Abstract
Background & aimLiver fibrosis screening in primary care population is a major public health issue. The FIB-4 index is a simple non-invasive fibrosis test combining age, transaminases, platelets count, developed for the diagnosis of advanced fibrosis. The aim of our study was to evaluate the interest of liver fibrosis screening using systematic calculation of FIB-4 in routine blood analysis.MethodsBetween December 2018 and May 2019, we conducted a prospective screening of liver fibrosis in 134 158 patients during a medical check-up including routine blood analysis. Among these patients, 29 707 had transaminases and platelets counts available and benefited from an automatic calculation of FIB-4. Results were obtained from 21 French clinical laboratories in the Bouches du Rhône region.ResultsAmong the 29 707 patients, 2161 (7.3%) had a high risk of advanced fibrosis (FIB-4>2.67). Individual investigation of patients with FIB-4>2.67 allowed to screen 1268 (1268/2161: 58.7%) patients who were not managed for any liver disease.ConclusionsThis work demonstrates the interest of FIB-4 for the screening of liver fibrosis in primary care population. Although additional clinical validation study is required to determine the utility and applicability of Fib-4 to daily practice, our study strongly supports this easy-to-implement strategy using a simple Fib-4 measure resulting from the use of available routine test results.
Highlights
Individual investigation of patients with FIB-4>2.67 allowed to screen 1268 (1268/2161: 58.7%) patients who were not managed for any liver disease
This work demonstrates the interest of FIB-4 for the screening of liver fibrosis in primary care population
Additional clinical validation study is required to determine the utility and applicability of Fib-4 to daily practice, our study strongly supports this easy-to-implement strategy using a simple Fib-4 measure resulting from the use of available routine test results
Summary
Liver fibrosis screening in primary care population is a major public health issue. Among the causes of liver fibrosis, non-alcoholic fatty liver disease (NAFLD) is highly prevalent, affecting *25% of the population and is likely to increase further because of the obesity epidemic [1, 2]. The only available data in French primary care population reported that 2.6% of patients were identified with advanced liver fibrosis (Constances Cohort) [3]. Various scoring systems/tools are available for the non-invasive assessment of liver fibrosis. Newsome et al recommend the use of FIB-4 in patients with potential NAFLD for the management of abnormal liver enzymes [11]. The UK NAFLD survey attempted to capture data on which tools are currently most widely used for non-invasive fibrosis assessment [8]. The survey indicates that primary care does not routinely perform any assessment of liver fibrosis, with only 7.9% routinely performing AST/ alanine aminotransferase (ALT) ratio in primary care. Liver fibrosis screening in primary care population is a major public health issue. The aim of our study was to evaluate the interest of liver fibrosis screening using systematic calculation of FIB-4 in routine blood analysis
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
