A combined and sequential non-invasive approach to diagnosing non-alcoholic steatohepatitis in patients with non-alcoholic fatty liver disease and persistently normal alanine aminotransferase levels

Zheng, Kenneth I.; Liu, Wen-Yue; X, Pan; Ma, Hongjuan; Zhu, Pei-Wu; Wu, Xixi; Targher, Giovanni; Byrne, Chris; Wang, Xiaodong; Chen, Yongping; Lü, Fang; Zheng, Ming‐Hua

doi:10.1016/s0168-8278(20)31322-2

“…In two meta-analyses, the pooled AUROC of CK-18 was 0.82 with a sensitivity of 66% to 78% and specificity of 82% to 87% [41,42] . To increase CK-18 sensitivity, several studies tried to combine it with other biological parameters, such as soluble Fas (sFas) levels, uric acid, serum Golgi protein 73, adiponectin and resistin, or ALT and presence of metabolic syndrome [43–46] …”

Section: Non-invasive Assessment Of Nashmentioning

confidence: 99%

“…[ 41 , 42 ] To increase CK-18 sensitivity, several studies tried to combine it with other biological parameters, such as soluble Fas (sFas) levels, uric acid, serum Golgi protein 73, adiponectin and resistin, or ALT and presence of metabolic syndrome. [ 43 – 46 ]…”

Section: Non-invasive Assessment Of Nashmentioning

confidence: 99%

Non-invasive tests of non-alcoholic fatty liver disease

Li

¹

,

Zhang

²

,

Lin

³

et al. 2022

Chinese Medical Journal

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For the detection of steatosis, quantitative ultrasound imaging techniques have achieved great progress in past years. Magnetic resonance imaging proton density fat fraction is currently the most accurate test to detect hepatic steatosis. Some blood biomarkers correlate with non-alcoholic steatohepatitis, but the accuracy is modest. Regarding liver fibrosis, liver stiffness measurement by transient elastography (TE) has high accuracy and is widely used across the world. Magnetic resonance elastography is marginally better than TE but is limited by its cost and availability. Several blood biomarkers of fibrosis have been used in clinical trials and hold promise for selecting patients for treatment and monitoring treatment response. This article reviews new developments in the non-invasive assessment of non-alcoholic fatty liver disease (NAFLD). Accumulating evidence suggests that various non-invasive tests can be used to diagnose NAFLD, assess its severity, and predict the prognosis. Further studies are needed to determine the role of the tests as monitoring tools. We cannot overemphasize the importance of context in selecting appropriate tests.

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“…Diagnoses of diabetes, metabolic syndrome, hypertension, and dyslipidemia were made according to commonly used diagnostic criteria, as previously described. 9 Homeostasis model assessment of insulin resistance (HOMA-IR) was also calculated by using an established formula. 10…”

Section: Clinical and Biochemical Parametersmentioning

confidence: 99%

Lower levels of plasma NT-proBNP are associated with higher prevalence of NASH in patients with biopsy-proven NAFLD

Qiao

¹

,

Zheng

²

,

Zhu

³

et al. 2020

Nutrition, Metabolism and Cardiovascular Diseases

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Background and Aims. Emerging evidence suggests that plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels are decreased in patients with imaging-defined nonalcoholic fatty liver disease (NAFLD), but no data are currently available on the association between plasma NT-proBNP levels and the histologic severity of NAFLD.Methods and Results. We enrolled 351 (73.5% men) consecutive adult patients with biopsyproven NAFLD without a prior history of cardiovascular disease. Plasma NT-proBNP levels were measured using a commercially available immunochemical system (VITROS® 5600, Johnson, New Jersey). Fifty-three percent of these subjects had nonalcoholic steatohepatitis (NASH). After stratification of patients by plasma NT-proBNP tertiles; compared to those in the 1 st tertile (NT-proBNP ≤16 pg/ml), the odds ratio for NASH was 0.52 (95% CI 0.29-0.95) in patients in the 2 nd tertile (NT-proBNP of 17-33 pg/ml) and 0.49 (95% CI 0.26-0.93) in those in the 3 rd tertile (NT-proBNP ≥34 pg/ml) of plasma NT-proBNP levels, even after adjustment for age, sex, body mass index, HOMA-estimated insulin resistance, pre-existing diabetes, hypertension and dyslipidemia. Conclusions.In subjects with biopsy-proven NAFLD without known cardiovascular disease, this cross-sectional study shows for the first time, that lower plasma NT-proBNP levels are strongly associated with a higher prevalence of NASH.

