A199 SCREENING FOR NONALCOHOLIC FATTY LIVER DISEASE BY TRANSIENT ELASTOGRAPHY WITH CONTROLLED ATTENUATION PARAMETER IN UNSELECTED PATIENTS WITH INFLAMMATORY BOWEL DISEASE
Bibliographic record
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most frequent liver disease in North America. Patients with inflammatory bowel disease (IBD) are at risk for NAFLD due to chronic inflammation, hepatotoxic drugs, and alteration of gut microbiota. However, prospective data in unselected patients by means of validated and accurate diagnostic methods are lacking. We prospectively investigated prevalence and predictors of NAFLD and liver fibrosis by transient elastography (TE) with associated controlled attenuation parameter (CAP) in unselected IBD patients free of liver disease as part of a routine screening program. Any grade (involving >10% of hepatocytes), moderate (>30%) and severe (>60%) steatosis were defined as CAP ≥238, CAP ≥260 and CAP ≥292 dB/m, respectively. Significant liver fibrosis and cirrhosis (stage 2 and 4 out of 4, respectively) were defined as TE measurement ≥8 and ≥13 kPa. Active IBD was defined as partial Mayo score ≥3 and Harvey Bradshaw Index ≥5 for ulcerative colitis and Crohn’s disease, respectively. Predictors of any grade NAFLD and significant liver fibrosis were determined by logistic regression analysis. 317 patients (mean age 42.9, 48.8% male) were included; 65.9% had Crohn’s disease, and 28% had active disease at time of recruitment. Prevalence of any grade, moderate and severe steatosis was as follows: 39.7%, 32.6% and 19.8%, respectively. The prevalence of significant liver fibrosis and cirrhosis was 9.5% and 1.9%, respectively. Main predictors of NAFLD were older age, being overweight (BMI >25) and methotrexate use (Table1). The main predictors of significant liver fibrosis were prior IBD-related surgery, being overweight, dyslipidemic and on methotrexate. NAFLD diagnosed by TE with CAP is a major comorbidity in unselected IBD patients without known liver disease. These patients may also have significant liver fibrosis and cirrhosis, likely suggesting the coexistence of non-alcoholic steatohepatitis. Non-invasive screening strategies can help early diagnosis and initiation of interventions in this population, including weight loss, treatment of dyslipidemia and potentially drug regimen modification. Table 1. Multivariate analysis of predictors of NAFLD and fibrosis None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".