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A.Assessment of hepatic fibrosis
Fibrosis-4 (FIB-4)Score
Age
Aspartate aminotransferase(AST)
Alanine aminotransferase (ALT)
Platelet Count(PLT)

 

肝纖維化指數 Fibrosis-4(FIB-4)
= age [years] x AST [U/L]/(platelet [109/L] x (ALT [U/L])1/2

判斷值 Cut off value
數值區間 風險分層 臨床意義
<1.3 低風險(Low Risk) 排除嚴重肝纖維化
1.3-2.67 不確定風險(Indeterminate risk) 不確定區間，需進一步評估
>2.67 高風險(High Risk) 高度懷疑具有嚴重肝纖維化

 

參考文獻 References: 

  • Berzigotti, A., Tsochatzis, E., Boursier, J., Castera, L., Cazzagon, N., Friedrich-Rust, M., ... & Thiele, M. (2021). EASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis–2021 update. Journal of hepatology, 75(3), 659-689.
AST to Platelet Ratio Index (APRI)
Aspartate aminotransferase(AST)
Upper limit of Normal AST (IU/L)
Platelet Count(PLT)

 

麩胺酸苯醋酸轉氨基酶-血小板比值指數 AST to Platelet Ratio Index (APRI) 
= AST [U/L] /ULN/Platelet [109/L] x 100

判斷值 Cut off value
數值區間 風險分層 臨床意義
<0.5 低風險(Low Risk) 排除顯著肝纖維化與肝硬化
0.5-1.5 不確定風險(Indeterminate risk) 不確定區間，需進一步評估
>1.5 高風險(High Risk) 高度懷疑具有嚴重肝纖維化(或早期肝硬化)

參考文獻 References: 

  • Wai, C. T., et al. (2003). A simple noninvasive index can predict significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology, 38(2), 518-526.
NAFLD fibrosis score(NFS)
Age
Body Mass Index(BMI)
Impaired fasting glucose(IFG)/ Diabetes
Platelet Count(PLT)
Aspartate aminotransferase(AST)
Alanine aminotransferase (ALT)
Albumin(Alb)

 

非酒精性脂肪肝疾病纖維化分數 NAFLD fibrosis score (NFS) 
= -1.675 + (0.037*age [years]) + (0.094*BMI [kg/m2]) + (1.13*IFG/diabetes [yes = 1, no = 0]) +

     (0.99*AST/ALT ratio) – (0.013*Platelet [X109/L]) – (0.66*Albumin [g/dl])

 

判斷值 Cut off value
數值區間 風險分層 臨床意義
< -1.455 低風險(Low Risk) 排除嚴重肝纖維化
-1.455 -0.676 不確定風險(Indeterminate risk) 不確定區間
>0.676 高風險(High Risk) 高度懷疑具有嚴重肝纖維化

 

參考文獻References: 

  • Angulo P, et al. The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology. 2007;45(4):846-54
B. Assessment of hepatic steatosis
Fatty liver index(FLI)
Body Mass Index(BMI)
Waist Circumference
Serum Triglycerides
Serum GGT

 

脂肪肝指數 Fatty liver index (FLI) 
= (e 0.953*loge (triglycerides) + 0.139*BMI + 0.718*loge (ggt) +
    0.053*waist circumference - 15.745) / (1 + e 0.953*loge (triglycerides) +
    0.139*BMI + 0.718*loge (ggt) + 0.053*waist circumference - 15.745) * 100

 

 

判斷值 Cut off value
  納入 Rule-in 排除 Rule-out
檢測具有脂肪肝 Assessment of Fatter liver ≥60 <30
:

 

 

參考文獻References: 

  • Rinella, Mary E., et al. "AASLD practice guidance on the clinical assessment and management of nonalcoholic fatty liver disease." Hepatology (2023): 10-1097.
  • Bedogni, Giorgio, et al. "The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population." BMC gastroenterology 6.1 (2006): 1-7.
Hepatic steatosis index (HSI)
Gender
Body Mass Index(BMI)
Aspartate aminotransferase(AST)
Alanine aminotransferase (ALT)
Diabetes

 

脂肪變性指數 Hepatic steatosis index (HSI) 
= 8 × (ALT / AST) + BMI + 2 (if diabetes) + 2 (if female)

 

判斷值 Cut off value
  納入Rule-in 排除Rule-out
檢測肝臟脂肪變性 Assessment of Hepatic steatosis >36 <30
:

 

 

參考文獻 References: 

  • Lee, Jeong-Hoon, et al. "Hepatic steatosis index: a simple screening tool reflecting nonalcoholic fatty liver disease." Digestive and liver disease 42.7 (2010): 503-508.
  • Sviklāne, Laura, et al. "Fatty liver index and hepatic steatosis index for prediction of non‐alcoholic fatty liver disease in type 1 diabetes." Journal of gastroenterology and hepatology 33.1 (2018): 270-276.