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“…Previous studies have demonstrated the potential utility of serum GP73 concentration in the assessment of the disease progression in chronic hepatitis B [4,5,8,12,13], [14], and our own previous findings have demonstrated that serum GP73 represents a surrogate biomarker of liver fibrosis, regardless of the disease etiology [15]. We reported that serum GP73 is closely related to the severity of liver necroinflammation and has the potential to identify moderate to severe liver necroinflammation in patients with either chronic hepatitis B virus infection or nonalcoholic steatohepatitis (NASH) [16][17][18]. In this study, we aimed to explore the relationship between GP73 and liver necroinflammation in AILDs, and we evaluated the potential value of serum GP73 as a noninvasive biomarker of liver inflammation in patients with AIH or PBC.…”

Section: Introductionmentioning

confidence: 82%

Diagnostic Value of Serum Golgi Protein 73 for Liver Inflammation in Patients with Autoimmune Hepatitis and Primary Biliary Cholangitis

Yao

¹

,

Wang

²

,

Wang

³

et al. 2022

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Background. There is lack of reliable serum biomarkers to reflect the severity of liver necroinflammation for those who suffer autoimmune liver diseases (AILDs). In this study, a previously established patient cohort was used to explore the potential of serum Golgi protein 73 (GP73) as a noninvasive marker of AILD-related liver necroinflammation. Methods. Serum GP73 concentration was measured in a retrospective cohort of 168 AILD patients, which included 74 patients with autoimmune hepatitis (AIH) and 94 with primary biliary cholangitis (PBC) who had undergone liver biopsy. Spearman’s correlation and multivariate analysis were used to evaluate the relationship between serum GP73 and liver necroinflammation. A receiver operating characteristic curve was constructed to evaluate the value of GP73 for the prediction of moderate or severe liver necroinflammation. The diagnostic value of serum GP73 was also compared with that of alkaline phosphatase (ALP) in patients with PBC. Histologically, immunohistochemical analysis was performed to assess hepatic GP73 expression. Results. Both the serum level and hepatic tissue expression of GP73 protein were aberrantly elevated and correlated well with the severity of necroinflammation in both AIH ( rho = 0.655 , P < 0.001 ) and PBC ( rho = 0.547 , P < 0.001 ) patients. The results here suggested that serum GP73 could be an independent biomarker to reflect the severity of liver necroinflammation. The AUROCs for GP73 to predict moderate necroinflammation (≥G2) and severe necroinflammation (≥G3) in patients with AIH were 0.828 and 0.832, respectively. Moreover, the AUROCs of serum GP73 for the identification of moderate necroinflammation (≥G2) ( AUROC = 0.820 , P < 0.001 ) and severe necroinflammation (≥G3) ( AUROC = 0.803 , P < 0.001 ) were superior to those of ALP (≥G2: AUROC = 0.607 , P = 0.028 and ≥G3: AUROC = 0.559 , P = 0.357 ) in patients with PBC. Mechanically, interlukin-6 (IL-6), the proinflammatory and prohepatic regenerating cytokine, could transcriptionally upregulate GP73 gene expression. Conclusion. Serum GP73 is a potential noninvasive biomarker to evaluate the severity of liver necroinflammation in patients with AILDs.

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A combined and sequential non-invasive approach to diagnosing non-alcoholic steatohepatitis in patients with non-alcoholic fatty liver disease and persistently normal alanine aminotransferase levels

Cited by 5 publications

References 30 publications

Non-invasive tests of non-alcoholic fatty liver disease

Non-invasive tests of non-alcoholic fatty liver disease

Lower levels of plasma NT-proBNP are associated with higher prevalence of NASH in patients with biopsy-proven NAFLD

Diagnostic Value of Serum Golgi Protein 73 for Liver Inflammation in Patients with Autoimmune Hepatitis and Primary Biliary Cholangitis

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