Evaluation of Six Noninvasive Methods for the Detection of Fibrosis in Chinese Patients with Obesity and Nonalcoholic Fatty Liver Disease

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the world, and liver fibrosis has been proven to be associated with liver disease related events and total mortality. Several noninvasive methods have been developed, but whether those methods are suitable for the detection of fibrosis in Chinese patients with obesity and NAFLD has not been completely elucidated. This study aimed to compare the efficacy of fibrosis-4 (FIB-4), aspartate transaminase to platelet ratio index (APRI), modified aspartate transaminase to platelet ratio index (m-APRI), BARD (BARD (BMI (body mass index) > 28 = 1 point, AAR (aspartate aminotransferase/alanine aminotransferase) > 0.8 = 2 points, DM (diabetes mellitus) = 1 point)), NAFLD fibrosis score (NFS), and shear wave elastography (SWE) in the evaluation of the degree of liver fibrosis in Chinese patients with obesity and NAFLD.A retrospective study consisted of 100 patients. The accuracy of FIB-4, APRI, m-APRI, BARD, NFS, and SWE in the assessment of significant or advanced liver fibrosis in Chinese patients with obesity and NAFLD was compared.Weight and alanine aminotransferase (ALT) were independent risk factors for liver fibrosis. SWE, APRI, and m-APRI had significant efficiency in the diagnosis of significant fibrosis in patients with obesity and NAFLD. APRI and SWE were superior to the other methods in the diagnosis of significant and advanced liver fibrosis in patients with obesity and NAFLD. APRI and SWE showed no statistically significant difference in diagnostic efficiency.Weight and ALT are independent risk factors for liver fibrosis progression in NAFLD patients. SWE and APRI have predictive value for significant and advanced fibrosis of NAFLD in Chinese patients with obesity.