Abstract
A reliable and inexpensive noninvasive marker of hepatic fibrosis is required in patients with nonalcoholic fatty liver disease (NAFLD). FIB4 index (based on age, aspartate aminotransferase [AST] and alanine aminotransferase [ALT] levels, and platelet counts) is expected to be useful for evaluating hepatic fibrosis. We examined the distribution of FIB4 index in Japanese subjects with NAFLD which were diagnosed by ultrasonography at health checkups. Advanced fibrosis was defined as stage 3-4 fibrosis. FIB4 index was assessed as: age (yr) ×AST (IU/L)/(platelet count (109/L) ×√ALT (IU/L)). After 346 patients with alcohol consumption more than 20 g/day, positivity of HBsAg and/or HCV Ab, or incomplete data were excluded, 4130 patients who were diagnosed with NAFLD were enrolled. Of them, 3277 (79.3%) patients showed a FIB4 index below the proposed low cut-off index (COI) (<1.30), and 37 (0.9%) above the high COI (>2.67). Implementation of the FIB4 index in the Japanese population with NAFLD would avoid approximately 80% of liver biopsies.
