Japan from 2002 to 2013 were enrolled in this study. Of these NAFLD patients, 353 were available for more than 100 days of follow-up and did not exhibit events (LREs, extrahepatic cancers, MACEs) at the time of entry. The mean follow-up duration of all the subjects was 2716 ± 1621 days (102–7483 days). New LREs (hepatocellular carcinoma (HCC) (n = 8), decompensation (n = 11), bleeding varices (n = 8)) developed in 18 patients. Twenty-four and twelve patients developed extrahepatic cancers and MACEs, respectively. The median FIB-4 index was 1.255; we divided our cohort into two groups according to this (FIB4 Low, FIB4 Hi). The incidence of HCC tended to be higher in FIB4 Hi (n = 7) than in FIB4 Low (n = 1). The incidence of LREs was significantly higher in FIB4 Hi (n = 17) than in FIB4 Low (n = 1). The incidence of extrahepatic cancers was significantly higher in FIB4 Hi (n = 20) than in FIB4 Low (n = 4); the incidence of MACEs was also significantly higher in FIB4 Hi (n = 10) than in FIB4 Low (n = 2). The FIB-4 index is a useful biomarker for predicting not only LREs but also extrahepatic cancers and MACEs.