Overview and developments in noninvasive diagnosis of nonalcoholic fatty liver disease.
High prevalence of non-alcoholic fatty liver disease (NAFLD) and very diverse outcomes that are related to disease form and severity at presentation have made the search for noninvasive diagnostic tools in NAFLD one of the areas with most intense development in hepatology today. Various methods have been investigated in the recent years, including imaging methods like ultrasound and magnetic resonance imaging, different forms of liver stiffness measurement, various biomarkers of necroinflammatory processes (acute phase reactants, cytokines, markers of apoptosis), hyaluronic acid and other biomarkers of liver fibrosis. Multicomponent tests, scoring systems and diagnostic panels were also developed with the purposes of differentiating non-alcoholic steatohepatitis from simple steatosis or discriminating between various fibrosis stages. In all of the cases, performance of noninvasive methods was compared with liver biopsy, which is still considered to be a gold standard in diagnosis, but is by itself far from a perfect comparative measure. We present here the overview of the published data on various noninvasive diagnostic tools, some of which appear to be very promising, and we address as well some of still unresolved issues in this interesting field.
Division of Gastroenterology and Hepatology, Department of Medicine, "Sestre milosrdnice" University Hospital Center, 10000 Zagreb, Croatia.
Neven
N
Baršić
Ivan
I
Lerotić
Lea
L
Smirčić-Duvnjak
Vedran
V
Tomašić
Marko
M
Duvnjak
D052242:Adiponectin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D018932:Chemokine CCL2 / Q000097:blood; D054459:Elasticity Imaging Techniques; D005234:Fatty Liver / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000097:blood; D053538:Keratin-18 / Q000097:blood; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D008111:Liver Function Tests; D008279:Magnetic Resonance Imaging; D065626:Non-alcoholic Fatty Liver Disease; D014057:Tomography, X-Ray Computed; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D052242:Adiponectin; D015415:Biomarkers; C111835:CCL2 protein, human; D018932:Chemokine CCL2; D015850:Interleukin-6; D053538:Keratin-18; D014409:Tumor Necrosis Factor-alpha; D006820:Hyaluronic Acid; D002097:C-Reactive Protein