Noninvasive Diagnosis of NAFLD and NASH

Piazzolla, Valeria; Mangia, Alessandra

doi:10.3390/cells9041005

Cited by 166 publications

(135 citation statements)

References 86 publications

Supporting

Mentioning

118

Contrasting

Unclassified

Order By: Relevance

“…Koehler et al, 23 in their retrospective study on 2652 patients with ultrasounddetected NAFLD, reported an AUROC of 0.81 for the FLI. Good performance of the FLI for the diagnosis of NAFLD has also been con rmed in other studies, 11,16,24 including a report by Motamed et al 25 that found an AUROC of 0.86 (95% CI: 0.85-0.87). Our study con rmed this conclusion as the correlation rate for the FLI and waist circumference was equal to 0.71 and 0.72, respectively.…”

Section: Biomarkerssupporting

confidence: 58%

Non-Invasive Assessment of Liver Steatosis: A Comprehensive Comparison of Biomarkers- and Ultrasound-Based Techniques

Kozłowska-Petriczko¹,

Petriczko

Syn

et al. 2021

Preprint

View full text Add to dashboard Cite

Background & Aims: In view of limited reliability of the biopsy in the assessment of liver fat, a non-invasive, trustworthy and more accessible method estimating a degree of steatosis is urgently needed. While controlled attenuation parameter (CAP) is used to quantify hepatic fat, its availability in routine practice is limited. Therefore, the aim of this study was to compare the diagnostic accuracy of biomarker- and ultrasound-based techniques for the diagnosis and grading of hepatic steatosis. Methods: This was a prospective study of 167 adults with and without non-alcoholic fatty liver disease. As measured against CAP, we assessed Hamaguchi’s score and the hepatorenal index (HRI), and the following biochemical measures: the fatty liver index, hepatic steatosis index and lipid accumulation product scores during a single out-patient visit. Area under the receiver operating curve (AUROC) analyses were used to evaluate the diagnostic accuracy of each test and to calculate optimal thresholds for the ultrasound techniques. Results: All non-invasive methods displayed high accuracy in detecting steatosis (mean AUC value ≥ 0.90), with Hamaguchi’s score and the HRI as the most precise. These two tests also had the highest sensitivity and specificity (82.2% and 100%; 86.9% and 94.8%, respectively). We propose new thresholds for Hamaguchi’s score and HRI for hepatic steatosis grading, indicated by optimal sensitivity and specificity. Conclusion: Ultrasound-based techniques are the most accurate for assessing liver steatosis compared to other non-invasive tests. Given the accessibility of ultrasonography, this finding is of practical importance for the assessment of liver steatosis in clinical settings.

show abstract

Section: Biomarkerssupporting

confidence: 58%

Non-Invasive Assessment of Liver Steatosis: A Comprehensive Comparison of Biomarkers- and Ultrasound-Based Techniques

Kozłowska-Petriczko¹,

Petriczko

Syn

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…( 3 ) Patients with more advanced NASH fibrosis have increased morbidity and mortality from both cardiovascular disease ( 4 ) and from progression of their liver disease, including progression to cirrhosis, liver failure, and hepatocellular carcinoma. ( 5,6 ) Diagnosis of NASH is complicated by the requirement for an invasive procedure, liver biopsy, to confirm diagnosis, and there is an unmet need for noninvasive biomarkers and imaging that can diagnose and stage advanced NASH with fibrosis ( 7,8 ) and monitor a patient's response to treatment.…”

mentioning

confidence: 99%

Effects of Resmetirom on Noninvasive Endpoints in a 36‐Week Phase 2 Active Treatment Extension Study in Patients With NASH

