Diagnosis of Fibrosis Using Blood Markers and Logistic Regression in Southeast Asian Patients With Non-alcoholic Fatty Liver Disease

Abstract

Non-alcoholic fatty liver disease (NAFLD) is one of the main causes of fibrosis. Liver biopsy remains the gold standard for the confirmation of fibrosis in NAFLD patients. Effective and non-invasive diagnosis of advanced fibrosis is essential to disease surveillance and treatment decisions. Herein we used routine medical test markers and logistic regression to differentiate early and advanced fibrosis in NAFLD patients from China, Malaysia, and India (n1 = 540, n2 = 147, and n3 = 97) who were confirmed by liver biopsy. Nine parameters, including age, body mass index, fasting blood glucose, presence of diabetes or impaired fasting glycemia, alanine aminotransferase, γ-glutamyl transferase, triglyceride, and aspartate transaminase/platelet count ratio, were selected by stepwise logistic regression, receiver operating characteristic curve (ROC), and hypothesis testing and were used for model construction. The area under the ROC curve (auROC) of the model was 0.82 for differentiating early and advanced fibrosis (sensitivity = 0.69, when specificity = 0.80) in the discovery set. Its diagnostic ability remained good in the two independent validation sets (auROC = 0.89 and 0.71) and was consistently superior to existing panels such as the FIB-4 and NAFLD fibrosis score. A web-based tool, LiveFbr, was developed for fast access to our model. The new model may serve as an attractive tool for fibrosis classification in NAFLD patients.

Altered bile acid glycine : taurine ratio in the progression of chronic liver disease

“…For detailed information on diagnosis and enrolment criteria, please refer to our original publication. 18 Study 2-liver fibrosis study. A total of 709 participants including 382 HBV-related fibrosis patients (324 [stage 0-3] and 58 cirrhosis [stage 4]) and 327 healthy controls were recruited from the Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.…”

“…14 A group of conjugated 12α-hydroxylated (12α-OH) BAs significantly increased in NASH patients and liver fibrosis mouse models and were potential promoters of liver fibrosis. 15 Based on these, we constructed and validated several machine learning models to classify early (stage 0-2) and advanced (stage 3-4) hepatic fibrosis using BAs and clinical parameters in patients with hepatitis B and C virus infections 16,17 and NAFLD 18 patients. Furthermore, we discussed the mechanistic links between BAs and HCC and highlighted the strategies and cutting-edge technologies to target gut microbiota-dependent alterations in BA metabolism in the context of cancer therapy.…”

Use of GP73 in the diagnosis of non-alcoholic steatohepatitis and the staging of hepatic fibrosis

“…Moreover, hepatitis virus can inhibit bone marrow megakaryocytes, which impairs platelet production, thereby reducing platelet count and their ability to aggregate, and increasing mean platelet volume and width. 42,43 Liver damage is associated with increases in the serum activities of AST and ALT, and these are commonly used as markers of hepatocyte injury. 44,45 These parameters are also used as a means of diagnosing NAFLD early, and the identification of a high-normal serum ALT activity is of great significance for the early prevention of NAFLD.…”

Serum Bile Acid Profiles Improve Clinical Prediction of Nonalcoholic Fatty Liver in T2DM patients

“…It was reported that fibrosis could be diagnosed using blood barkers and Logistic regression in Southeast Asian patients with NAFLD. 9 However, there were no related studies describing biomarkers, which can predict the development of NAFLD in T2DM patients, which could cause the high risk of occurrence of CVD or severe liver diseases. Therefore, it is urgent and important to find simple, noninvasive diagnostic biomarkers that can help in the early detection and understanding of the mechanism involved in the formation of NAFLD in T2DM patients to prevent the occurrence of CVD and HCC.…”