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논문 기본 정보

자료유형
학술저널
저자정보
Moon Sang Yi (Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea) Baek Yang Hyun (Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.) Jang Se Young (Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea) Jun Dae Won (Department of Internal Medicine, Hanyang University College of Medicine, Seoul, KoreaHanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, Korea) Yoon Ki Tae (Department of Internal Medicine, Pusan National University College of Medicine, Yangsan, KoreaLiver Center, Pusan National University Yangsan Hospital, Yangsan, Korea) Cho Young Youn (Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea.) Jo Hoon Gil (Division of Gastroenterology, Department of Internal Medicine, Wonkwang University Hospital, Wonkwang University College of Medicine, Iksan, Korea) Jo Ae Jeong (Department of Information Statistics, Andong National University, Andong, Korea)
저널정보
거트앤리버 발행위원회 Gut and Liver Gut and Liver Vol.18 No.2
발행연도
2024.3
수록면
283 - 293 (11page)
DOI
10.5009/gnl230128

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Background/Aims: Noninvasive methods have become increasingly critical in the diagnosis of fibrosis in chronic liver diseases. Herein, we compared the diagnostic performance of serum Mac2 binding protein glycosylation isomer (M2BPGi) and other serological panels for fibrosis in patients with nonalcoholic fatty liver disease (NAFLD) and proposed an improved two-step diagnostic algorithm for advanced fibrosis. Methods: We enrolled 231 patients diagnosed with NAFLD who underwent a liver biopsy. We subsequently evaluated the diagnostic performance of serological panels, including serum M2BPGi, a fibrosis index based on four factors (FIB-4), aspartate aminotransferase-to-platelet ratio index (APRI), and NAFLD fibrosis score (NFS), in predicting the stage of liver fibrosis. We then constructed a two-step algorithm to better differentiate advanced fibrosis. Results: The areas under the receiver operating characteristic curves of serum M2BPGi, FIB-4, APRI, and NFS for advanced fibrosis (≥F3) were 0.823, 0.858, 0.779, and 0.827, respectively. To reduce the performance of unnecessary liver biopsy, we propose a two-step algorithm using FIB-4 as an initial diagnostic tool and serum M2BPGi (≥0.6) as an additional diagnostic method for patients classified as intermediate (23%). Using the proposed algorithm, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 0.812, 0.814, 0.814, 0.600, and 0.927, respectively. Conclusions: Serum M2BPGi is a simple and effective test for advanced fibrosis in patients with NAFLD. Application of the two-step algorithm based on FIB-4 and M2BPGi proposed here can improve diagnostic performance and reduce unnecessary tests, making diagnosis easily accessible, especially in primary medical centers.

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