Abstract
Introduction: Advanced hepatic fibrosis is an essential prognostic indicator in patients with fatty liver disease, including those with non-alcoholic fatty liver disease.
Objective: The present study aimed to evaluate the identification of patients with advanced hepatic fibrosis in individuals who underwent abdominal ultrasonography during a complete medical checkup.
Patients and Methods: Among 1141 individuals who underwent abdominal ultrasonography during a complete medical checkup between January and December 2018, the FIB-4 index (calculated from ALT and AST levels, platelet count, and age; the severity of hepatic fibrosis was categorized according to scores of <1.3, 1.3–2.66, and ≥2.67) was used to identify patients with advanced hepatic fibrosis, and factors related to advanced hepatic fibrosis and the relationship between advanced hepatic fibrosis and ALT levels were examined.
Results: Overall, 42 patients with advanced hepatic fibrosis were identified (3.7%), and factors associated with advanced hepatic fibrosis included male sex, fatty liver, HbA1c of >6.5%, and lifestyle-related diseases such as hypertension. Advanced hepatic fibrosis was not associated with ALT levels, with 26.2% of patients with advanced hepatic fibrosis exhibiting ALT levels of <51 IU/L, suggesting that abnormalities are not identified during the checkup.
Conclusion: ALT levels alone are insufficient in identifying patients with advanced hepatic fibrosis among those with fatty liver disease. Therefore, simple and non-invasive diagnostic methods, such as the FIB-4 index, should be used during routine medical checkups to diagnose hepatic fibrosis.
