Time-dependent Changes in FIB4 Index in Patients with Fatty Liver Disease

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  • 脂肪肝症例における肝線維化指標FIB4 Indexの経時的変化
  • シボウ カン ショウレイ ニ オケル カン センイカ シヒョウ FIB4 Index ノ ケイジテキ ヘンカ

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Objective: To examine the effectiveness of the FIB4 index as an indicator of fibrosis in fatty liver. <br>Methods: In fatty liver patients examined several times, we calculated the FIB4 index for the initial and final examinations. Taking the cutoff point for fibrosis as 2.67, 12,059 individuals in whom the index was less than 2.67 were enrolled as the subjects of this study. The change in the FIB4 index during the period from the initial to the final examination was determined. For subjects in whom the FIB4 index had risen to 2.67 or over at the final examination, we made comparisons by gender as well as by whether the fatty liver was alcoholic or non-alcoholic. We analyzed changes in the factors of the FIB4 calculation formula (age, AST, ALT, platelet counts) as well as those in ultrasonography images. <br>Results: The FIB4 index had risen to 2.67 or above in 161 subjects (1.3%) at the final examination and in these subjects it was significantly higher than at the initial examination. There had been an increase in FIB4 index in 1.1% of subjects followed up for less than 5 years, whereas FIB4 index had increased in 1.6% of those followed up for 5 years or more and the difference between these groups was significant. There were no differences in frequencies of rises in FIB4 index between males and females or between alcoholic and non-alcoholic fatty livers. Regarding the 4 factors of the FIB4 index calculation formula, the biggest change was in AST, with the AST/ALT ratio increasing from 0.86 at the initial examination to 1.18 at the final examination. The only change in ultrasonography images observed was dullness of the hepatic margin in 3 of the 161 subjects. <br>Conclusion: The length of time required for changes in the FIB4 index and the greater change in AST suggest that it could be used as a predictive index of fibrosis.

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