網頁計算

A.評估肝纖維化指標

肝纖維化指數 Fibrosis-4 (FIB-4)Score

年齡(Age)

麩胺酸苯醋酸轉氨基酶(AST)

麩丙酮酸轉胺酶(ALT)

血小板(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
	納入Rule-in	排除Rule-out
檢測具有嚴重肝纖維化 Assessment of Advanced fibrosis*	≥2.67	<1.3
檢測具有肝硬化 Assessment of Cirrhosis	≥3.48	<1.67

*不適用於年齡小於35歲以及高風險族群(糖尿病、肥胖等)。Not accurate in age <35 y and lower rule-out threshold among high-risk individuals who have high pretest probability.:

參考文獻 References:

European Association for the Study of the Liver. (2015). EASL-ALEH Clinical Practice Guidelines: Non-invasive tests for evaluation of liver disease severity and prognosis. Journal of hepatology, 63(1), 237-264.
McPherson, Stuart, et al. "Age as a confounding factor for the accurate non-invasive diagnosis of advanced NAFLD fibrosis." The American journal of gastroenterology 112.5 (2017): 740.
Barb, Diana, et al. "Type 2 diabetes mellitus increases the risk of hepatic fibrosis in individuals with obesity and nonalcoholic fatty liver disease." Obesity 29.11 (2021): 1950-1960.
Graupera, Isabel, et al. "Low accuracy of FIB-4 and NAFLD fibrosis scores for screening for liver fibrosis in the population." Clinical Gastroenterology and Hepatology 20.11 (2022): 2567-2576.

麩胺酸苯醋酸轉氨基酶-血小板比值指數 AST to Platelet Ratio Index (APRI)

麩胺酸苯醋酸轉氨基酶(AST)

AST正常值上限(AST ULN)

血小板(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
	納入Rule-in	排除Rule-out
檢測具有嚴重肝纖維化 Assessment of Advanced fibrosis*	≥1.5	<0.3
檢測具有肝硬化 Assessment of Cirrhosis	≥2.0	<0.5

參考文獻 References:

European Association for the Study of the Liver. (2015). EASL-ALEH Clinical Practice Guidelines: Non-invasive tests for evaluation of liver disease severity and prognosis. Journal of hepatology, 63(1), 237-264.
Sripongpun, Pimsiri, et al. "Evaluation of aspartate aminotransferase to platelet ratio index and fibrosis 4 scores for hepatic fibrosis assessment compared with transient elastography in chronic hepatitis C patients." JGH Open 4.1 (2020): 69-74.

非酒精性脂肪肝疾病纖維化分數 NAFLD fibrosis score(NFS)

年齡(Age)

身體質量指數(BMI)

空腹血糖異常(IFG)/糖尿病(DM)

血小板(PLT)

麩胺酸苯醋酸轉氨基酶(AST)

麩丙酮酸轉胺酶(ALT)

白蛋白(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
	納入Rule-in	排除Rule-out
檢測具有嚴重肝纖維化 Assessment of Advanced fibrosis*	≥0.672	<-1.44

*不適用於年齡小於35歲以及高風險族群(糖尿病、肥胖等)。 Not accurate in age <35 y, people with obesity and/or type 2 diabetes.

*空腹血糖偏高 (IFG) 定義為空腹血糖指數(FPG) 數值介於 110–125 mg/dL. Impaired fasting glucose (IFG) defined as a fasting plasma glucose(FPG) level of 110–125 mg/dL.:

參考文獻References:

Mellitus, D. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1997, 20, 1183–1197.
McPherson, Stuart, et al. "Age as a confounding factor for the accurate non-invasive diagnosis of advanced NAFLD fibrosis." The American journal of gastroenterology 112.5 (2017): 740.
Barb, Diana, et al. "Type 2 diabetes mellitus increases the risk of hepatic fibrosis in individuals with obesity and nonalcoholic fatty liver disease." Obesity 29.11 (2021): 1950-1960.
Graupera, Isabel, et al. "Low accuracy of FIB-4 and NAFLD fibrosis scores for screening for liver fibrosis in the population." Clinical Gastroenterology and Hepatology 20.11 (2022): 2567-2576.

B. 評估脂肪變性程度

脂肪肝指數 Fatty liver index(FLI)

身體質量指數(BMI)

腰圍(WC)

三酸甘油脂(TG)

麩胺轉酸酶(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.

肝脂肪變性指數Hepatic steatosis index (HSI)

性別(Gender)

身體質量指數(BMI)

麩胺酸苯醋酸轉氨基酶(AST)

麩丙酮酸轉胺酶(ALT)

糖尿病(DM)

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.