Detecting Liver Disease Early: New Tool Could Make a Big Difference. Chronic liver disease, a growing threat to global health, often progresses silently in its early stages.
Detecting its precursor, steatotic liver disease (SLD), and advanced liver fibrosis before complications arise is crucial to prevent devastating outcomes.
The newly developed Chronic Liver Disease (CLivD) score offers a promising non-invasive approach to this challenge.
The CLivD score:
This simple score, originally designed to predict future liver issues in the general population, shows exciting potential in two key areas:
Spotting liver fat buildup (steatosis):
This early stage of liver disease often goes unnoticed, but the CLivD score can flag it for further investigation.
Identifying advanced liver scarring (fibrosis):
This serious condition can lead to liver failure, but the CLivD score, combined with another test (FIB-4), can accurately identify it early, when treatment is most effective.
Parameters of CLivD score:
The non-laboratory CLivDnon-lab score is calculated based on age, sex, smoking status (current vs previous/never), weekly alcohol use, waist-to-hip ratio and diabetes (yes vs no).2
The laboratory version, CLivDlab, also included GGT (U/L).
Both CLivD scores are then categorised into subgroups (minimal, low, intermediate and high risk) based on previously reported thresholds.2
FIB-4 was calculated based on age, ALT, AST and platelet count as previously described.6
FIB-4 was categorised into low, intermediate and high subgroups using the cutoffs 1.3 and 2.67 suggested by both European Association for the Study of the Liver (EASL) and American Association for the Study of Liver Diseases (AASLD).7 8
Here’s how it works:
Calculate your CLivD score:
This easy-to-use online tool considers factors like age, weight, blood pressure, and diabetes to estimate your liver disease risk.
Low risk?
You’re likely good to go! No need for further testing unless your situation changes.
Moderate or high risk?
The FIB-4 test comes into play. This additional blood test helps confirm the presence and severity of liver fibrosis.
Benefits of this approach:
More accurate:
Combining CLivD and FIB-4 significantly improves the detection of advanced fibrosis compared to using FIB-4 alone.
More targeted:
This sequential approach focuses testing on those with higher risk, saving resources and reducing unnecessary tests for low-risk individuals.
Early intervention:
Identifying liver problems early allows for prompt treatment, potentially preventing serious complications.
Limitations:
- The study was based on a specific age group (40-70 years) and needs further research in other age groups.
- The CLivD score may not be as accurate in individuals with obesity.
Conclusion:
Overall, the CLivD score offers a promising tool for early liver disease detection. This could lead to improved screening strategies and ultimately, better health outcomes for millions of people.
Remember, this is just a summary of the research. Always consult your doctor for personalized medical advice.
More information:
Detecting Liver Disease Early: New Tool Could Make a Big Difference.
Fredrik Åberg et al, CLivD score modifies FIB-4 performance in liver fibrosis detection in the US general population, eGastroenterology (2023). DOI: 10.1136/egastro-2023-100035