A method of predicting fibrosis risk in women with non-alcoholic fatty liver disease and postmenopausal obesity

Objective. To develop a method of predicting fibrosis risk in women with non-alcoholic fatty liver disease (NAFLD) and postmenopausal obesity. Materials and methods. 70 patients with NAFLD and postmenopausal obesity with an average age of 51.0 (49.0–52.0) participated in the study. Hepatic steatosis signs were confirmed by ultrasound examination after other causes of its development had been excluded. The count of thrombocytes, glucose concentration, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activity were determined and body mass index (BMI), steatosis index HSI and fibrosis indices APRI and FIB4 were calculated in all the patients. Results. The patients with NAFLD and postmenopausal obesity were divided into 2 groups: with a high fibrosis risk and with a low one. Women with a high fibrosis risk were significantly older (р=0,044), had a lower number of thrombocytes (р0,001), and a higher glucose concentration (р=0,046) and transaminase activity. We selected 4 signs that significantly affect the probability of fibrosis and calculated the predicted risk of its development using the formula: Y = 0.4258 – 0.0038 · platelets + 0.0567 · glucose + 0.0350 · AST – 0.0110 · ALT, where Y (rounded to a whole) is a predicted risk of fibrosis formation in patients with NAFLD and postmenopausal obesity. With Y ≥ 1 the risk of fibrosis formation is predicted in this cohort, and there is no risk when Y value is 1. The sensitivity and specificity indicators of this method were 100 % and 97.5 %. Conclusions. The suggested method for predicting the risk of fibrosis in NAFLD includes available laboratory tests, has good diagnostic characteristics, no "grey area" and is developed for the risk group (postmenopausal women). Its use will expand the possibilities of minimally invasive diagnosis, ensure earlier detection of the risk of liver fibrosis in this risk group, which will help to determine the further tactics of these patients’ management.