title: Usefulness of a combined evaluation of the serum adiponectin level, HOMA-IR, and serum type IV collagen 7S level to predict the early stage of nonalcoholic steatohepatitis.
abstract: OBJECTIVE
  Since nonalcoholic steatohepatitis (NASH) may progress to cirrhosis, it is important to differentiate NASH from simple steatosis, especially in its early stages. However, a liver biopsy cannot be performed in all patients with nonalcoholic fatty liver disease (NAFLD). We herein investigated whether serum biochemical markers are useful for predicting early-stage NASH.
  
  
  METHODS
  Nineteen patients with simple steatosis and 66 patients with early-stage NASH (stage 1-2 in Brunt's criteria) were studied. The area under the receiver operating characteristic curve (AUC) was used to illustrate the diagnostic ability of serum biochemical parameters to distinguish between simple steatosis and early-stage NASH.
  
  
  RESULTS
  The serum adiponectin level was found to be significantly lower with early-stage NASH group (3.6 mug/mL) than in the simple steatosis group (6.0 mug/mL) (P < 0.001). The AUC was high (0.765) in the early-stage NASH group, and it was also the highest among all other markers. The sensitivity of the serum adiponectin level in the diagnosis of early-stage NASH was 68%, which was higher than for any other factors, while its specificity was 79%. The corresponding sensitivity and specificity of HOMA-IR were 51% and 95%, respectively. For type IV collagen 7S, sensitivity was 41% and specificity 95%. The sensitivity of the combination of three markers was 94%, with a specificity of 74%.
  
  
  CONCLUSIONS
  Approximately 90% of the patients with early-stage NASH can be predicted by a combined evaluation of the serum adiponectin level, HOMA-IR, and serum type IV collagen 7S level.
authors.affiliation: Department of Gastroenterology, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Shimada
authors.forename: Hiromu
authors.initials: H
authors.lastname: Kawahara
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Ozaki
authors.forename: Masayuki
authors.initials: M
authors.lastname: Fukura
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Yano
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Tsuchishima
authors.forename: Mikihiro
authors.initials: M
authors.lastname: Tsutsumi
authors.forename: Shujiro
authors.initials: S
authors.lastname: Takase
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D024141:Collagen Type IV / Q000097:blood*; D005234:Fatty Liver / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity
chemical_list: D052242:Adiponectin; D015415:Biomarkers; D024141:Collagen Type IV; D006820:Hyaluronic Acid