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NAFLD Fibrosis Score

Test code(s) 91979(X)

Question 1. What is NAFLD?

Nonalcoholic fatty liver disease (NAFLD) is a liver condition that is associated with obesity, diabetes, and dyslipidemia. This liver disease affects 20% to 30% of adults in Western developed countries. The disease encompasses a broad range of functionally distinct liver disorders. In its most indolent form (simple steatosis), it is characterized by the histologic accumulation of fat within hepatocytes. In some patients, this fat accumulation is accompanied by varying degrees of inflammation and fibrosis (nonalcoholic steatohepatitis [NASH]). In patients with NAFLD, liver fibrosis is among the most important predictors of progression to end-stage liver disease and outcome.

Question 2. What is the clinical significance of the NAFLD fibrosis score?

The NAFLD fibrosis score is a validated, noninvasive tool for identifying patients whose NAFLD has advanced to liver fibrosis.1-3 It relies on readily available clinical information and routinely measured laboratory data. The NAFLD fibrosis score is recommended by the American Association for the Study of Liver Diseases (AASLD), American College of Gastroenterology (ACG), and the American Gastroenterological Association (AGA).4 Patients with a high NAFLD fibrosis score may be in need of additional studies such as elastography or liver biopsy. The score also identifies patients at low risk who should be reassured and/or followed at periodic intervals.

Question 3. How should the NAFLD fibrosis score be interpreted?

In patients with an NAFLD fibrosis score above 0.676, the presence of advanced liver fibrosis can be diagnosed with high accuracy. In patients with an NAFLD fibrosis score below -1.455, advanced liver fibrosis can be excluded with high accuracy. Scores between -1.455 and 0.676 are considered “indeterminate.”1

Question 4. What is included in the NAFLD fibrosis score panel?

The panel assesses selected laboratory values (serum glucose, platelet count, albumin, AST/ALT ratio) and readily available patient characteristics (age, BMI, and diabetes status).

Question 5. Can I calculate an NAFLD fibrosis score myself?

Yes. An NAFLD fibrosis score online calculator is available at http://nafldscore.com/.

Question 6. No NAFLD fibrosis score was reported for my patient. Why?

An NAFLD fibrosis score cannot be calculated if the required patient information is missing. The following information is required: age, height, weight, and diabetes status.

 

References
 
  1. Angulo P, Hui JM, Marchesini G, et al. The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology. 2007;45:846-854.
  2. Angulo P, Bugianesi E, Bjornsson ES, et al. Simple noninvasive systems predict long-term outcomes of patients with nonalcoholic fatty liver disease. Gastroenterology. 2013;145:782-789.
  3. Castera L, Vilgrain V, Angulo P. Noninvasive evaluation of NAFLD. Nat Rev Gastroenterol Hepatol. 2013;10:666-675.
  4. Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of non-alcoholic fatty liver disease: practice guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology. 2012;55:2005-2023.
This FAQ is provided for informational purposes only and is not intended as medical advice. A physician’s test selection and interpretation, diagnosis, and patient management decisions should be based on his/her education, clinical expertise, and assessment of the patient.

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