Diagnostic value of a group of biochemical markers of liver fibrosis in patients with non-alcoholic steatohepatitis.
OBJECTIVE
The objectives of this study were to investigate the use of non-invasive biochemical markers to evaluate the severity of liver fibrosis in patients with non-alcoholic steatohepatitis (NASH).


METHODS
This was a cross-sectional study of patients with histopathologically confirmed NASH between January 2005 and December 2006. The patients' characteristics were recorded and the body mass index was calculated for each patient. All patients underwent ultrasound-guided liver biopsy and a fibrosis assessment was performed using the Brunt criteria. The non-invasive laboratory markers measured were insulin resistance, tumor necrosis factor (TNF-alpha), type IV collagen and hyaluronic acid (HA).


RESULTS
Thirty patients were recruited, of whom 18 (60%) were men. Their mean age was 45 +/- 13.9 (18-71) years. About 83% of patients had fibrosis stage 1-2. In bivariate analysis, age, TNF-alpha and type IV collagen concentrations showed a weak but significant correlation with the fibrosis stage. When the patients were grouped into mild fibrosis (stages 1-2) and advanced fibrosis (stages 3-4), the mean concentrations of HA and type IV collagen were significantly higher in those with advanced fibrosis than those with mild fibrosis (180.8 +/- 49.63 vs 543.6 +/- 360.45 ng/mL; for HA; P = 0.026 and 125.3 +/- 32.11 vs 288.0 +/- 171.22 ng/mL for type IV collagen; P = 0.010).


CONCLUSIONS
Our study showed that the degree of liver fibrosis was significantly correlated with age, TNF-alpha and type IV collagen concentrations. The level of HA and type IV collagen could differentiate between mild (F1-2) and advanced fibrosis (F3-4).
Lesmana
C Rinaldi A
CR
Department of Internal Medicine, Division of Hepatology, University of Indonesia, Jakarta, Indonesia.
Hasan
Irsan
I
Budihusodo
Unggul
U
Gani
Rino A
RA
Krisnuhoni
Ening
E
Akbar
Nurul
N
Lesmana
Laurentius A
LA
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D024141:Collagen Type IV / Q000097:blood*; D005234:Fatty Liver / Q000097:blood; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood*; D008103:Liver Cirrhosis / Q000097:blood*; D008297:Male; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*; D055815:Young Adult
D015415:Biomarkers; D024141:Collagen Type IV; D014409:Tumor Necrosis Factor-alpha; D006820:Hyaluronic Acid