Noninvasive predictors for liver fibrosis in patients with nonalcoholic steatohepatitis

Abstract

AIM:To evaluate certain anthropometric, clinical and laboratory features indicating liver fibrosis in nonalcoholic steatohepatitis and to establish the noninvasive markers for liver fibrosis. METHODS:Eighty-one patients (40 male, 41 female) who were diagnosed with fatty liver by ultrasonographic examination and fulfilled the inclusion criteria participated in the study. Anamnesis, anthropometric, clinical and laboratory features of all cases were recorded and then liver biopsy was performed after obtaining patient consent. Steatosis, necroinflammation and liver fibrosis were examined according to age ≥ 45, gender, body mass index, central obesity, aspartate aminotransferase (AST)/alanine aminotransferase (ALT) > 1, γ-glutamyltransferase (GGT)/ALT > 1, platelet count, insulin, c-peptide levels and the presence of hypertension, diabetes, hypertriglyceridemia and insulin resistance. RESULTS:Eighty-one patients with non-alcoholic steatohepatitis (NASH) enrolled in the study. 69 of 81 patients were diagnosed with NASH, 11 were diagnosed with simple fatty liver and 1 was diagnosed with cirrhosis. AST/ALT > 1, GGT/ALT > 11, high serum ferritin and fasting insulin levels, the presence of diabetes, hypertension, hypertriglyceridemia and insulin resistance seemed to enhance the severity of steatosis, necroinflammation and fibrosis but these results were not statistically significant. CONCLUSION:Liver steatosis and fibrosis can occur in individuals with normal weight. There was no significant concordance between severity of liver histology and the presence of predictors for liver fibrosis including metabolic risk factors.

Can FIB4 and NAFLD fibrosis scores help endocrinologists refer patients with non-alcoholic fat liver disease to a hepatologist?

“…Assessment of the different clinical parameters analyzed in this population, such as gender, BMI, waist circumference, glucose intolerance, diabetes and metabolic syndrome, failed to identify the presence of liver fibrosis or steatohepatitis. These parameters were found in similar proportions in all the groups, as reported in other studies (35). Only patient age varied significantly, as patients with more advanced disease stage were older.…”

To Biopsy or Not to Biopsy: Evaluation of a Large German Cohort of Patients with Abnormal Liver Tests of Unknown Etiology

“…However, other authors have reported no significant difference in these parameters [35]. This may be partly due to the different sizes of patient cohorts.…”

Predictive Factors of Steatosis and Non-Alcoholic Steatohepatitis in Morbidly Obese Patients Undergoing Bariatric Surgery

“…In contrast to the current study results, recent studies expressed that ALT and AST were not reliable markers for NASH or fibrosis (41). Moreover, Uslusoy et al found no relationship between ALT and AST levels, and liver fibrosis (38). In the study by Gholam et al it is observed that except for BMI and hyperglycemia, insulin resistance and the metabolic syndrome were associated with the presence of NASH and fibrosis (42).…”

“…Also, disturbed liver function test results had significant association with NASH in several studies (35)(36)(37). Uslusoy et al found no relationship between NASH and BMI (38).…”