A simple clinical scoring system using ferritin, fasting insulin, and type IV collagen 7S for predicting steatohepatitis in nonalcoholic fatty liver disease

摘要: Liver histology is the gold standard for diagnosis of nonalcoholic steatohepatitis (NASH). Noninvasive, simple, reproducible, and reliable biomarkers are greatly needed to differentiate NASH from fatty liver disease (NAFLD). To construct a scoring system predicting NASH, 177 Japanese patients with biopsy-proven NAFLD were enrolled. validate system, 442 eight hepatology centers in Japan also In estimation group, 98 (55%) had NASH. Serum ferritin [≥200 ng/ml (female) or ≥300 ng/ml (male)], fasting insulin (≥10 μU/ml), type IV collagen 7S (≥5.0 ng/ml) selected as independent variables associated by multilogistic regression analysis. These three combined weighted sum [serum ≥200 ng/ml (male) = 1 point, ≥10 μU/ml = 1 ≥5.0 ng/ml = 2 points] form an easily calculated composite score called NAFIC score. The area under receiver operating characteristic (AUROC) curve was 0.851 group 0.782 validation group. AUROC greatest among several previously established systems detecting but severe fibrosis. can predict sufficient accuracy simplicity be considered clinical use.