Clinical usefulness of biochemical markers of liver fibrosis in patients with nonalcoholic fatty liver disease.
OBJECTIVE
Nonalcoholic steatohepatitis (NASH) is a severe form of nonalcoholic fatty liver disease (NAFLD), and progresses to the end stage of liver disease. Biochemical markers of liver fibrosis are strongly associated with the degree of histological liver fibrosis in patients with chronic liver disease. However, data are few on the usefulness of markers in NAFLD patients. The aim of this study was to identify better noninvasive predictors of hepatic fibrosis, with special focus on markers of liver fibrosis, type VI collagen 7S domain and hyaluronic acid.


METHODS
One hundred and twelve patients with histologically proven NAFLD were studied.


RESULTS
The histological stage of NAFLD correlated with several clinical and biochemical variables, the extent of hepatic fibrosis and the markers of liver fibrosis were relatively strong associated. The best cutoff values to detect NASH were assessed by using receiver operating characteristic analysis: type VI collagen 7S domain > or =5.0 ng/mL, hyaluronic acid > or =43 ng/mL. Both markers had a high positive predictive value: type VI collagen 7S domain, 86% and hyaluronic acid, 92%. Diagnostic accuracies of these markers were evaluated to detect severe fibrosis. Both markers showed high negative predictive values: type VI collagen 7S domain (> or =5.0 ng/mL), 84% and hyaluronic acid (> or =50 ng/mL), 78%, and were significantly and independently associated with the presence of NASH or severe fibrosis by logistic regression analysis.


CONCLUSIONS
Both markers of liver fibrosis are useful in discriminating NASH from fatty liver alone or patients with severe fibrosis from patients with non-severe fibrosis.
Sakugawa
Hiroshi
H
First Department of Internal Medicine, University Hospital, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215 Japan. b987607@med.u-ryukyu.ac.jp
Nakayoshi
Tomofumi
T
Kobashigawa
Kasen
K
Yamashiro
Tsuyoshi
T
Maeshiro
Tatsuji
T
Miyagi
Satoru
S
Shiroma
Joji
J
Toyama
Akiyo
A
Nakayoshi
Tomokuni
T
Kinjo
Fukunori
F
Saito
Atsushi
A
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D024141:Collagen Type IV / Q000097:blood; D005234:Fatty Liver / Q000097:blood* / Q000473:pathology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008103:Liver Cirrhosis / Q000097:blood* / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results
D015415:Biomarkers; D024141:Collagen Type IV; D006442:Glycated Hemoglobin; D006820:Hyaluronic Acid; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M