Distribution of FIB4 Index in Japanese Nonalcoholic Fatty Liver Disease Population: a Multi-center Study

抄録

The FIB4 index (based on age, AST and ALT levels, and platelet counts) is expected to be useful for evaluating hepatic fibrosis in patients with not only viral hepatitis but also nonalcoholic fatty liver disease (NAFLD). We investigated the FIB4 index in a large Japanese population with NAFLD undergoing health check-ups to evaluate the prevalence of severe fibrosis in NAFLD. We recruited a total of 5,410 people with NAFLD receiving health check-ups from five centers in Japan. The FIB4 index was assessed as: age (years)×AST (IU/L)/(platelet count (10⁹/L)×√ALT (IU/L)). Participants were divided into 3 groups according to the proposed cut-off points (<1.45, 1.45–3.25, >3.25). The FIB4 index in the overall study population was 1.027±0.549. Of the 5,410 people with NAFLD, 4,729 (87.4%) had an FIB4 index below the low cut-off point (<1.45), 654 (12.1%) had an FIB4 index in the indeterminate range (1.45–3.25) and 27 (0.5%) had an FIB4 index above the high cut-off point (>3.25). In conclusion, most (87%) Japanese people with NAFLD are unlikely to have severe fibrosis, while in the remaining 13% severe fibrosis cannot be ruled out so such people should be considered for referral to hepatologists or liver biopsies should be conducted on them.