{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T19:09:33Z","timestamp":1785179373310,"version":"3.55.0"},"reference-count":47,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,9,5]],"date-time":"2017-09-05T00:00:00Z","timestamp":1504569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Korean Association of Internal Medicine"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2018,2]]},"abstract":"Abstract<\/jats:title>Background & Aims<\/jats:title>Nonalcoholic fatty liver disease (NAFLD<\/jats:styled-content>) includes a wide spectrum of heterogeneous metabolic subtypes. This study compared the diagnostic performances of noninvasive fibrosis tests in predicting advanced fibrosis among patients with NAFLD<\/jats:styled-content> and examined the effects of the subgroups on their diagnostic performances.<\/jats:p><\/jats:sec>Methods<\/jats:title>Three hundred fifteen patients with biopsy\u2010proven NAFLD<\/jats:styled-content> were prospectively enrolled. Acoustic radiation force impulse imaging (ARFI<\/jats:styled-content>) was performed to obtain liver stiffness measurements (LSM<\/jats:styled-content>s). The aspartate aminotransferase\u2010to\u2010alanine aminotransferase ratio (AAR<\/jats:styled-content>), aspartate aminotransferase\u2010to\u2010platelet ratio index (APRI<\/jats:styled-content>), fibrosis 4 index (FIB<\/jats:styled-content>\u20104), NAFLD<\/jats:styled-content> fibrosis score (NFS<\/jats:styled-content>) and BARD<\/jats:styled-content> score were calculated. The diagnostic performances of noninvasive fibrosis tests were evaluated using the area under the receiver operating characteristic curve (AUROC<\/jats:styled-content>).<\/jats:p><\/jats:sec>Results<\/jats:title>Fibrosis 4 index (FIB<\/jats:styled-content>\u20104) showed the highest AUROC<\/jats:styled-content> for advanced fibrosis (0.866; 95% CI<\/jats:styled-content>, 0.811\u20100.922). AUROC<\/jats:styled-content> subgroup analyses were performed to assess the effects of the subgroups on diagnostic performance. For patients with advanced fibrosis, the APRI<\/jats:styled-content>, BARD<\/jats:styled-content>, FIB<\/jats:styled-content>\u20104 and NFS AUROC<\/jats:styled-content>s were significantly different among the radiological steatosis grades. Additionally, the AUROC<\/jats:styled-content> of ARFI<\/jats:styled-content> tended to decrease with increasing radiological steatosis severity. FIB<\/jats:styled-content>\u20104 and NFS<\/jats:styled-content> showed significantly lower AUROC<\/jats:styled-content>s for advanced fibrosis in obese NAFLD<\/jats:styled-content> than in nonobese NAFLD<\/jats:styled-content> (P\u00a0<\/jats:italic>=\u00a0<\/jats:italic>.002 and P\u00a0<\/jats:italic><\u00a0<\/jats:italic>.001 respectively). However, only radiological steatosis severity was independently associated with advanced fibrosis in multivariable analysis.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Steatosis severity may affect the diagnostic performances of noninvasive fibrosis tests in patients with NAFLD<\/jats:styled-content>. The application of different tools should be tailored for various NAFLD<\/jats:styled-content> subgroups to optimize noninvasive fibrosis assessments.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.13549","type":"journal-article","created":{"date-parts":[[2017,8,10]],"date-time":"2017-08-10T10:13:33Z","timestamp":1502360013000},"page":"331-341","source":"Crossref","is-referenced-by-count":56,"title":["Steatosis severity affects the diagnostic performances of noninvasive fibrosis tests in nonalcoholic fatty liver disease"],"prefix":"10.1111","volume":"38","author":[{"given":"Sae Kyung","family":"Joo","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul National University College of Medicine Seoul Metropolitan Government Boramae Medical Center Seoul 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