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Liver Stiffness on Magnetic Resonance Elastography and the MEFIB Index and Liver-Related Outcomes in Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis of Individual Participants
DC Field | Value | Language |
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dc.contributor.author | 김범경 | - |
dc.date.accessioned | 2022-12-22T04:44:27Z | - |
dc.date.available | 2022-12-22T04:44:27Z | - |
dc.date.issued | 2022-10 | - |
dc.identifier.issn | 0016-5085 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/192204 | - |
dc.description.abstract | Background & aims: Magnetic resonance elastography (MRE) is an accurate biomarker of liver fibrosis; however, limited data characterize its association with clinical outcomes. We conducted an individual participant data pooled meta-analysis on patients with nonalcoholic fatty liver disease to evaluate the association between liver stiffness on MRE and liver-related outcomes. Methods: A systematic search identified 6 cohorts of adults with nonalcoholic fatty liver disease who underwent a baseline MRE and were followed for hepatic decompensation, hepatocellular carcinoma, and death. Cox and logistic regression were used to assess the association between liver stiffness on MRE and liver-related outcomes, including a composite primary outcome defined as varices needing treatment, ascites, and hepatic encephalopathy. Results: This individual participant data pooled meta-analysis included 2018 patients (53% women) with a mean (± standard deviation) age of 57.8 (±14) years and MRE at baseline of 4.15 (±2.19) kPa, respectively. Among 1707 patients with available longitudinal data with a median (interquartile range) of 3 (4.2) years of follow-up, the hazard ratio for the primary outcome for MRE of 5 to 8 kPa was 11.0 (95% confidence interval [CI]: 7.03-17.1, P < .001) and for ≥ 8 kPa was 15.9 (95% CI: 9.32-27.2, P < .001), compared with those with MRE <5 kPa. The MEFIB index (defined as positive when MRE ≥3.3 kPa and Fibrosis-4 ≥1.6) had a robust association with the primary outcome with a hazard ratio of 20.6 (95% CI: 10.4-40.8, P < .001) and a negative MEFIB had a high negative predictive value for the primary outcome, 99.1% at 5 years. The 3-year risk of incident hepatocellular carcinoma was 0.35% for MRE <5 kPa, 5.25% for 5 to 8 kPa, and 5.66% for MRE ≥8 kPa, respectively. Conclusion: Liver stiffness assessed by MRE is associated with liver-related events, and the combination of MRE and Fibrosis-4 has excellent negative predictive value for hepatic decompensation. These data have important implications for clinical practice. | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | English | - |
dc.publisher | W.B. Saunders | - |
dc.relation.isPartOf | GASTROENTEROLOGY | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.subject.MESH | Adult | - |
dc.subject.MESH | Aged | - |
dc.subject.MESH | Biomarkers | - |
dc.subject.MESH | Carcinoma, Hepatocellular* / pathology | - |
dc.subject.MESH | Elasticity Imaging Techniques* | - |
dc.subject.MESH | Female | - |
dc.subject.MESH | Fibrosis | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Liver / diagnostic imaging | - |
dc.subject.MESH | Liver / pathology | - |
dc.subject.MESH | Liver Cirrhosis / pathology | - |
dc.subject.MESH | Liver Neoplasms* / pathology | - |
dc.subject.MESH | Magnetic Resonance Imaging | - |
dc.subject.MESH | Male | - |
dc.subject.MESH | Middle Aged | - |
dc.subject.MESH | Non-alcoholic Fatty Liver Disease* / complications | - |
dc.subject.MESH | Non-alcoholic Fatty Liver Disease* / diagnostic imaging | - |
dc.subject.MESH | Non-alcoholic Fatty Liver Disease* / pathology | - |
dc.title | Liver Stiffness on Magnetic Resonance Elastography and the MEFIB Index and Liver-Related Outcomes in Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis of Individual Participants | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학교실) | - |
dc.contributor.googleauthor | Veeral Ajmera | - |
dc.contributor.googleauthor | Beom Kyung Kim | - |
dc.contributor.googleauthor | Kun Yang | - |
dc.contributor.googleauthor | Abdul M Majzoub | - |
dc.contributor.googleauthor | Tarek Nayfeh | - |
dc.contributor.googleauthor | Nobuharu Tamaki | - |
dc.contributor.googleauthor | Namiki Izumi | - |
dc.contributor.googleauthor | Atsushi Nakajima | - |
dc.contributor.googleauthor | Ramazan Idilman | - |
dc.contributor.googleauthor | Mesut Gumussoy | - |
dc.contributor.googleauthor | Digdem Kuru Oz | - |
dc.contributor.googleauthor | Ayse Erden | - |
dc.contributor.googleauthor | Natalie E Quach | - |
dc.contributor.googleauthor | Xin Tu | - |
dc.contributor.googleauthor | Xinlian Zhang | - |
dc.contributor.googleauthor | Mazen Noureddin | - |
dc.contributor.googleauthor | Alina M Allen | - |
dc.contributor.googleauthor | Rohit Loomba | - |
dc.identifier.doi | 10.1053/j.gastro.2022.06.073 | - |
dc.contributor.localId | A00487 | - |
dc.relation.journalcode | J00917 | - |
dc.identifier.eissn | 1528-0012 | - |
dc.identifier.pmid | 35788349 | - |
dc.identifier.url | https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(22)00735-1 | - |
dc.subject.keyword | Ascites | - |
dc.subject.keyword | Cirrhosis | - |
dc.subject.keyword | Nonalcoholic Fatty Liver Disease | - |
dc.subject.keyword | Portal Hypertension | - |
dc.subject.keyword | Varices | - |
dc.contributor.alternativeName | Kim, Beom Kyung | - |
dc.contributor.affiliatedAuthor | 김범경 | - |
dc.citation.volume | 163 | - |
dc.citation.number | 4 | - |
dc.citation.startPage | 1079 | - |
dc.citation.endPage | 1089.e5 | - |
dc.identifier.bibliographicCitation | GASTROENTEROLOGY, Vol.163(4) : 1079-1089.e5, 2022-10 | - |
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