Systematic review and meta‐analysis: non‐invasive detection of non‐alcoholic fatty liver disease related fibrosis in the obese
Summary Background Non‐alcoholic fatty liver disease (NAFLD) is a significant disease burden in obesity. Liver fibrosis is an important prognostic factor in NAFLD, and detection is vital. The pathophysiological changes of obesity can alter the accuracy of non‐invasive NAFLD tests. We aimed to review...
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| Veröffentlicht in: | Obesity reviews 2018-02, Vol.19 (2), p.281-294 |
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| creator | Ooi, G. J. Mgaieth, S. Eslick, G. D. Burton, P. R. Kemp, W. W. Roberts, S. K. Brown, W. A. |
| description | Summary
Background
Non‐alcoholic fatty liver disease (NAFLD) is a significant disease burden in obesity. Liver fibrosis is an important prognostic factor in NAFLD, and detection is vital. The pathophysiological changes of obesity can alter the accuracy of non‐invasive NAFLD tests. We aimed to review current evidence for common non‐invasive tests for NAFLD‐related fibrosis in obesity.
Methods
We systematically searched for studies assessing the diagnostic accuracy of 11 biomarker panels and elastography techniques for NAFLD‐related fibrosis in obesity. Meta‐analyses were performed where possible.
Results
Thirty‐eight studies were identified assessing the selected tests in obese populations. Simple biomarker panels (e.g. NAFLD fibrosis score) were the most validated. Evidence showed better accuracy of complex biomarker panels (NAFLD fibrosis score: summary receiver operator characteristic [SROC] 0.795–0.813 vs. enhanced liver fibrosis: SROC 0.962); however, these were poorly validated in obesity. Elastography techniques were better studied and had high diagnostic accuracy (transient elastography: SROC 0.859; magnetic resonance elastography: SROC 0.965) but were limited by BMI‐dependent failure. Limited evidence was found to validate the accuracy of any test in exclusively obese populations.
Conclusion
In obese subjects, complex biomarker panels and elastography have been reasonable to good accuracy for NAFLD‐related fibrosis; however, these methods have not been well validated. Further study in this high‐risk population is needed. |
| doi_str_mv | 10.1111/obr.12628 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1962426038</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1962426038</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4548-821ae010845803ca67f07d8ffb9624fb42c52fe569dc745c977440c89ac3469b3</originalsourceid><addsrcrecordid>eNp1kUtqHDEQhoVJ8CtZ-AJGkI29GFtSq_XIzjZ5gcHgJJBdo1aXsIy65UiaMb3LIgfIGXOSaDITLwKuTZXQxwdVP0JHlJzRWuexT2eUCaZ20D7lQi6k0t9ePM2K7qGDnO8JoVI3dBftMU2plqzdRz8_z7nAaIq3OMHKwyM204BHKOb3j19mMmHOPr_FU5zq208rk_0K8AAFbPFxwtFt_0yw8S6G6nGmlBmHyiU8-AwmQ3UHU2DAzvcpViP2Ey53gGMPGV6hl86EDK-3_RB9ff_uy9XHxfXNh09XF9cLy1uuFopRA4QSxVtFGmuEdEQOyrleC8Zdz5ltmYNW6MFK3lotJefEKm1sw4Xum0N0svE-pPh9Cbl0o88WQjATxGXu6NrDBGlURd_8h97HZarnWFNKMCYF55U63VC2LpUTuO4h-dGkuaOkW0fT1Wi6v9FU9nhrXPYjDE_kvywqcL4BHn2A-XlTd3N5u1H-AWdcnGA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1986227644</pqid></control><display><type>article</type><title>Systematic review and meta‐analysis: non‐invasive detection of non‐alcoholic fatty liver disease related fibrosis in the obese</title><source>Wiley Online Library - AutoHoldings Journals</source><source>MEDLINE</source><creator>Ooi, G. J. ; Mgaieth, S. ; Eslick, G. D. ; Burton, P. R. ; Kemp, W. W. ; Roberts, S. K. ; Brown, W. A.</creator><creatorcontrib>Ooi, G. J. ; Mgaieth, S. ; Eslick, G. D. ; Burton, P. R. ; Kemp, W. W. ; Roberts, S. K. ; Brown, W. A.</creatorcontrib><description>Summary
Background
Non‐alcoholic fatty liver disease (NAFLD) is a significant disease burden in obesity. Liver fibrosis is an important prognostic factor in NAFLD, and detection is vital. The pathophysiological changes of obesity can alter the accuracy of non‐invasive NAFLD tests. We aimed to review current evidence for common non‐invasive tests for NAFLD‐related fibrosis in obesity.
