Determining the risk of liver cirrhosis with a blood test

Repeated measurement of the FIB-4 index score over several years helps to assess the risk of developing a serious liver disease such as cirrhosis, according to a recent study from Sweden.

The risk of cirrhosis increases with a rise in FIB-4 scores

Repeated measurement of the blood biomarker fibrosis-4 index (FIB-4) over several years allows statements to be made about the risk of developing a serious liver disease such as cirrhosis, according to a recent study from Sweden.

Obesity and diabetes are two major causes of fatty liver, from which more and more people in industrialized countries are suffering. It is not uncommon for it to develop into cirrhosis or liver cancer later in life.

Until now, it has been difficult to determine the risk of individual patients developing cirrhotic changes in the liver. However, Swedish researchers showed in a study that the blood biomarker  fibrosis-4 index (FIB-4) is a very good risk predictor for liver cirrhosis.

Measuring the course of cirrhosis over the years allows a risk estimation

However, according to the researchers, in order to assess the risk of liver cirrhosis, it is necessary to measure the biomarker index continuously over several years instead of recording a single value for FIB-4. For their study, the scientists used databases that made it possible to track patients over a period of 27 years until they developed cirrhosis.

Patients in whom the FB-4 score had risen between two measurements had a higher risk of disease. Those for whom the biomarker score dropped in the course of the disease also showed cirrhosis less frequently.

Unfortunately, the accuracy of the measurements was rather low, so the test had a very high error rate for false-positive results. More trials are needed to improve this, according to the researchers.

Editor's note: The study was sponsored by Astra Zeneca's pharmaceutical division.

Hagström H et al, Repeated FIB-4 measurements can help identify individuals at risk of severe liver disease. Journal of Hepatology 2020; doi:10.1016/j.jhep.2020.06.007

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