用意诊断分析对2型糖尿病门诊患者的非侵入性肝检测进行前性直接比较
Thierry Poynard1,2, Olivier Deckmyn2, Valentina Peta2
1Centre de Recherche Saint-Antoine (CRSA), INSERM, Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Université, Paris, France.
Alimentary pharmacology & therapeutics
|August 29, 2023
概括
像FibroTest-T2D,TD-SWE和VCTE这样的非侵入性肝检测可以准确地确定2型糖尿病患者的纤维化阶段. 标准分析高估了VCTE的性能,强调了意图诊断方法对于可靠结果的重要性.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 诊断的准确性 诊断的准确性
- 与代谢功能障碍相关的脂肪性肝病 (MASLD)
背景情况:
- 在2型糖尿病 (T2D) 患者的非侵入性肝检测中,使用意图诊断方法进行有限的直接比较.
- MASLD的主要组织学特征,包括纤维化,MASH和肥胖症,需要准确的非侵入性评估.
研究的目的:
- 为了比较使用意图诊断方法对T2D患者进行的九项非侵入性肝检测的诊断性能.
- 评估纤维化,MASH和肥胖症的测试,以先进纤维化为主要终点.
主要方法:
- 活检作为参考标准.
- 评估了九项非侵入性测试,包括FibroTest-T2D,SteatoTest-T2D,MashTest-T2D,振动控制的短暂弹性学 (VCTE),二维剪切波弹性学 (TD-SWE),Fibrosis-4,酸氨基转移酶,控制的减弱参数和肝梯度.
- 使用诊断意图分析,包括所有参与者,与标准方法不同,标准方法排除了无法评估的病例.
主要成果:
- 在意图诊断分析中,FibroTest-T2D,TD-SWE和VCTE在晚期纤维化阶段测定方面表现相似 (AUROC ~0.77-0.78),表现优于Fibrosis-4 (AUROC ~0.70).
- 标准分析高估了VCTE在晚期纤维化中的表现,与意向诊断分析 (0.83对0.77) 相比,高估了6%.
- 在MashTest-T2D中,MASH的AUROC比阿斯巴酸氨基转移酶 (0.76比0.72) 高.
结论:
- FibroTest-T2D,TD-SWE和VCTE在使用意向诊断方法对T2D门诊患者的纤维化病的分期具有可比性和有效性.
- 标准分析方法可能会高估VCTE等非侵入性肝检测的性能.
- 对T2D中MASLD特征进行准确的非侵入性评估对于患者管理至关重要.
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