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Hindi Research Article
A Caution in the use of the NAFIC Scoring System as a Diagnostic Screening Tool for Nonalcoholic Steatohepatitis
Akinobu Nakamura1, Masato Yoneda2, Yoshio Sumida3, Hideaki Miyoshi1, Atsushi Nakajima4, Tatsuya Atsumi1 and Yasuo Terauchi5*1Division of Immunology and Metabolism, Hokkaido University Graduate School of Medicine, Sapporo, Japan
2Schiff Center for Liver Diseases, University of Miami Miller School of Medicine, Miami, FL, USA
3Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan
4Department of Gastroenterology and Hepatology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
5Department of Endocrinology and Metabolism, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
- *Corresponding Author:
- Yasuo Terauchi, MD, PhD
Professor, Department of Endocrinology and Metabolism
Graduate School of Medicine, Yokohama City University
3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan
Tel: +81-45-787-2639
Fax: +81-45-784-3012
E-mail: terauchi-tky@umin.ac.jp
Received date: August 21, 2014; Accepted date: September 12, 2014; Published date: September 18, 2014
Citation: Nakamura A, Yoneda M, Sumida Y, Miyoshi H, Nakajima A, et al. (2014) A Caution in the use of the NAFIC Scoring System as a Diagnostic Screening Tool for Nonalcoholic Steatohepatitis. J Gastroint Dig Syst 4:221. doi:10.4172/2161-069X.1000221
Copyright: © 2014 Nakamura A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Objective: We reinvestigated the clinical usefulness of the NAFIC and modified NAFIC scoring systems in Japanese patients with nonalcoholic fatty liver disease (NAFLD) according to the presence/absence of obesity. Methods: A total of 141 Japanese patients with liver-biopsy-confirmed NAFLD were enrolled. All patients were classified as having nonalcoholic fatty liver (NAFL) or nonalcoholic steatohepatitis (NASH) on the basis of Matteoni’s classification. Obesity was defined as a body mass index of ≥25. To evaluate the overall accuracy of the NAFIC and modified NAFIC scoring systems, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of these scoring systems for the diagnosis of NASH were calculated. Results: In the obese group, the sensitivity, specificity, PPV and NPV of the NAFIC scoring system for the diagnosis of NASH were 67.3%, 76.2%, 77.8% and 65.3%, respectively, while the corresponding values for the modified NAFIC scoring systems were 78.8%, 69.0%, 75.9% and 72.5%. On the other hand, in the nonobese group, the sensitivity, specificity, PPV and NPV of the NAFIC scoring system were 47.1%, 86.7%, 66.7% and 74.3%, respectively, while those of the modified NAFIC scoring system were 58.8%, 83.3%, 66.7% and 78.1%, respectively. When the patients were divided by sex, the sensitivity of the NAFIC and modified NAFIC scoring systems in the female nonobese group were 53.8% and 69.2%, respectively. However, surprisingly, in the male nonobese group, the sensitivity of both the scoring systems was only 25.0%. Conclusion: The sensitivity of both the NAFIC and modified NAFIC scoring systems for the diagnosis of NASH was lower in the male nonobese group than in all the other groups. These findings suggest that caution should be exercised in the use of the NAFIC scoring system as a diagnostic screening tool for NASH in Japanese patients with NAFLD, especially male nonobese patients.
