{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T16:10:24Z","timestamp":1790871024047,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,6,14]],"date-time":"2017-06-14T00:00:00Z","timestamp":1497398400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009647","name":"Ministry of Health","doi-asserted-by":"publisher","award":["ING\u2010CITMA\u20102009"],"award-info":[{"award-number":["ING\u2010CITMA\u20102009"]}],"id":[{"id":"10.13039\/100009647","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>The dynamic response of serum fibrosis biomarkers to histological changes within the liver following lifestyle intervention (<jats:styled-content style=\"fixed-case\">LI<\/jats:styled-content>) is unknown. We explored relationships between changes in serum biomarkers and liver fibrosis in <jats:styled-content style=\"fixed-case\">NASH<\/jats:styled-content> patients undergoing <jats:styled-content style=\"fixed-case\">LI<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Paired liver biopsies were performed in 261 <jats:styled-content style=\"fixed-case\">NASH<\/jats:styled-content> patients to assess fibrosis change after 1\u00a0year of <jats:styled-content style=\"fixed-case\">LI<\/jats:styled-content>. We explored the utility of serum fibrosis markers to predict changes in hepatic fibrosis and developed and internally validated a model for predicting fibrosis improvement in patients with baseline fibrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Regression, stabilization and worsening of fibrosis occurred in 51 (20%), 165 (63%) and 45 (17%) patients respectively. By multivariable analysis, change in HbA1c (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 0.39, <jats:italic>P<\/jats:italic>&lt;.01), platelets (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 1.22, <jats:italic>P<\/jats:italic>&lt;.01) and <jats:styled-content style=\"fixed-case\">NFS<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 0.27, <jats:italic>P<\/jats:italic>&lt;.01), as well as <jats:styled-content style=\"fixed-case\">ALT<\/jats:styled-content> normalization (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 9.7, <jats:italic>P<\/jats:italic>&lt;.01) were independently associated with fibrosis improvement, whereas change in platelets (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 0.96, <jats:italic>P<\/jats:italic>&lt;.01), and <jats:styled-content style=\"fixed-case\">NFS<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 1.8, <jats:italic>P<\/jats:italic>&lt;.01) as well as <jats:styled-content style=\"fixed-case\">ALT<\/jats:styled-content> normalization (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 0.21, <jats:italic>P<\/jats:italic>&lt;.01) were linked to fibrosis progression. A model, including change in HbA1c, platelet and <jats:styled-content style=\"fixed-case\">ALT<\/jats:styled-content> normalization, was significantly more accurate (<jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content> of 0.96, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, l0.94\u20100.99) than <jats:styled-content style=\"fixed-case\">NFS<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> FIB<\/jats:styled-content>\u20104 and <jats:styled-content style=\"fixed-case\">APRI<\/jats:styled-content> for predicting fibrosis improvement. Using a threshold of \u22650.497, positive and negative predictive values were 94% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 84\u201098) and 91% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 81\u201096) respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Change in <jats:styled-content style=\"fixed-case\">NFS<\/jats:styled-content>, platelets and <jats:styled-content style=\"fixed-case\">ALT<\/jats:styled-content> normalization are associated with change in liver fibrosis after 1\u00a0year of <jats:styled-content style=\"fixed-case\">LI<\/jats:styled-content>. A model including change in HbA1c, platelet and <jats:styled-content style=\"fixed-case\">ALT<\/jats:styled-content> normalization discriminated patients with fibrosis improvement significantly better than other biomarkers.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.13480","type":"journal-article","created":{"date-parts":[[2017,5,25]],"date-time":"2017-05-25T16:38:40Z","timestamp":1495730320000},"page":"1887-1896","source":"Crossref","is-referenced-by-count":59,"title":["Serum biomarkers can predict a change in liver fibrosis 1\u00a0year after lifestyle intervention for biopsy\u2010proven <scp>NASH<\/scp>"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1435-4013","authenticated-orcid":false,"given":"Eduardo","family":"Vilar\u2010Gomez","sequence":"first","affiliation":[{"name":"Department of Hepatology National Institute of Gastroenterology  Havana Cuba"},{"name":"Division of Gastroenterology and Hepatology Indiana University School of Medicine  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Gastroenterology  Havana Cuba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sacha","family":"Lazo\u2010del Vallin","sequence":"additional","affiliation":[{"name":"Department of Radiology National Institute of Gastroenterology  Havana Cuba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moises","family":"Diago","sequence":"additional","affiliation":[{"name":"Liver Unit Department of Gastroenterology Valencia University General Hospital  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leon A.","family":"Adams","sequence":"additional","affiliation":[{"name":"School of Medicine and Pharmacology The University of Western Australia  Nedlands 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