title: Screening for liver disease using non-invasive biomarkers (FibroTest, SteatoTest and NashTest) in patients with hyperlipidaemia.
abstract: BACKGROUND
  Mortality related to complications of cirrhosis is increasing in patients with insulin-resistance factors. Hyperlipidaemic patients have multiple risk factors of insulin resistance. It is impossible to perform liver biopsy in such a large number of hyperlipidaemic patients to identify patients with advanced liver fibrosis or with steatohepatitis (non-alcoholic steatohepatitis, NASH).
  
  
  OBJECTIVE
  To use the non-invasive biomarkers, FibroTest (FT), SteatoTest and NashTest, and to assess the prevalence of advanced liver disease in a large population of hyperlipidaemic patients.
  
  
  METHODS
  A consecutive cohort of hyperlipidaemic patients was followed prospectively in a lipid centre and the sera were analysed retrospectively.
  
  
  RESULTS
  A total of 2834 subjects were included: 1909 hyperlipidaemic patients and 925 blood donors (BD). Advanced fibrosis was identified by FT in 53/1909 (2.8%) hyperlipidaemic patients vs. 0/925 BD (0%) (P < 0.0001); advanced steatosis in 569/1893 hyperlipidaemic patients (30.1%) vs. 8/164 (4.9%) BD (P < 0.0001) and NASH in 132/1893 (7%) vs. 0/164 (0%), respectively (P < 0.0001). There was a highly significant and linear association between the number of metabolic syndrome factors and liver disease prevalence - the highest being for type 2 diabetics: advanced steatosis 66%, NASH 24% and advanced fibrosis 6%. CONCLUSIONS The prevalence of fibrosis, steatosis and NASH in hyperlipidaemic patients appears to be high (3%, 30% and 7%, respectively). Biomarkers could be useful for screening of advanced fibrosis and NASH in patients with several metabolic syndrome factors, to prevent liver mortality.
authors.affiliation: APHP Hépatologie GHPS, Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Ratziu
authors.forename: P
authors.initials: P
authors.lastname: Giral
authors.forename: M
authors.initials: M
authors.lastname: Munteanu
authors.forename: D
authors.initials: D
authors.lastname: Messous
authors.forename: A
authors.initials: A
authors.lastname: Mercadier
authors.forename: M
authors.initials: M
authors.lastname: Bernard
authors.forename: R
authors.initials: R
authors.lastname: Morra
authors.forename: F
authors.initials: F
authors.lastname: Imbert-Bismut
authors.forename: E
authors.initials: E
authors.lastname: Bruckert
authors.forename: T
authors.initials: T
authors.lastname: Poynard
mesh_terms: D015415:Biomarkers / Q000097:blood*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D008107:Liver Diseases / Q000175:diagnosis* / Q000209:etiology; D008111:Liver Function Tests / Q000592:standards*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D015415:Biomarkers