Methods
We systematically searched for studies assessing the diagnostic accuracy of 11 biomarker panels and elastography techniques for NAFLD‐related fibrosis in obesity. Meta‐analyses were performed where possible.
Results
Thirty‐eight studies were identified assessing the selected tests in obese populations. Simple biomarker panels (e.g. NAFLD fibrosis score) were the most validated. Evidence showed better accuracy of complex biomarker panels (NAFLD fibrosis score: summary receiver operator characteristic [SROC] 0.795–0.813 vs. enhanced liver fibrosis: SROC 0.962); however, these were poorly validated in obesity. Elastography techniques were better studied and had high diagnostic accuracy (transient elastography: SROC 0.859; magnetic resonance elastography: SROC 0.965) but were limited by BMI‐dependent failure. Limited evidence was found to validate the accuracy of any test in exclusively obese populations.
Conclusion
In obese subjects, complex biomarker panels and elastography have been reasonable to good accuracy for NAFLD‐related fibrosis; however, these methods have not been well validated. Further study in this high‐risk population is needed.</description><identifier>ISSN: 1467-7881</identifier><identifier>EISSN: 1467-789X</identifier><identifier>DOI: 10.1111/obr.12628</identifier><identifier>PMID: 29119725</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Accuracy ; Biomarkers ; Biomarkers - metabolism ; Body mass ; Diagnostic systems ; Disease Progression ; Elasticity Imaging Techniques ; Elastography ; Fatty liver ; Fibrosis ; Humans ; Liver ; Liver Cirrhosis - diagnosis ; Liver Cirrhosis - etiology ; Liver Cirrhosis - physiopathology ; Liver diseases ; liver fibrosis ; Magnetic resonance ; Meta-analysis ; Non-alcoholic Fatty Liver Disease - complications ; Non-alcoholic Fatty Liver Disease - diagnosis ; Non-alcoholic Fatty Liver Disease - physiopathology ; non‐alcoholic fatty liver disease ; Obesity ; Obesity - complications ; Obesity - physiopathology ; Panels ; Population studies ; Populations ; Reproducibility of Results ; Risk Factors ; Sensitivity and Specificity ; Systematic review</subject><ispartof>Obesity reviews, 2018-02, Vol.19 (2), p.281-294</ispartof><rights>2017 World Obesity Federation</rights><rights>2017 World Obesity Federation.</rights><rights>2018 World Obesity Federation</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4548-821ae010845803ca67f07d8ffb9624fb42c52fe569dc745c977440c89ac3469b3</citedby><cites>FETCH-LOGICAL-c4548-821ae010845803ca67f07d8ffb9624fb42c52fe569dc745c977440c89ac3469b3</cites><orcidid>0000-0002-4540-408X</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%2Fobr.12628$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fobr.12628$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27922,27923,45572,45573</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29119725$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ooi, G. J.</creatorcontrib><creatorcontrib>Mgaieth, S.</creatorcontrib><creatorcontrib>Eslick, G. D.</creatorcontrib><creatorcontrib>Burton, P. R.</creatorcontrib><creatorcontrib>Kemp, W. W.</creatorcontrib><creatorcontrib>Roberts, S. K.</creatorcontrib><creatorcontrib>Brown, W. A.</creatorcontrib><title>Systematic review and meta‐analysis: non‐invasive detection of non‐alcoholic fatty liver disease related fibrosis in the obese</title><title>Obesity reviews</title><addtitle>Obes Rev</addtitle><description>Summary
Background
Non‐alcoholic fatty liver disease (NAFLD) is a significant disease burden in obesity. Liver fibrosis is an important prognostic factor in NAFLD, and detection is vital. The pathophysiological changes of obesity can alter the accuracy of non‐invasive NAFLD tests. We aimed to review current evidence for common non‐invasive tests for NAFLD‐related fibrosis in obesity.
Methods
We systematically searched for studies assessing the diagnostic accuracy of 11 biomarker panels and elastography techniques for NAFLD‐related fibrosis in obesity. Meta‐analyses were performed where possible.
