一般人群中长期肝脏相关结果的风险评分的开发,验证和预后评估:多队列研究
Miquel Serra-Burriel1, Adrià Juanola2, Feliu Serra-Burriel3
1Epidemiology, Statistics, and Prevention Institute, University of Zurich, Zurich, Switzerland.
Lancet (London, England)
|August 12, 2023
概括
一个新的LiverRisk评分识别了患肝病进展的高风险个体. 通过常规实验室检测,这种简单的评分可以预测肝纤维化和未来肝脏相关的结果,从而使早期干预和预防性护理成为可能.
科学领域:
- 肝病学和胃肠病学
- 预防医学
- 生物统计学和流行病学
背景情况:
- 肝硬化是全球主要的死亡原因,
- 目前用于早期识别有风险的个体的工具有限, 阻碍及时干预.
- 开发新的评分对于识别未来肝脏相关结果的个体至关重要.
研究的目的:
- 开发和验证一个新的评分, LiverRisk,用于识别患有肝纤维化和相关结果的个体.
- 评估评分是否能够将个体分为不同的风险组,以积极管理肝脏健康.
主要方法:
- 使用年龄,性别和六个实验室变量,从前性国际队列 (n=6357) 获得肝脏风险得分.
- 过渡性弹性扫描评估了肝纤维化;风险分层包括最小,低,中和高风险组.
- 在两个队列 (n=4370,n=3999) 的外部验证和在英国生物库评估的预后值 (中位数为12年的随访).
主要成果:
- 肝脏风险得分准确预测肝硬度 (AUC 0. 83),超过FIB-4 (AUC 0. 68).
- 该评分有效地确定了肝脏死亡,住院和癌症的风险.
- 与风险较小的个体相比,高风险个体的肝脏相关死亡风险增加了471倍 (10年AUC为0. 90而FIB为0. 84).
结论:
- 使用简单的参数,肝脏风险得分有效预测肝脏纤维化和一般人群的未来肝脏相关结果.
- 这一分数有助于风险分层,并可能指导肝脏健康的预防策略.
- 肝脏风险为早期发现和管理肝脏疾病风险提供了有价值的工具.
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