A model for estimating cirrhosis in patients with type 1 autoimmune hepatitis

  1. Yasuhiro Miyake1,*,
  2. Yoshiaki Iwasaki1,
  3. Ryo Terada1,
  4. Takuya Nagano2,
  5. Haruhiko Kobashi1,
  6. Kohsaku Sakaguchi1,
  7. Yasushi Shiratori1

Article first published online: 5 MAR 2008

DOI: 10.1111/j.1872-034X.2008.00329.x

Issue

Hepatology Research

Hepatology Research

Volume 38, Issue 7, pages 658–663, July 2008

Additional Information

How to Cite

Miyake, Y., Iwasaki, Y., Terada, R., Nagano, T., Kobashi, H., Sakaguchi, K. and Shiratori, Y. (2008), A model for estimating cirrhosis in patients with type 1 autoimmune hepatitis. Hepatology Research, 38: 658–663. doi: 10.1111/j.1872-034X.2008.00329.x

Author Information

  1. 1

    Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, and

  2. 2

    Department of Internal Medicine, Kagawa Prefectural Central Hospital, Takamatsu, Japan

*Dr Yasuhiro Miyake, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. Email: miyakeyasuhiro@hotmail.com

Publication History

  1. Issue published online: 5 MAR 2008
  2. Article first published online: 5 MAR 2008
  3. Received 25 September 2007; revision 23 November 2007; accepted 10 December 2007.

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Keywords:

  • AST/ALT ratio;
  • autoimmune hepatitis;
  • cirrhosis;
  • immunoglobulin A;
  • platelet

Aim:  Longstanding cirrhosis has been recognized as a risk factor for the development of hepatocellular carcinoma in patients with autoimmune hepatitis (AIH). Thus, the accurate determination of cirrhosis is important for prognostication, decisions regarding treatment and monitoring of disease progression. The aim of this study was to identify independent predictors of cirrhosis and to develop a model for estimating cirrhosis in patients with type 1 AIH.

Methods:  Using the training sample, consisting of 121 patients with type 1 AIH, we retrospectively examined independent predictors of cirrhosis and constructed a model for estimating cirrhosis. Validation was prospectively performed in the validation sample, consisting of 35 patients.

Results:  Using a stepwise multiple linear regression analysis, three predictors of serum immunoglobulin A level, ratio of aspartate aminotransferase to alanine aminotransferase, and platelet count were elicited, and a model for estimating cirrhosis was determined as follows: risk score = −0.113 + 0.0006056 × immunoglobulin A (mg/dL) + 0.155 × ratio of aspartate aminotransferase to alanine aminotransferase − 0.007079 × platelet (×104/mm3). In the training sample, the sensitivity and specificity were 90% and 83%, respectively, when patients presenting a risk score ≥0.20 were estimated to be cirrhotic. When this model was applied to the validation sample, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 83%, 97%, 83%, 97% and 94%, respectively.

Conclusion:  It is suggested that this model could be useful for the estimation of cirrhosis in patients with type 1 autoimmune hepatitis.

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