RESUMEN
Introduction: Non-Alcoholic fatty liver disease (NAFLD)is increasing worldwide. Among the spectrum of NAFLD,presence of advanced fibrosis is associated with increasedmorbidity and if unchecked can progress to cirrhosis.Advanced fibrosis is also associated with cardiac dysfunction.Hence it is important to predict advanced fibrosis so thatmore intensive lifestyle changes and pharmacotherapy withemerging drugs can be tried. Aims and objectives: To evaluatea novel predictor model for advanced fibrosis in NAFLD.Material and Methods:Present cross sectional study wasperformed on 500 patients with NFALD at GastroenterologyDepartment of Medical College Trivandrum. All the patientsunder went transient elastography(TE) after dividing themin to those having advanced fibrosis (TE>=10Kpa) andwithout advanced fibrosis (TE<10Kpa). Anthropometric andbiochemical variables were assessed on the date of TE.Logisticregression was performed, coefficient of beta of independentvariables was found out and a new score was proposed.Results: Mean age of study cohort was 48.2±11.76 yearswhich ranged from 18 to 74 years. Female preponderance(52.4%) was observed.Weight, body mass index (BMI),platelet count, fasting blood sugar (FBS), serum glutamicoxaloacetictransaminas (SGOT), albumin, alkalinephosphatase and thyroid stimulating hormone (TSH) wereindependent predictors of advanced fibrosis. Logisticregression confirmed TSH, platelet count, albumin and SGOTas the independent predictors. New score has higher AUROCof 0.824(Cut off ≥ - 13.5 has 100% sensitivity in predictingadvanced fibrosis) compared to BARD score (AUROC of0.653) and APRI score (AUROC of 0.802).Specificity of thenew score was less than 50%.Conclusion: New score is a better prognostic model to predictadvanced fibrosis than BARD score and APRI score. It is asimple bedside tool that can be in cooperated into day today practice. Validity of the score needs to be checked in adifferent cohort.