Clinical usefulness of biochemical markers of liver fibrosis in patients with nonalcoholic fatty liver disease

Abstract

Both markers of liver fibrosis are useful in discriminating NASH from fatty liver alone or patients with severe fibrosis from patients with non-severe fibrosis.

Serum hyaluronan and collagen IV as non-invasive markers of liver fibrosis in patients from an endemic area for schistosomiasis mansoni: a field-based study in Brazil

“…However, such a comparison has been carried out by others for different liver diseases. Their results were consistent and reliable for diagnosis of the presence and intensity of fibrosis in viral hepatitis (Guéchot et al 1996, Zheng et al 2002), alcoholic cirrhosis (parés et al 1996, Stickel et al 2003 and non-alcoholic steatohepatitis (Sakugawa et al 2005, Suzuki et al 2005. Nevertheless, in the present paper, serum HA was not able to detect fibrosis progression.…”

“…The ultrasound variables included were as follows: left and right liver lobe length, spleen length, portal, splenic and superior mesenteric vein diameters, periportal fibrosis (subjective evaluation), WHO patterns of fibrosis, gallbladder wall thickness, periportal thickness in the hilum and on first and second order branches. Data was also adjusted by age and body mass index (BMI), based on literature evidence of HA variations with aging and nonalcoholic steatohepatitis (Fraser et al 1997, Sakugawa et al 2005, Suzuki et al 2005.…”

The NAFLD fibrosis score

“…The potential diagnostic accuracy of serum markers of fibrosis has been evaluated by others. [19][20][21] The European liver fibrosis group assessed the combination of age and serum levels of hyaluronic acid, aminoterminal propeptide of type 3 collagen, and tissue inhibitor of matrix metalloproteinase 1 in predicting advanced fibrosis in patients with a wide range of liver disease. 19 The proposed algorithm had an acceptable accuracy overall, but only 61 of the 912 patients studied had NAFLD, a number that is too small to derive meaningful conclusions for the NAFLD population.…”

“…The combination of serum levels of hyaluronic acid and type 6 collagen 7S domain 20 and serum YKL-40 21 levels also have been proposed as a diagnostic tool on the basis of small studies that lacked a validation group. More recently, liver stiffness measured by the ultrasonographicbased FibroScan has been proposed as a useful noninvasive method for the identification of advanced liver fibrosis in patients with chronic hepatitis C infection, 26,27 A recent prospective study of 2,114 FibroScan examinations, however, found presence of BMI greater than 28 kg/m 2 to be the only independent factor associated with failure of FibroScan examination for the identification of liver fibrosis.…”

“…Noninvasive approaches for assessing the severity of fibrosis in NAFLD have included a combination of clinical features and routine laboratory investigations [15][16][17][18] as well as some less readily available serum markers of fibrosis. [19][20][21][22] These noninvasive approaches are, however, either insufficiently accurate in their prediction of liver fibrosis or their diagnostic accuracy has been evaluated in only a limited number of patients with NAFLD; further, most have not been validated in a separate population of NAFLD patients. A model using routinely measured clinical and laboratory variables that accurately predicts the severity of liver fibrosis in patients with NAFLD has therefore yet to be developed and validated.…”