Practical diagnosis of cirrhosis in non-alcoholic fatty liver disease using currently available non-invasive fibrosis tests

Jérôme Boursier (), Marine Roux, Charlotte Costentin, Julien Chaigneau, Céline Fournier-Poizat, Aldo Trylesinski, Clémence M. Canivet, Sophie Michalak, Brigitte Bail, Valérie Paradis, Pierre Bedossa, Nathalie Sturm, Victor Ledinghen and Philip N. Newsome
Additional contact information
Jérôme Boursier: Angers University Hospital
Marine Roux: Angers University
Charlotte Costentin: Clinique Universitaire d’Hépato-gastroentérologie, CHU Grenoble Alpes
Julien Chaigneau: Angers University
Céline Fournier-Poizat: Echosens
Aldo Trylesinski: AdvanzPharma
Clémence M. Canivet: Angers University Hospital
Sophie Michalak: Angers University
Brigitte Bail: Bordeaux University Hospital
Valérie Paradis: Beaujon Hospital Paris Diderot University
Pierre Bedossa: Beaujon Hospital Paris Diderot University
Nathalie Sturm: CHU Grenoble Alpes
Victor Ledinghen: INSERM, Université de Bordeaux
Philip N. Newsome: Birmingham Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust

Nature Communications, 2023, vol. 14, issue 1, 1-11

Abstract: Abstract Unlike for advanced liver fibrosis, the practical rules for the early non-invasive diagnosis of cirrhosis in NAFLD remain not well defined. Here, we report the derivation and validation of a stepwise diagnostic algorithm in 1568 patients with NAFLD and liver biopsy coming from four independent cohorts. The study algorithm, using first the elastography-based tests Agile3+ and Agile4 and then the specialized blood tests FibroMeterV3G and CirrhoMeterV3G, provides stratification in four groups, the last of which is enriched in cirrhosis (71% prevalence in the validation set). A risk prediction chart is also derived to allow estimation of the individual probability of cirrhosis. The predicted risk shows excellent calibration in the validation set, and mean difference with perfect prediction is only −2.9%. These tools improve the personalized non-invasive diagnosis of cirrhosis in NAFLD.

Date: 2023
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DOI: 10.1038/s41467-023-40328-4

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