Results
Thirty‐eight studies were identified assessing the selected tests in obese populations. Simple biomarker panels (e.g. NAFLD fibrosis score) were the most validated. Evidence showed better accuracy of complex biomarker panels (NAFLD fibrosis score: summary receiver operator characteristic [SROC] 0.795–0.813 vs. enhanced liver fibrosis: SROC 0.962); however, these were poorly validated in obesity. Elastography techniques were better studied and had high diagnostic accuracy (transient elastography: SROC 0.859; magnetic resonance elastography: SROC 0.965) but were limited by BMI‐dependent failure. Limited evidence was found to validate the accuracy of any test in exclusively obese populations.
Conclusion
In obese subjects, complex biomarker panels and elastography have been reasonable to good accuracy for NAFLD‐related fibrosis; however, these methods have not been well validated. Further study in this high‐risk population is needed.</description><subject>Accuracy</subject><subject>Biomarkers</subject><subject>Biomarkers - metabolism</subject><subject>Body mass</subject><subject>Diagnostic systems</subject><subject>Disease Progression</subject><subject>Elasticity Imaging Techniques</subject><subject>Elastography</subject><subject>Fatty liver</subject><subject>Fibrosis</subject><subject>Humans</subject><subject>Liver</subject><subject>Liver Cirrhosis - diagnosis</subject><subject>Liver Cirrhosis - etiology</subject><subject>Liver Cirrhosis - physiopathology</subject><subject>Liver diseases</subject><subject>liver fibrosis</subject><subject>Magnetic resonance</subject><subject>Meta-analysis</subject><subject>Non-alcoholic Fatty Liver Disease - complications</subject><subject>Non-alcoholic Fatty Liver Disease - diagnosis</subject><subject>Non-alcoholic Fatty Liver Disease - physiopathology</subject><subject>non‐alcoholic fatty liver disease</subject><subject>Obesity</subject><subject>Obesity - complications</subject><subject>Obesity - physiopathology</subject><subject>Panels</subject><subject>Population studies</subject><subject>Populations</subject><subject>Reproducibility of Results</subject><subject>Risk Factors</subject><subject>Sensitivity and Specificity</subject><subject>Systematic review</subject><issn>1467-7881</issn><issn>1467-789X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUtqHDEQhoVJ8CtZ-AJGkI29GFtSq_XIzjZ5gcHgJJBdo1aXsIy65UiaMb3LIgfIGXOSaDITLwKuTZXQxwdVP0JHlJzRWuexT2eUCaZ20D7lQi6k0t9ePM2K7qGDnO8JoVI3dBftMU2plqzdRz8_z7nAaIq3OMHKwyM204BHKOb3j19mMmHOPr_FU5zq208rk_0K8AAFbPFxwtFt_0yw8S6G6nGmlBmHyiU8-AwmQ3UHU2DAzvcpViP2Ey53gGMPGV6hl86EDK-3_RB9ff_uy9XHxfXNh09XF9cLy1uuFopRA4QSxVtFGmuEdEQOyrleC8Zdz5ltmYNW6MFK3lotJefEKm1sw4Xum0N0svE-pPh9Cbl0o88WQjATxGXu6NrDBGlURd_8h97HZarnWFNKMCYF55U63VC2LpUTuO4h-dGkuaOkW0fT1Wi6v9FU9nhrXPYjDE_kvywqcL4BHn2A-XlTd3N5u1H-AWdcnGA</recordid><startdate>201802</startdate><enddate>201802</enddate><creator>Ooi, G. J.</creator><creator>Mgaieth, S.</creator><creator>Eslick, G. D.</creator><creator>Burton, P. R.</creator><creator>Kemp, W. W.</creator><creator>Roberts, S. K.</creator><creator>Brown, W. A.</creator><general>Wiley Subscription Services, Inc</general><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>7T2</scope><scope>7TS</scope><scope>C1K</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4540-408X</orcidid></search><sort><creationdate>201802</creationdate><title>Systematic review and meta‐analysis: non‐invasive detection of non‐alcoholic fatty liver disease related fibrosis in the obese</title><author>Ooi, G. J. ; Mgaieth, S. ; Eslick, G. D. ; Burton, P. R. ; Kemp, W. W. ; Roberts, S. K. ; Brown, W. A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4548-821ae010845803ca67f07d8ffb9624fb42c52fe569dc745c977440c89ac3469b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Accuracy</topic><topic>Biomarkers</topic><topic>Biomarkers - metabolism</topic><topic>Body mass</topic><topic>Diagnostic systems</topic><topic>Disease Progression</topic><topic>Elasticity Imaging Techniques</topic><topic>Elastography</topic><topic>Fatty liver</topic><topic>Fibrosis</topic><topic>Humans</topic><topic>Liver</topic><topic>Liver Cirrhosis - diagnosis</topic><topic>Liver Cirrhosis - etiology</topic><topic>Liver Cirrhosis - physiopathology</topic><topic>Liver diseases</topic><topic>liver fibrosis</topic><topic>Magnetic resonance</topic><topic>Meta-analysis</topic><topic>Non-alcoholic Fatty Liver Disease - complications</topic><topic>Non-alcoholic Fatty Liver Disease - diagnosis</topic><topic>Non-alcoholic Fatty Liver Disease - physiopathology</topic><topic>non‐alcoholic fatty liver disease</topic><topic>Obesity</topic><topic>Obesity - complications</topic><topic>Obesity - physiopathology</topic><topic>Panels</topic><topic>Population studies</topic><topic>Populations</topic><topic>Reproducibility of Results</topic><topic>Risk Factors</topic><topic>Sensitivity and Specificity</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ooi, G. J.