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Multicenter Study
. 2018 Nov;53(11):1216-1224.
doi: 10.1007/s00535-018-1474-y. Epub 2018 May 9.

The novel cutoff points for the FIB4 index categorized by age increase the diagnostic accuracy in NAFLD: a multi-center study

Hiroshi Ishiba  1   2 , Yoshio Sumida  3 , Saiyu Tanaka  4 , Masato Yoneda  5 , Hideyuki Hyogo  6 , Masafumi Ono  7 , Hideki Fujii  8 , Yuichiro Eguchi  9 , Yasuaki Suzuki  10 , Masashi Yoneda  11 , Hirokazu Takahashi  9 , Takashi Nakahara  11 , Yuya Seko  2 , Kojiro Mori  4 , Kazuyuki Kanemasa  4 , Keiji Shimada  12 , Sunsuke Imai  12 , Kento Imajo  5 , Takumi Kawaguchi  13 , Atsushi Nakajima  5 , Kazuaki Chayama  11 , Toshiji Saibara  7 , Toshihide Shima  14 , Kazuma Fujimoto  9 , Takeshi Okanoue  14 , Yoshito Itoh  2 ; Japan Study Group of Non-Alcoholic Fatty Liver Disease (JSG-NAFLD)
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Multicenter Study

The novel cutoff points for the FIB4 index categorized by age increase the diagnostic accuracy in NAFLD: a multi-center study

Hiroshi Ishiba et al. J Gastroenterol. 2018 Nov.

Erratum in

Abstract

Background: The FIB4 index is clinically useful, but because its formula includes age, the appropriate cutoff point may differ by age group. Here, new FIB4 index cutoff points were validated using cohort data from 14 hepatology centers in Japan.

Methods: The FIB4 index was determined in biopsy-confirmed NAFLD patients (n = 1050) who were divided into four groups: ≤ 49, 50-59, 60-69, and ≥ 70 years. ROC analysis predicted advanced fibrosis in each age group; low and high cutoff points were defined by a sensitivity and specificity of 90%. The new and conventional cutoffs were compared for detecting advanced fibrosis.

Results: The modified low and high cutoff points were 1.05 and 1.21 in ≤ 49 years, 1.24 and 1.96 in 50-59 years, 1.88 and 3.24 in 60-69 years, and 1.95 and 4.56 in ≥ 70 years. In ≥ 60 years, the false-negative rate was increased using the modified high cutoff point, and the high cutoff point was better with the conventional cutoff point. The new proposed low and high cutoff points are 1.05 and 1.21 in ≤ 49 years, 1.24 and 1.96 in 50-59 years, 1.88 and 2.67 in 60-69 years, and 1.95 and 2.67 in ≥ 70 years; these cutoff points improved the accuracy of advanced fibrosis diagnosis.

Conclusions: FIB4 index cutoff points for predicting advanced fibrosis in NAFLD increased with age. Cutoff points modified by age improved the diagnostic accuracy of estimations of advanced liver fibrosis using the FIB4 index.

Keywords: Advanced fibrosis; Diagnostic accuracy; FIB4 index; Non-alcoholic fatty liver disease; Non-invasive fibrosis marker.

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