2023-08-10 12:54:03
Cirrhosis is one of the main causes of mortality in the world —the seventh in particular— and the second issue that causes loss of years in Europe. The reason is that it can cause Liver cancer (hepatocellular carcinoma) and together with cirrhosis are the two diseases that cause two million deaths each year.
Because of this, researchers from the Hospital Clínic-Idibaps have led an international study, within the framework of the European ‘LiverScreen’ project, through which they have designed a predictive tool that allows determining the risk of developing cirrhosis or other serious liver diseases. in the general population.
The work, published in the UK magazine ‘The Lancet’, focused on the development of a risk index. To do this, the experts relied on data from 6.400 personas without known liver disease, who were diagnosed with liver fibrosis after a liver elastography test, which allows determining liver stiffness.
This risk index was subsequently validated in a group of 8.369 personas of the general population and its prognostic value was determined in a cohort of more than 416,000 participants without liver disease and with a follow-up of 12 years.
The index, called ‘LiverRisk‘, is based on two factors (age and sex) and six standard laboratory parameters, allows a prediction of the appearance of liver fibrosis and what is the normal or abnormal situation of a person’s liver, and also anticipate the possibility of long-term complications. These values are glucose, cholesterol, the two after tansaminases, the enzyme gamma glutamyl transpeptidase (GGT) and the rate of blood platelets.
By entering this data on the ‘LiverRisk’ website, a calculation is automatically performed and a risk scale. Below 6 the risk is minimal, from 6 to 10 it is low, between 10 and 15 intermediate and from 15 it is high.
“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,” explained Pere Ginès, consultant to the Clínic’s Hepatology Service and coordinator of the study.
silent disease
Pere Ginès stressed that cirrhosis is a disease that «develops very slowly and produces no symptomsso that very often when it is diagnosed it is in a very advanced phase and in which the possibilities of treatment are very limited”, therefore “being able to identify early which people are at risk of having progressive fibrosis in the liver would make it possible to apply changes in people’s lifestyles or carry out treatments to prevent the development of cirrhosis”.
To date, non-invasive techniques or analytics-based risk calculators they had certain limitations. There was an unmet medical need for simple tools based on clinical or laboratory variables to identify people at risk of liver fibrosis.
Pere Ginès argued that the applicability of the new technique 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.” In his opinion, “in this case, it would be similar, but determining the risk of severe liver disease”, which is “very important” to “diagnose these diseases early and treat them before patients develop cirrhosis.” ».
The Hospital Clínic-Idibaps coordinates the European ‘LiverScreen’ project, funded by the EU’s ‘Horizon 2020’ program with six million euros, whose objective is to “evaluate the potential of a non-invasive technique, hepatic elastography, in screening of chronic liver diseases in the general population. 43 hospitals and research centers from Spain, Denmark, France, the Netherlands, England, Germany, Italy and Croatia participate in this project, and it includes health professionals and experts in economics, statistics and quality control.
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