et al. 2021

View full text Add to dashboard Cite

Resmetirom (MGL‐3196), a selective thyroid hormone receptor‐β agonist, was evaluated in a 36‐week paired liver biopsy study (NCT02912260) in adults with biopsy‐confirmed nonalcoholic steatohepatitis (NASH). The primary endpoint was relative liver fat reduction as assessed by MRI–proton density fat fraction (MRI‐PDFF), and secondary endpoints included histopathology. Subsequently, a 36‐week active treatment open‐label extension (OLE) study was conducted in 31 consenting patients (including 14 former placebo patients) with persistently mild to markedly elevated liver enzymes at the end of the main study. In patients treated with resmetirom (80 or 100 mg orally per day), MRI‐PDFF reduction at OLE week 36 was −11.1% (1.5%) mean reduction (standard error [SE]; P < 0.0001) and −52.3% (4.4%) mean relative reduction, P < 0.0001. Low‐density lipoprotein (LDL) cholesterol (−26.1% [4.5%], P < 0.0001), apolipoprotein B (−23.8% [3.0%], P < 0.0001), and triglycerides (−19.6% [5.4%], P = 0.0012; −46.1 [14.5] mg/dL, P = 0.0031) were reduced from baseline. Markers of fibrosis were reduced, including liver stiffness assessed by transient elastography (−2.1 [0.8] mean kilopascals [SE], P = 0.015) and N‐terminal type III collagen pro‐peptide (PRO‐C3) (−9.8 [2.3] ng/mL, P = 0.0004 (baseline ≥ 10 ng/mL). In the main and OLE studies, PRO‐C3/C3M (matrix metalloproteinase‐degraded C3), a marker of net fibrosis formation, was reduced in resmetirom‐treated patients (−0.76 [−1.27, −0.24], P = 0.0044 and −0.68, P < 0.0001, respectively). Resmetirom was well tolerated, with few, nonserious adverse events. Conclusion: The results of this 36‐week OLE study support the efficacy and safety of resmetirom at daily doses of 80 mg and 100 mg, used in the ongoing phase 3 NASH study, MAESTRO‐NASH (NCT03900429). The OLE study demonstrates a potential for noninvasive assessments to monitor the response to resmetirom from an individual patient with NASH.

show abstract

“…In addition, the high financial cost and the potential procedural risks, withhold the liver biopsy to be used as a tool for regular patient follow-up in medical practice, creating a severe hiatus in NAFLD-management. Multiple non-invasive techniques have therefore been suggested to be more suitable as manner of first-line investigation, including laboratory (blood)tests, and imaging-based tools ( 13 ).…”

Section: Current Clinical Diagnostic Means For Fatty Liver Diseasementioning

confidence: 99%

Controversies and Opportunities in the Use of Inflammatory Markers for Diagnosis or Risk Prediction in Fatty Liver Disease

Lambrecht

Tacke

2021

Front. Immunol.

View full text Add to dashboard Cite

In the Western society, non-alcoholic fatty liver disease (NAFLD), characterized by the excessive accumulation of fat in the liver, represents the most common cause of chronic liver disease. If left untreated, approximately 15%–20% of patients with NAFLD will progress to non-alcoholic steatohepatitis (NASH), in which lobular inflammation, hepatocyte ballooning and fibrogenesis further contribute to a distorted liver architecture and function. NASH initiation has significant effects on liver-related mortality, as even the presence of early stage fibrosis increases the chances of adverse patient outcome. Therefore, adequate diagnostic tools for NASH are needed, to ensure that relevant therapeutic actions can be taken as soon as necessary. To date, the diagnostic gold standard remains the invasive liver biopsy, which is associated with several drawbacks such as high financial costs, procedural risks, and inter/intra-observer variability in histology analysis. As liver inflammation is a major hallmark of disease progression, inflammation-related circulating markers may represent an interesting source of non-invasive biomarkers for NAFLD/NASH. Examples for such markers include cytokines, chemokines or shed receptors from immune cells, circulating exosomes related to inflammation, and changing proportions of peripheral blood mononuclear cell (PBMC) subtypes. This review aims at documenting and critically discussing the utility of such novel inflammatory markers for NAFLD/NASH-diagnosis, patient stratification and risk prediction.

show abstract

Noninvasive Diagnosis of NAFLD and NASH

Cited by 166 publications

References 86 publications

Non-Invasive Assessment of Liver Steatosis: A Comprehensive Comparison of Biomarkers- and Ultrasound-Based Techniques

Non-Invasive Assessment of Liver Steatosis: A Comprehensive Comparison of Biomarkers- and Ultrasound-Based Techniques

Effects of Resmetirom on Noninvasive Endpoints in a 36‐Week Phase 2 Active Treatment Extension Study in Patients With NASH

Controversies and Opportunities in the Use of Inflammatory Markers for Diagnosis or Risk Prediction in Fatty Liver Disease

Contact Info

Product

Resources

About