Association of liver fibrosis biomarkers with overall and CVD mortality in the Korean population: The Dong-gu study

PLoS One. 2022 Dec 13;17(12):e0277729. doi: 10.1371/journal.pone.0277729. eCollection 2022.

Abstract

This study evaluated the associations of liver fibrosis biomarkers [non-alcoholic fatty liver disease fibrosis score (NFS), fibrosis-4 (FIB-4), aspartate aminotransferase/platelet ratio index (APRI), and BARD score] with mortality in Korean adults aged ≥50 years. We analyzed 7,702 subjects who participated in Dong-gu Study. The associations of liber fibrosis biomarkers with mortality were investigated using Cox proportional hazards models. Overall mortality increased with increasing NFS level [adjusted hazard ratio (aHR) 4.3, 95% confidence interval (CI) 3.3-5.5 for high risk vs. low risk], increasing FIB-4 level (aHR 3.5, 95% CI 2.9-4.4 for high risk vs. low risk), and increasing APRI level (aHR 3.5, 95% CI 2.1-5.8 for high risk vs. low risk) but not with BARD score. The Harrell's concordance index for overall mortality for the NFS and FIB-4 was greater than that for the APRI and BARD score. In conclusion, NFS, FIB-4, and APRI showed a significant relationship with the overall mortality, and NFS and FIB-4 showed a significant relationship with the CVD mortality after adjustment for covariates. In addition, the NFS and FIB-4 were more predictive of overall mortality than the APRI and BARD score in Korean adults aged ≥50 years.

MeSH terms

  • Adult
  • Aspartate Aminotransferases
  • Biomarkers
  • Biopsy
  • Cardiovascular Diseases* / complications
  • Fibrosis
  • Humans
  • Liver / pathology
  • Liver Cirrhosis / pathology
  • Non-alcoholic Fatty Liver Disease* / pathology
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Severity of Illness Index

Substances

  • Aspartate Aminotransferases
  • Biomarkers

Grants and funding

The authors received no specific funding for this work.