Serum biomarkers can predict a change in liver fibrosis 1 year after lifestyle intervention for biopsy‐proven NASH
Background & Aims The dynamic response of serum fibrosis biomarkers to histological changes within the liver following lifestyle intervention (LI) is unknown. We explored relationships between changes in serum biomarkers and liver fibrosis in NASH patients undergoing LI. Methods Paired liver bio...
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| Veröffentlicht in: | Liver international 2017-12, Vol.37 (12), p.1887-1896 |
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| container_title | Liver international |
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| creator | Vilar‐Gomez, Eduardo Calzadilla‐Bertot, Luis Friedman, Scott L. Gra‐Oramas, Bienvenido Gonzalez‐Fabian, Licet Lazo‐del Vallin, Sacha Diago, Moises Adams, Leon A. |
| description | Background & Aims
The dynamic response of serum fibrosis biomarkers to histological changes within the liver following lifestyle intervention (LI) is unknown. We explored relationships between changes in serum biomarkers and liver fibrosis in NASH patients undergoing LI.
Methods
Paired liver biopsies were performed in 261 NASH patients to assess fibrosis change after 1 year of LI. We explored the utility of serum fibrosis markers to predict changes in hepatic fibrosis and developed and internally validated a model for predicting fibrosis improvement in patients with baseline fibrosis.
Results
Regression, stabilization and worsening of fibrosis occurred in 51 (20%), 165 (63%) and 45 (17%) patients respectively. By multivariable analysis, change in HbA1c (OR, 0.39, P |
| doi_str_mv | 10.1111/liv.13480 |
| format | Article |
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The dynamic response of serum fibrosis biomarkers to histological changes within the liver following lifestyle intervention (LI) is unknown. We explored relationships between changes in serum biomarkers and liver fibrosis in NASH patients undergoing LI.
Methods
Paired liver biopsies were performed in 261 NASH patients to assess fibrosis change after 1 year of LI. We explored the utility of serum fibrosis markers to predict changes in hepatic fibrosis and developed and internally validated a model for predicting fibrosis improvement in patients with baseline fibrosis.
Results
Regression, stabilization and worsening of fibrosis occurred in 51 (20%), 165 (63%) and 45 (17%) patients respectively. By multivariable analysis, change in HbA1c (OR, 0.39, P<.01), platelets (OR, 1.22, P<.01) and NFS (OR, 0.27, P<.01), as well as ALT normalization (OR, 9.7, P<.01) were independently associated with fibrosis improvement, whereas change in platelets (OR, 0.96, P<.01), and NFS (OR, 1.8, P<.01) as well as ALT normalization (OR, 0.21, P<.01) were linked to fibrosis progression. A model, including change in HbA1c, platelet and ALT normalization, was significantly more accurate (AUC of 0.96, 95% CI, l0.94‐0.99) than NFS, FIB‐4 and APRI for predicting fibrosis improvement. Using a threshold of ≥0.497, positive and negative predictive values were 94% (95% CI, 84‐98) and 91% (95% CI, 81‐96) respectively.
Conclusions
Change in NFS, platelets and ALT normalization are associated with change in liver fibrosis after 1 year of LI. A model including change in HbA1c, platelet and ALT normalization discriminated patients with fibrosis improvement significantly better than other biomarkers.]]></description><identifier>ISSN: 1478-3223</identifier><identifier>EISSN: 1478-3231</identifier><identifier>DOI: 10.1111/liv.13480</identifier><identifier>PMID: 28544769</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Biomarkers - blood ; Cohort Studies ; Disease Progression ; Female ; Fibrosis ; fibrosis regression ; Humans ; lifestyle interventions ; Liver - pathology ; Liver Cirrhosis - blood ; Liver Cirrhosis - etiology ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease - blood ; Non-alcoholic Fatty Liver Disease - complications ; Non-alcoholic Fatty Liver Disease - pathology ; Non-alcoholic Fatty Liver Disease - therapy ; nonalcoholic steatohepatitis ; noninvasive biomarkers ; Risk Reduction Behavior</subject><ispartof>Liver international, 2017-12, Vol.37 (12), p.1887-1896</ispartof><rights>2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3910-faa68bbf26f81bb326405ad4fcfc2404a85ab109c95643205a7a67dba3a1226a3</citedby><cites>FETCH-LOGICAL-c3910-faa68bbf26f81bb326405ad4fcfc2404a85ab109c95643205a7a67dba3a1226a3</cites><orcidid>0000-0003-1435-4013</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fliv.13480$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fliv.13480$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28544769$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vilar‐Gomez, Eduardo</creatorcontrib><creatorcontrib>Calzadilla‐Bertot, Luis</creatorcontrib><creatorcontrib>Friedman, Scott L.</creatorcontrib><creatorcontrib>Gra‐Oramas, Bienvenido</creatorcontrib><creatorcontrib>Gonzalez‐Fabian, Licet</creatorcontrib><creatorcontrib>Lazo‐del Vallin, Sacha</creatorcontrib><creatorcontrib>Diago, Moises</creatorcontrib><creatorcontrib>Adams, Leon A.</creatorcontrib><title>Serum biomarkers can predict a change in liver fibrosis 1 year after lifestyle intervention for biopsy‐proven NASH</title><title>Liver international</title><addtitle>Liver Int</addtitle><description><![CDATA[Background & Aims
The dynamic response of serum fibrosis biomarkers to histological changes within the liver following lifestyle intervention (LI) is unknown. We explored relationships between changes in serum biomarkers and liver fibrosis in NASH patients undergoing LI.
