title: Classification of patients with non-alcoholic fatty liver disease using rapid immunoassay of serum type IV collagen compared with liver histology and other fibrosis markers.
abstract: OBJECTIVE
  Non-alcoholic fatty liver disease (NAFLD) can progress to non-alcoholic fatty liver (NAFL) or non-alcoholic steatohepatitis (NASH). We investigated the association among serum type IV collagen level, liver histology, and other fibrosis markers in NAFLD progression.
  
  
  METHODS
  We evaluated 184 patients diagnosed with NAFLD following biopsy, including 89 males and 95 females with an average age of 52.6 and 62.6 years, respectively. Non-alcoholic fatty liver disease was classified as NAFL or NASH using Matteoni's classification, and the grade and stage of NASH were assessed using Brunt's classification. Serum type IV collagen was measured by a rapid and sensitive latex particle-enhanced turbidimetric immunoassay.
  
  
  RESULTS
  Forty-two patients with NAFL and 142 patients with NASH were included in this study. Compared with patients with NAFL, patients with NASH showed more significant liver function disorder and increased expression of fibrosis markers including type IV collagen, collagen 7S, Mac2-binding protein (M2BP), and hyaluronic acid (HA). Expression of type IV collagen and collagen 7S, but not M2BP and HA, was more significantly elevated in patients with stage 1 NASH than in patients with NAFL, indicating that type IV collagen and collagen 7S may be better discriminators of NASH and NAFL than M2BP and HA at an early stage of fibrosis. When patients were stratified by NAFLD activity score, type IV collagen and collagen 7S were significantly elevated as NAFLD activity score progressed, whereas M2BP and HA expression were not significantly elevated.
  
  
  CONCLUSIONS
  Type IV collagen may be a useful measure of NASH severity as latex particle-enhanced turbidimetric immunoassay-based rapid type IV collagen assay can be carried out routinely.
authors.affiliation: Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Osaka, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Mizuno
authors.affiliation: Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Osaka, Japan.
authors.forename: Toshihide
authors.initials: T
authors.lastname: Shima
authors.affiliation: Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Osaka, Japan.
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Oya
authors.affiliation: Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Osaka, Japan.
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Mitsumoto
authors.affiliation: Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Osaka, Japan.
authors.forename: Chiemi
authors.initials: C
authors.lastname: Mizuno
authors.affiliation: Department of Clinical Laboratory, Saiseikai Suita Hospital, Osaka, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Isoda
authors.affiliation: Department of Clinical Laboratory, Saiseikai Suita Hospital, Osaka, Japan.
authors.forename: Mizue
authors.initials: M
authors.lastname: Kuramoto
authors.affiliation: Department of Clinical Laboratory, Saiseikai Suita Hospital, Osaka, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Taniguchi
authors.affiliation: Department of Clinical Laboratory, Saiseikai Suita Hospital, Osaka, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Noda
authors.affiliation: Department of Clinical Laboratory, Saiseikai Suita Hospital, Osaka, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Sakai
authors.affiliation: Eidia Co. Ltd, Tokyo, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Koyama
authors.affiliation: Department of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Osaka, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okanoue
keywords: fibrosis; non-alcoholic fatty liver disease; non-alcoholic steatohepatitis; type IV collagen