title: Utility of the ELF Test for Detecting Steatohepatitis in Morbid Obese Patients with Suspicion of Nonalcoholic Fatty Liver Disease.
abstract: Morbid obese patients have a high rate of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). NASH is related to the progression and poor evolution of chronic hepatopathy in NAFLD, so that its detection makes it possible to identify the subjects who are most at risk in order to prioritize treatment. The ELF test (Enhanced Liver Fibrosis test; Siemens Diagnostics, NY, USA) has been assessed for its capacity to detect fibrosis in patients with NAFLD, but its capacity for diagnosing NASH has not been checked.
  
  
  
  Our objective is to determine the utility of the ELF test for detecting NASH in morbid obese patients with suspected NAFLD.
  
  
  
  ELF values were determined in a cohort of obese patients who underwent bariatric surgery with suspected NAFLD. Liver biopsy was used as the reference standard.
  
  
  
  The values of ELF were significantly higher in patients with NASH (p = 0.002) and in those who presented with metabolic syndrome (p = 0.047). An ELF cut-off point of 8.72 allows the detection of patients with NASH with a sensitivity of 71.4% and a specificity of 74.1% (AUC = 0.742, p = 0.002).
  
  
  
  The ELF test is efficient for the identification of obese patients with NAFLD and early signs of steatohepatitis and fibrosis.
authors.affiliation: Department of Clinical Analysis, Clinic University Hospital Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, 30120, Murcia, Spain. iriacebreiros@hotmail.com.
authors.forename: Iria Cebreiros
authors.initials: IC
authors.lastname: López
authors.affiliation: Department of Radiology, Clinic University Hospital Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, 30120, Murcia, Spain.
authors.forename: Florentina Guzmán
authors.initials: FG
authors.lastname: Aroca
authors.affiliation: Department of Surgery, Clinic University Hospital Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, 30120, Murcia, Spain.
authors.forename: Maria Dolores Frutos
authors.initials: MDF
authors.lastname: Bernal
authors.affiliation: Department of Surgery, Clinic University Hospital Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, 30120, Murcia, Spain.
authors.forename: Juan Antonio Luján
authors.initials: JAL
authors.lastname: Mompeán
authors.affiliation: Department of Pathology, Clinic University Hospital Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, 30120, Murcia, Spain.
authors.forename: Águeda Bas
authors.initials: ÁB
authors.lastname: Bernal
authors.affiliation: Department of Endocrinology and Nutrition, Clinic University Hospital Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, 30120, Murcia, Spain.
authors.forename: Antonio Miguel Hernández
authors.initials: AMH
authors.lastname: Martínez
authors.affiliation: Department of Pathology, Clinic University Hospital Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, 30120, Murcia, Spain.
authors.forename: Enrique Martínez
authors.initials: EM
authors.lastname: Barba
authors.affiliation: Department of Clinical Analysis, Clinic University Hospital Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, 30120, Murcia, Spain.
authors.forename: Jose Antonio Noguera
authors.initials: JAN
authors.lastname: Velasco
authors.affiliation: Department of Surgery, Clinic University Hospital Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, 30120, Murcia, Spain.
authors.forename: Pascual Parilla
authors.initials: PP
authors.lastname: Paricio
mesh_terms: D000328:Adult; D000465:Algorithms; D050110:Bariatric Surgery; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D015331:Cohort Studies; D018450:Disease Progression; D005234:Fatty Liver / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D008111:Liver Function Tests / Q000379:methods / Q000592:standards; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D009767:Obesity, Morbid / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D011237:Predictive Value of Tests; D012015:Reference Standards; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers
keywords: Biomarkers; ELF; Morbid obesity; NAFLD; NASH