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.
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.
Shimada
Masahiko
M
Department of Gastroenterology, Kanazawa Medical University, Ishikawa, Japan.
Kawahara
Hiromu
H
Ozaki
Kazuaki
K
Fukura
Masayuki
M
Yano
Hirokazu
H
Tsuchishima
Mutsumi
M
Tsutsumi
Mikihiro
M
Takase
Shujiro
S
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
D052242:Adiponectin; D015415:Biomarkers; D024141:Collagen Type IV; D006820:Hyaluronic Acid