Adding readily available clinical and biochemical data on age, glucose impairment, and gamma-glutamyl transferase (gGT) levels can significantly improve 10-year prediction of severe liver disease, according to study findings published in Alimentary Pharmacology & Therapeutics.
Researchers conducted a national population cohort study and obtained relevant data from the Swedish Apolipoprotein Mortality Risk (AMORIS) cohort of 812,073 individuals who underwent routine blood testing between 1985 and 1996. They explored the possibility of improving identification of patients at risk for developing severe liver disease within 10 years beyond the commonly applied Fibrosis-4 (FIB-4) scoring system.
Of these 812,073 individuals in the AMORIS cohort, 126,925 had available FIB-4 data. After a mean follow-up of 9.3 years, approximately 630 of the 126,925 (0.5%) participants developed severe liver disease based on International Classification of Diseases codes that indicated compensated or decompensated cirrhosis, hepatocellular carcinoma (HCC), alcohol-related cirrhosis, or mortality from these conditions.
The researchers analyzed incidence of severe liver disease in the context of 24 devised subgroups based on combinations of 4 different biochemical and clinical variables: glucose, gGT, age between 35 and 65 years, and FIB-4 score.
Only 7.3% of those with high FIB-4 scores developed severe liver disease within 10 years when using this factor alone to predict risk. After adding age between 35 and 65 years, level of glucose impairment, and gGT levels to their own risk prediction model, the researchers found that 10-year incidence of severe liver disease ranged from 0.2% for people between 35 and 65 years of age with low FIB-4 scores, normal gGT levels, and no diabetes or glucose impairment to 32.1% for people between 35 and 65 with high FIB-4 scores, high gGT levels, and diabetes or glucose impairment.
Limitations of the study include the lack of generalizability of study findings to the general population, the lack of external validation of the findings, and the lack of available data on alcohol biomarkers.
“Identification of subjects at increased risk of severe liver disease in the general population using the FIB-4 score can be substantially improved by adding age and specific biomarkers commonly available in the primary care setting,” the researchers conclude.
Disclosures: This study was partially funded by industry via a research grant. Please see the original source for more information.
Hagström H, Yan J, Talbäck M, et al. Improved prediction of 10-year risk of severe liver disease in the general population using commonly available biomarkers. Aliment Pharmacol Ther. Published online December 25, 2022. doi:10.1111/apt.17374