Simple blood tests identify advanced liver disease
Vienna (OTS) – Advanced liver disease is the second most common cause of lost working years, as young patients are disproportionately affected. A scientific team at MedUni Vienna was able to determine a threshold value for a simple blood test that can be used to identify people with an increased risk of complications without special examinations. The research group was also able to demonstrate that non-invasive tests can provide results that are comparable to those of minimally invasive tests. The studies have been published in the renowned journals Hepatology and Journal of Hepatology and provide a basis for promoting liver health through early detection.
In Austria, no structured programs are offered to identify asymptomatic patients with advanced liver disease, partly because the availability of the special examinations required to date (such as ultrasound-based liver stiffness measurement) is largely limited to specialized hepatology departments.
New threshold in the laboratory identifies patients at risk
In the first of the two current studies, the research group at the University Clinic for Internal Medicine III (Clinical Department of Gastroenterology and Hepatology) led by Georg Semmler, Lukas Hartl, Mathias Jachs and Mattias Mandorfer analyzed several thousand patients from Vienna and Salzburg to determine a threshold value for the FIB-4 score (easily calculated from a routine laboratory) that corresponds to a liver stiffness of 10 kPa – i.e. advanced liver disease. The group of people identified in this way has a massively increased risk of liver-related complications (occurrence of ascites, bleeding from the digestive tract, and confusion) and requires immediate hepatological evaluation and treatment. “Previous threshold values may have been either too insufficiently specific or sensitive, which meant that too many healthy people were incorrectly identified or sick people were overlooked,” explain the lead authors Georg Semmler and Lukas Hartl.
Individual risk can be determined gently
In another study, the research group demonstrated that non-invasive tests (liver stiffness measurement and/or blood tests) can be used to assess the individual risk of the patients recorded in this way as well as with the minimally invasive determination of the liver vein pressure gradient. Lead author Mathias Jachs summarizes: “In high-risk patients, a minimally invasive measurement of the liver vein pressure gradient has previously been used to determine whether medication should be administered to reduce the risk of decompensation. However, this measurement of the liver vein pressure gradient represents a burden – albeit a small one – for the patients and, above all, requires a great deal of medical expertise, which is not widely available. We have now been able to show that various non-invasive tests can reliably perform this task.”
Promoting liver health in Austria
“Despite the high importance of advanced liver disease for the national economy and health and the excellent therapeutic options when detected early, no corresponding preventive examination has been established in Austria,” explains hepatologist Mattias Mandorfer. Known risk factors are obesity, diabetes, or alcohol consumption (>20 grams/day for women or >30g/day for men). “My goal as head of the Hepatology Working Group of the Austrian Society for Gastroenterology and Hepatology (ÖGGH) is to include the determined FIB-4 threshold value of 1.75 for all patients with risk factors for liver disease in the Austrian health examination. As a result, non-invasive follow-up examinations should also be offered nationwide for the newly detected patients. In addition to liver stiffness measurement and the VITRO score developed in Austria, spleen stiffness measurement will also play a central role.”
Publications:
Hepatology
Simple blood tests to diagnose compensated advanced chronic liver disease and stratify the risk of clinically significant portal hypertension.
Georg Semmler, Lukas Hartl, Yuly Paulin Mendoza, Benedikt Simbrunner, Mathias Jachs, Lorenz Balcar, Michael Schwarz, Benedikt Silvester Hofer, Laurenz Fritz, Anna Schedlbauer, Katharina Stopfer, Daniela Neumayer, Jurij Maurer, Robin Szymanski, Elias Laurin Meyer, Bernhard Scheiner, Peter Quehenberger, Michael Trauner, Elmar Aigner, Annalisa Berzigotti, Thomas Reiberger, Mattias Mandorfer
https://doi.org/10.1097/HEP.0000000000000829
Journal of Hepatology
Prognostic performance of non-invasive tests for portal hypertension is comparable to that of hepatic venous pressure gradient
Mathias Jachs, Lukas Hartl, Benedikt Simbrunner, Georg Semmler, Lorenz Balcar, Benedikt Silvester Hofer, Michael Schwarz, David Bauer, Albert Friedrich Stattermayer, Matthias Pinter, Michael Trauner, Thomas Reiberger, Mattias Mandorfer
Inquiries & Contact:
medical university Vienna
Mag. Johannes Angerer
Head of Communications and Public Relations
+431 40160-1150, +43 664 80016 11501
johannes.angerer@meduniwien.ac.at
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