Methods
Paired liver biopsies were performed in 261 NASH patients to assess fibrosis change after 1 year of LI. We explored the utility of serum fibrosis markers to predict changes in hepatic fibrosis and developed and internally validated a model for predicting fibrosis improvement in patients with baseline fibrosis.
Results
Regression, stabilization and worsening of fibrosis occurred in 51 (20%), 165 (63%) and 45 (17%) patients respectively. By multivariable analysis, change in HbA1c (OR, 0.39, P<.01), platelets (OR, 1.22, P<.01) and NFS (OR, 0.27, P<.01), as well as ALT normalization (OR, 9.7, P<.01) were independently associated with fibrosis improvement, whereas change in platelets (OR, 0.96, P<.01), and NFS (OR, 1.8, P<.01) as well as ALT normalization (OR, 0.21, P<.01) were linked to fibrosis progression. A model, including change in HbA1c, platelet and ALT normalization, was significantly more accurate (AUC of 0.96, 95% CI, l0.94‐0.99) than NFS, FIB‐4 and APRI for predicting fibrosis improvement. Using a threshold of ≥0.497, positive and negative predictive values were 94% (95% CI, 84‐98) and 91% (95% CI, 81‐96) respectively.
Conclusions
Change in NFS, platelets and ALT normalization are associated with change in liver fibrosis after 1 year of LI. A model including change in HbA1c, platelet and ALT normalization discriminated patients with fibrosis improvement significantly better than other biomarkers.]]></description><subject>Adult</subject><subject>Biomarkers - blood</subject><subject>Cohort Studies</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Fibrosis</subject><subject>fibrosis regression</subject><subject>Humans</subject><subject>lifestyle interventions</subject><subject>Liver - pathology</subject><subject>Liver Cirrhosis - blood</subject><subject>Liver Cirrhosis - etiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Non-alcoholic Fatty Liver Disease - blood</subject><subject>Non-alcoholic Fatty Liver Disease - complications</subject><subject>Non-alcoholic Fatty Liver Disease - pathology</subject><subject>Non-alcoholic Fatty Liver Disease - therapy</subject><subject>nonalcoholic steatohepatitis</subject><subject>noninvasive biomarkers</subject><subject>Risk Reduction Behavior</subject><issn>1478-3223</issn><issn>1478-3231</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kE9OAjEUhxujUUQXXsB0qQug_6bMLAlRISG6QN1OXkur1WEGWwYzO4_gETyLR_EkFkF3dtO-1y-_134InVDSpXH1CrfqUi5SsoNaVPTTDmec7v6dGT9AhyE8EUKzLKH76ICliRB9mbVQPTW-nmPlqjn4Z-MD1lDihTczp5cYsH6E8sFgV-I4xHhsnfJVcAHTz4_GgMdgl7FdOGvCsinWZKxXply6qsS28uvoRWi-3t4Xvop9fD2Yjo7QnoUimOPt3kZ3lxe3w1FncnM1Hg4mHc0zSjoWQKZKWSZtSpXiTAqSwExYbTUTRECagKIk01kiBWfxrg-yP1PAgTImgbfR2SY3zn6p4wvzuQvaFAWUpqpDTjPCqWSSkIieb1Ad_xe8sfnCu-ikySnJ15bzKCD_sRzZ021sreZm9kf-ao1AbwO8usI0_yflk_H9JvIblmGJqA</recordid><startdate>201712</startdate><enddate>201712</enddate><creator>Vilar‐Gomez, Eduardo</creator><creator>Calzadilla‐Bertot, Luis</creator><creator>Friedman, Scott L.</creator><creator>Gra‐Oramas, Bienvenido</creator><creator>Gonzalez‐Fabian, Licet</creator><creator>Lazo‐del Vallin, Sacha</creator><creator>Diago, Moises</creator><creator>Adams, Leon A.</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1435-4013</orcidid></search><sort><creationdate>201712</creationdate><title>Serum biomarkers can predict a change in liver fibrosis 1 year after lifestyle intervention for biopsy‐proven NASH</title><author>Vilar‐Gomez, Eduardo ; Calzadilla‐Bertot, Luis ; Friedman, Scott L. ; Gra‐Oramas, Bienvenido ; Gonzalez‐Fabian, Licet ; Lazo‐del Vallin, Sacha ; Diago, Moises ; Adams, Leon A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3910-faa68bbf26f81bb326405ad4fcfc2404a85ab109c95643205a7a67dba3a1226a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Biomarkers - blood</topic><topic>Cohort Studies</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Fibrosis</topic><topic>fibrosis regression</topic><topic>Humans</topic><topic>lifestyle interventions</topic><topic>Liver - pathology</topic><topic>Liver Cirrhosis - blood</topic><topic>Liver Cirrhosis - etiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Non-alcoholic Fatty Liver Disease - blood</topic><topic>Non-alcoholic Fatty Liver Disease - complications</topic><topic>Non-alcoholic Fatty Liver Disease - pathology</topic><topic>Non-alcoholic Fatty Liver Disease - therapy</topic><topic>nonalcoholic steatohepatitis</topic><topic>noninvasive biomarkers</topic><topic>Risk Reduction Behavior</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vilar‐Gomez, Eduardo</creatorcontrib><creatorcontrib>Calzadilla‐Bertot, Luis</creatorcontrib><creatorcontrib>Friedman, Scott L.