KHẢO SÁT CHỈ SỐ FIB-4, NAFLD FIBROSIS SCORE Ở BỆNH NHÂN GAN NHIỄM MỠ CÓ RỐI LOẠN CHUYỂN HÓA

Abstract

Objective: To survey the FIB-4 index, NAFLD Fibrosis score (NFS) and compare these indexes with Fibroscan in patients with fatty liver with metabolic disorders (nMAFLD). Subjects and methods: Including 398 MAFLD patients examined and treated at the Department of On-demand Examination and the Center for Gastroenterology - Hepatobiliary, Bach Mai Hospital from December 2023 to June 2024. Patients were assessed for FIB-4 index, NFS and compared with fibroscan in predicting the degree of liver fibrosis. Results: As a result of our study, we selected 398 MAFLD patients who fully met standart. Causes of comorbidities with MAFLD: 55.8% alone, 23.9% with VGB, 18.1% with alcohol, 723.9% with VGC. Mean age 48.46  ± 13.12 (18- 83) years old. Male/Female ratio: 2.1:1. Assessment of liver fibrosis level by severe fibrosis and cirrhosis indexes FIB4 (9.5%), NFS (7.3%), Fibroscan (14.3%). There was a good correlation between FIB4, NFS and Fibroscan on fibrosis level according to each group of associated causes: MAFLD alone with Kappa = 0.576 and 7.4 (p<0.01) (p < 0.01); MAFLD with alcohol with Kappa = 0.657 and 0.683 (p < 0.01); MAFLD with VGB with Kappa = 0.668 và 0.537  (p < 0.01); However, MAFLD with VGC with Kappa both = 1 but not statistically significant p > 0.05. However, according to the NFS classification, there were 63 patients (15.8) whose liver fibrosis could not be determined, so it was necessary to combine another classification system. Conclusion: There is a good correlation between FIB4, NFS and Fibroscan in terms of fibrosis according to each group of associated causes with kappa > 0.6. FIB4 can replace Fibroscan, while NFS must be combined with Fibroscan to assess the degree of liver fibrosis in MAFLD patients.