</creatorcontrib><creatorcontrib>Mgaieth, S.</creatorcontrib><creatorcontrib>Eslick, G. D.</creatorcontrib><creatorcontrib>Burton, P. R.</creatorcontrib><creatorcontrib>Kemp, W. W.</creatorcontrib><creatorcontrib>Roberts, S. K.</creatorcontrib><creatorcontrib>Brown, W. 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>Health and Safety Science Abstracts (Full archive)</collection><collection>Physical Education Index</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Obesity reviews</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ooi, G. J.</au><au>Mgaieth, S.</au><au>Eslick, G. D.</au><au>Burton, P. R.</au><au>Kemp, W. W.</au><au>Roberts, S. K.</au><au>Brown, W. A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Systematic review and meta‐analysis: non‐invasive detection of non‐alcoholic fatty liver disease related fibrosis in the obese</atitle><jtitle>Obesity reviews</jtitle><addtitle>Obes Rev</addtitle><date>2018-02</date><risdate>2018</risdate><volume>19</volume><issue>2</issue><spage>281</spage><epage>294</epage><pages>281-294</pages><issn>1467-7881</issn><eissn>1467-789X</eissn><abstract>Summary
Background
Non‐alcoholic fatty liver disease (NAFLD) is a significant disease burden in obesity. Liver fibrosis is an important prognostic factor in NAFLD, and detection is vital. The pathophysiological changes of obesity can alter the accuracy of non‐invasive NAFLD tests. We aimed to review current evidence for common non‐invasive tests for NAFLD‐related fibrosis in obesity.
Methods
We systematically searched for studies assessing the diagnostic accuracy of 11 biomarker panels and elastography techniques for NAFLD‐related fibrosis in obesity. Meta‐analyses were performed where possible.
Results
Thirty‐eight studies were identified assessing the selected tests in obese populations. Simple biomarker panels (e.g. NAFLD fibrosis score) were the most validated. Evidence showed better accuracy of complex biomarker panels (NAFLD fibrosis score: summary receiver operator characteristic [SROC] 0.795–0.813 vs. enhanced liver fibrosis: SROC 0.962); however, these were poorly validated in obesity. Elastography techniques were better studied and had high diagnostic accuracy (transient elastography: SROC 0.859; magnetic resonance elastography: SROC 0.965) but were limited by BMI‐dependent failure. Limited evidence was found to validate the accuracy of any test in exclusively obese populations.
Conclusion
In obese subjects, complex biomarker panels and elastography have been reasonable to good accuracy for NAFLD‐related fibrosis; however, these methods have not been well validated. Further study in this high‐risk population is needed.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>29119725</pmid><doi>10.1111/obr.12628</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-4540-408X</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley Online Library - AutoHoldings Journals; MEDLINE |
| subjects | Accuracy Biomarkers Biomarkers - metabolism Body mass Diagnostic systems Disease Progression Elasticity Imaging Techniques Elastography Fatty liver Fibrosis Humans Liver Liver Cirrhosis - diagnosis Liver Cirrhosis - etiology Liver Cirrhosis - physiopathology Liver diseases liver fibrosis Magnetic resonance Meta-analysis Non-alcoholic Fatty Liver Disease - complications Non-alcoholic Fatty Liver Disease - diagnosis Non-alcoholic Fatty Liver Disease - physiopathology non‐alcoholic fatty liver disease Obesity Obesity - complications Obesity - physiopathology Panels Population studies Populations Reproducibility of Results Risk Factors Sensitivity and Specificity Systematic review |
| title | Systematic review and meta‐analysis: non‐invasive detection of non‐alcoholic fatty liver disease related fibrosis in the obese |
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