</creatorcontrib><creatorcontrib>Gra‐Oramas, Bienvenido</creatorcontrib><creatorcontrib>Gonzalez‐Fabian, Licet</creatorcontrib><creatorcontrib>Lazo‐del Vallin, Sacha</creatorcontrib><creatorcontrib>Diago, Moises</creatorcontrib><creatorcontrib>Adams, Leon A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Liver international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vilar‐Gomez, Eduardo</au><au>Calzadilla‐Bertot, Luis</au><au>Friedman, Scott L.</au><au>Gra‐Oramas, Bienvenido</au><au>Gonzalez‐Fabian, Licet</au><au>Lazo‐del Vallin, Sacha</au><au>Diago, Moises</au><au>Adams, Leon A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Serum biomarkers can predict a change in liver fibrosis 1 year after lifestyle intervention for biopsy‐proven NASH</atitle><jtitle>Liver international</jtitle><addtitle>Liver Int</addtitle><date>2017-12</date><risdate>2017</risdate><volume>37</volume><issue>12</issue><spage>1887</spage><epage>1896</epage><pages>1887-1896</pages><issn>1478-3223</issn><eissn>1478-3231</eissn><abstract><![CDATA[Background & Aims
The dynamic response of serum fibrosis biomarkers to histological changes within the liver following lifestyle intervention (LI) is unknown. We explored relationships between changes in serum biomarkers and liver fibrosis in NASH patients undergoing LI.
Methods
Paired liver biopsies were performed in 261 NASH patients to assess fibrosis change after 1 year of LI. We explored the utility of serum fibrosis markers to predict changes in hepatic fibrosis and developed and internally validated a model for predicting fibrosis improvement in patients with baseline fibrosis.
Results
Regression, stabilization and worsening of fibrosis occurred in 51 (20%), 165 (63%) and 45 (17%) patients respectively. By multivariable analysis, change in HbA1c (OR, 0.39, P<.01), platelets (OR, 1.22, P<.01) and NFS (OR, 0.27, P<.01), as well as ALT normalization (OR, 9.7, P<.01) were independently associated with fibrosis improvement, whereas change in platelets (OR, 0.96, P<.01), and NFS (OR, 1.8, P<.01) as well as ALT normalization (OR, 0.21, P<.01) were linked to fibrosis progression. A model, including change in HbA1c, platelet and ALT normalization, was significantly more accurate (AUC of 0.96, 95% CI, l0.94‐0.99) than NFS, FIB‐4 and APRI for predicting fibrosis improvement. Using a threshold of ≥0.497, positive and negative predictive values were 94% (95% CI, 84‐98) and 91% (95% CI, 81‐96) respectively.
Conclusions
Change in NFS, platelets and ALT normalization are associated with change in liver fibrosis after 1 year of LI. A model including change in HbA1c, platelet and ALT normalization discriminated patients with fibrosis improvement significantly better than other biomarkers.]]></abstract><cop>United States</cop><pmid>28544769</pmid><doi>10.1111/liv.13480</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-1435-4013</orcidid></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Biomarkers - blood Cohort Studies Disease Progression Female Fibrosis fibrosis regression Humans lifestyle interventions Liver - pathology Liver Cirrhosis - blood Liver Cirrhosis - etiology Male Middle Aged Non-alcoholic Fatty Liver Disease - blood Non-alcoholic Fatty Liver Disease - complications Non-alcoholic Fatty Liver Disease - pathology Non-alcoholic Fatty Liver Disease - therapy nonalcoholic steatohepatitis noninvasive biomarkers Risk Reduction Behavior |
| title | Serum biomarkers can predict a change in liver fibrosis 1 year after lifestyle intervention for biopsy‐proven NASH |
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