A recent study from the Karolinska Institutet has unveiled a straightforward blood test capable of predicting the risk of developing severe liver disease, including cirrhosis and liver cancer. Published in the scientific journal The BMJ, this research aims to enhance early detection within primary healthcare settings, addressing a growing health concern.
Researchers, including Rickard Strandberg and Hannes Hagström, developed a predictive model named CORE, which utilizes three standard blood tests to estimate the likelihood of severe liver disease over a ten-year period. “These diseases have a poor prognosis if detected late,” Strandberg stated, emphasizing the importance of timely intervention.
The CORE model evaluates five key factors: age, sex, and levels of three liver enzymes—AST, ALT, and GGT. These enzymes are routinely measured during health check-ups. The aim was to create a user-friendly tool for primary care professionals, where most patients initially seek medical advice.
A web-based calculator is now accessible for healthcare providers at www.core-model.com, streamlining the process of risk assessment. Hagström, who serves as an adjunct professor at the Department of Medicine in Huddinge, remarked, “This is an important step towards being able to offer early screening for liver disease in primary care.”
The study analyzed health check data from over 480,000 individuals in Stockholm, collected between 1985 and 1996. Over the course of up to 30 years, approximately 1.5 percent of participants developed severe liver conditions, necessitating liver transplants or resulting in liver cancer. The CORE model demonstrated a high accuracy rate, successfully differentiating between individuals who developed liver disease and those who did not in 88 percent of cases. This represents a significant improvement over the currently utilized FIB-4 method.
“Primary care hasn’t had the tools to detect the risk of severe liver disease in time,” Hagström explained. He noted that the FIB-4 model does not serve the general population well and falls short in predicting future risks effectively.
Validation of the CORE model extended beyond Sweden, as it was tested on additional population groups in Finland and the UK, where it again showed promising accuracy in predicting liver disease risk. Despite these advances, the researchers stress the need for further validation within high-risk groups, such as individuals with type 2 diabetes or obesity. They also highlight the necessity of integrating the CORE model into electronic medical records to enhance its clinical application.
The collaborative study involved experts from the Karolinska Institutet, Helsinki University Hospital, Helsinki University, and the Finnish Institute for Health and Welfare. Funding was secured from the Swedish Research Council, Region Stockholm (CIMED), and the Swedish Cancer Society. Although Hagström is engaged in collaborations with the pharmaceutical industry regarding liver disease prognosis, he clarified that none pertain to the current study.
This innovative approach to risk assessment for liver disease may pave the way for significant improvements in early detection and treatment options in the future, potentially saving countless lives.
