Some of the data contained in a conventional blood test can scale to predict the long-term risk of developing cirrhosis or other serious liver diseases, so that they can be treated early and stopped before they manifest.
Clínic-Idibaps researchers have led an international study to design this predictive tool. to which they attribute the potential to revolutionize the early diagnosis of liver pathologies. Cirrhosis and liver cancer, two related diseases, are the seventh leading cause of death in the world.
The predictive tool is the product of years of work by various teams, in 43 European hospitals, within the framework of the LiverScreen community program, but it is terribly simple, cheap, applicable and within the reach of any health care provider, even anyone.
Researchers have determined that two factors (age and sex) and six other variables that can be calibrated by any laboratory in a standard blood test anticipate the chances of having liver disease. These values are those of glucose, cholesterol, the two transaminases, gamma glutamyl transpeptidase (GGT, an enzyme present throughout the body, especially in the liver), and the rate of blood platelets.
By entering this data on a web page (www.liverriskscore.com) the calculation is automatically performed and a scale of risk of becoming ill appears. Below 6 the risk is minimal, from 6 to 10 it is low, between 10 and 15 intermediate and from 15 it is high.
"As of the intermediate risk, action must be taken," explains Pere Ginès, consultant at the Clínic's Hepatology service and head of the Idibaps Chronic Liver Diseases group. Taking action means making changes to the lifestyle of people at risk or starting treatments that slow down the progression.
Cirrhosis is caused by the accumulation of fibrous tissue in the liver and can cause hepatocellular carcinoma, the most common liver cancer. The two diseases cause more than two million deaths a year in the world and constitute the second cause of years of life lost in Europe. Its prevalence in Western countries is growing due to obesity and type 2 diabetes, and alcohol as a second cause.
Cirrhosis develops very slowly and does not produce symptoms, so it is usually diagnosed in advanced stages and with limited treatment possibilities. “If you can identify the disease years before it occurs, it will be reversible; if not, it often ends in death or transplantation. If the early detection model is applied in a context of monitoring established treatment protocols, many deaths can be avoided”, says Dr. Ginès.
Published in The Lancet , the study is based on data from 6,400 people who were initially healthy but some were later found to have fibrosis. The liver risk factor was subsequently applied to a cohort of more than 400,000 people in the UK followed for more than 12 years.
“It has been proven that those with a high risk of liver disease died earlier than the rest for this reason and it has been possible to classify people based on this risk”, explains Ginès. In his opinion, the liver disease risk detection model is similar to that of myocardial infarction risk factors that has been used for many years. According to the doctor, due to its simplicity, the system could be applied in population screenings such as breast cancer in women or colon cancer in men.
In a next phase, in regions of Germany, Denmark and Croatia, and in Catalonia (part of Barcelona), the diagnostic instrument will be tested to determine which apparently healthy people are incubating a serious liver disease.
