A new tool designed in an international study led by Spanish scientists from the Clinic-IDIBAPS allows to predict the risk of developing cirrhosis or other serious liver diseasesand also has eight variables that can be used to establish lifestyle changes for people at riskdiagnose these pathologies early, and establish treatments that prevent their progression.
The study was carried out within the framework of the European LiverScreen project coordinated by the Dr. Pere Ginèsconsultant to the Clínic’s Hepatology Service and head of the group Chronic liver diseases: molecular mechanisms and clinical consequences of IDIBAPS, head of the CIBEREHD group and professor of Medicine at the University of Barcelona and has been published in the journal The Lancet.
Cirrhosis is due to the accumulation of fibrous tissue in the liver as a consequence of any inflammatory process caused by various factors and produces irreversible deterioration of this organ. It is one of the main causes of mortality worldwide and can cause hepatocellular carcinoma, the most common type of liver cancer; Together, these two diseases are responsible for the death of two million people every year in the world.
“Identifying early which people are at risk of progressive fibrosis in the liver would make it possible to apply changes in their lifestyle or carry out treatments to prevent cirrhosis”
Although the hepatitis C viruswhich is one of the main factors for developing cirrhosis, has decreased thanks to the new treatments available to combat it, the disease by metabolic type fatty liver (hepatic steatosis) associated with type 2 diabetes and obesity has caused the cases of cirrhosis to increase significantly.
“It is a disease that develops very slowly and does not produce symptoms, so that very often when it is diagnosed it is in a very advanced phase and in which the possibilities of treatment are very limited”, explains Pere Ginès. “Being able to identify early which people are at risk of progressive liver fibrosis would make it possible to apply changes in people’s lifestyles or carry out treatments to prevent the development of cirrhosis,” he adds.
Early identification of people at risk of liver fibrosis
Until now, non-invasive techniques or laboratory-based risk calculators had certain limitations and it was necessary to create new, simple tools based on clinical or laboratory variables to identify people who were at risk of developing liver fibrosis.
The new research focused first on developing a risk index, and for this the researchers based themselves on data from 6,400 people with no known liver disease, but who, after undergoing hepatic elastography – a test that determines the stiff liver – some of them were found to have liver fibrosis. This risk index was subsequently validated in a group of 8,369 people from the general population, and its prognostic value was determined in a cohort of more than 416,000 participants without liver disease and with a 12-year follow-up.
He index is called ©LiverRisk and is based on eight variables: age, gender and six standard laboratory variables that can be determined in any laboratory in the world. Lets make a prediction of the occurrence of liver fibrosis and what is the situation of normality or abnormality of the liver of a person and also anticipate the possibility of long-term complications. “In this way, the possibility of a person having cirrhosis in the long term and ending up developing cancer or dying from the disease can be foreseen”, points out Dr. Ginès.
“The applicability is similar to that of cardiovascular risk factors that have existed for many years and that predict whether a person is at risk of having a myocardial infarction,” says Dr. Ginès. “In this case it would be similar, but determining the risk of severe liver disease. And this is important because it may have applicability in terms of early diagnosis of these diseases and make a treatment before the patients develop cirrhosis and, therefore, the applicability is very important in an area in which until now there was no possibility of early diagnosis”, he concludes.