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. 2010 Jun 28;10:67.
doi: 10.1186/1471-230X-10-67.

Validation of the BARD Scoring System in Polish Patients With Nonalcoholic Fatty Liver Disease (NAFLD)

Free PMC article

Validation of the BARD Scoring System in Polish Patients With Nonalcoholic Fatty Liver Disease (NAFLD)

Joanna Raszeja-Wyszomirska et al. BMC Gastroenterol. .
Free PMC article


Background: Nonalcoholic fatty liver disease (NAFLD) includes a wide spectrum of liver diseases, ranging from pure steatosis to nonalcoholic steatohepatitis (NASH), and eventually to liver cirrhosis with its complications. Identifying advanced fibrosis in patients is crucial to evaluating prognosis and possible therapeutic intervention. A novel, simple, and highly accurate scoring system called BARD, which identifies patients with NAFLD and without significant fibrosis, has been recently introduced and validated in North America..The aim of this study is to validate the BARD scoring system in a Polish cohort with NAFLD.

Methods: A group of 104 Caucasians with biopsy-proven NAFLD were included in this study. Fibrosis in liver biopsies was evaluated according to the Histological Scoring System for Nonalcoholic Fatty Liver Disease. The BARD scoring system was assessed according to Harrison et al.: BMI > or = 28 = 1 point, AST/ALT ratio (AAR) > or = 0.8 = 2 points, type 2 diabetes mellitus = 1 point.

Results: Age over 50 and AAR over 0.8 showed, respectively, a moderate and strong association with advanced fibrosis. A BARD score of 2-4 points was associated with F3 or F4 stages of fibrosis with an odds ratio of 17.333 (95% Cl; 3,639 - 82.558) and negative predictive value of 97%.

Conclusion: Our results demonstrate that the BARD scoring system has value in the non-invasive diagnosis of advanced fibrosis in NAFLD patients. The vast majority of patients with NAFLD would avoid liver biopsy if BARD was broadly introduced into the clinic.


Figure 1
Figure 1
Simple steatosis plus non-alcoholic steatohepatitis (NASH) with fibrosis stages 0-2 vs. NASH with fibrosis stages 3-4.

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    1. Fracanzani AL, Valenti L, Bugianesi E, Andreoletti M, Colli A, Vanni E, Bertelli C, Fatta E, Bignamini D, Marchesini G, Fargion S. Risk of severe level disease in nonalcoholic fatty liver disease with normal aminotransferase levels: a role for insulin resistance and diabetes. Hepatology. 2008;48:792–798. doi: 10.1002/hep.22429. - DOI - PubMed
    1. Tarantino G, Saldalamacchia G, Conca P, Arena A. Non-alcoholic fatty liver disease: further expression of the metabolic syndrome. J Gastroenterol Hepatol. 2007;22:293–303. doi: 10.1111/j.1440-1746.2007.04824.x. - DOI - PubMed
    1. Tarher G, Bertolini L, Padovani R, Rodella S, Tessari R, Zenari L, Day Ch, Arcaro G. Prevalence of nonalcoholic fatty liver disease and its association with cardiovascular disease among type 2 diabetic patients. Diabetes Care. 2007;30:1212–1218. doi: 10.2337/dc06-2247. - DOI - PubMed
    1. Harrison SA, Oliver D, Arnold HL, Gogia S, Neuschwandet-Tetri BA. Development and validation of a simple NAFLD clinical scoring system for identifying patients without advanced disease. Gut. 2008;57:1441–1447. doi: 10.1136/gut.2007.146019. - DOI - PubMed
    1. Angulo P, Hui JM, Marchesini G, Bugianesi E, George J, Farrell GC, Enders F, Saksena S, Burt AD, Bida JP, Lindor K, Sanderson SO, Lenzi M, Adams LA, Kench J, Therneau TB, Day CP. The NAFLD Fibrosis Score: a noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology. 2007;45:846–854. doi: 10.1002/hep.21496. - DOI - PubMed

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