科研之友
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摘要
Nonalcoholic fatty liver disease (NAFLD) is emerging as one of the leading disorders of liver worldwide. NAFLD fibrosis score (NFS) is a noninvasive simple test for staging fibrosis in patients with NAFLD, with an acceptable diagnostic performance and extensively validated in various populations. In clinical practice, the suboptimal diagnostic accuracy however makes it clinically valuable only in excluding severe fibrosis, or in a combination with other complimentary approaches. Nevertheless, the NFS could be used as a helpful tool to monitor disease progression and to evaluate efficacy of potential therapies for NAFLD adults. This review describes the implementation of NFS in fibrosis staging and outcome predicting. The outcome prediction of NAFLD traditionally depends on baseline histology of biopsy specimen, and advanced fibrosis is best associated with overall and liver-related mortality among the individual pathologic features. Accordingly, NFS exhibits an intriguing ability for outcome prediction, including the long term mortality, hepatic and extra hepatic complications and whether liver related or not. Its merit in predication for long-term outcomes could derive substantially from its ability in fibrosis evaluation, as a moderately prognostic accuracy was replicated by FIB-4, another good noninvasive simple test for identifying liver fibrosis, in our study and others. In addition, this ability could be explained by the incorporated variables. In more detail, lower level of albumin, older age and the concomitant injury of glucometabolism, all suggest an overall poorer outcome in complications whether liver related or not for NAFLD patients. Here we propose to calculate NFS in newly diagnosed patients with NAFLD and recalculate annually to timely monitor disease progression. Nonetheless, the appropriate cutoff values of the NFS for different purposes remain to be determined.
