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The Accuracy of Serum Biomarkers in the Diagnosis of Steatosis, Fibrosis, and Inflammation in Patients with Nonalcoholic Fatty Liver Disease in Comparison to a Liver Biopsy

Background and Objective: This study was conducted to evaluate the diagnostic performance of various biomarkers for steatosis, fibrosis, and inflammation in comparison to a liver biopsy (LB) in patients with nonalcoholic fatty liver disease (NAFLD). Materials and Methods: This was a cross-sectional...

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Autores principales: Mikolasevic, Ivana, Domislovic, Viktor, Krznaric-Zrnic, Irena, Krznaric, Zeljko, Virovic-Jukic, Lucija, Stojsavljevic, Sanja, Grgurevic, Ivica, Milic, Sandra, Vukoja, Ivan, Puz, Petra, Aralica, Merica, Hauser, Goran
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8880154/
https://www.ncbi.nlm.nih.gov/pubmed/35208576
http://dx.doi.org/10.3390/medicina58020252
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author Mikolasevic, Ivana
Domislovic, Viktor
Krznaric-Zrnic, Irena
Krznaric, Zeljko
Virovic-Jukic, Lucija
Stojsavljevic, Sanja
Grgurevic, Ivica
Milic, Sandra
Vukoja, Ivan
Puz, Petra
Aralica, Merica
Hauser, Goran
author_facet Mikolasevic, Ivana
Domislovic, Viktor
Krznaric-Zrnic, Irena
Krznaric, Zeljko
Virovic-Jukic, Lucija
Stojsavljevic, Sanja
Grgurevic, Ivica
Milic, Sandra
Vukoja, Ivan
Puz, Petra
Aralica, Merica
Hauser, Goran
author_sort Mikolasevic, Ivana
collection PubMed
description Background and Objective: This study was conducted to evaluate the diagnostic performance of various biomarkers for steatosis, fibrosis, and inflammation in comparison to a liver biopsy (LB) in patients with nonalcoholic fatty liver disease (NAFLD). Materials and Methods: This was a cross-sectional study that included 135 patients with biopsy-proven NAFLD. Fatty liver index (FLI), hepatic steatosis index (HSI), cell death markers (CK-18 M30 and CK-18 M65), FIB-4 index, NAFLD fibrosis score (NFS), BARD, and AST to platelet ratio index (APRI) were calculated and analysed. Results: FLI, HSI scores, and the cell death biomarkers showed poor diagnostic accuracy for steatosis detection and quantification, with an area under the curve (AUC) of <0.70. The cell death biomarkers likewise did not perform well for the detection of nonalcoholic steatohepatitis (NASH) (AUC < 0.7). As for the fibrosis staging, only APRI and the cell death biomarkers had moderate accuracy (AUC > 0.7) for advanced fibrosis, whereas FIB-4, BARD, and NFS scores demonstrated poor performance (AUC < 0.70). However, a combination of FIB-4 and NFS with the cell death biomarkers had moderate accuracy for advanced (≥F3) fibrosis detection, with an AUC of >0.70. Conclusions: In this first study on Croatian patients with NAFLD, serum biomarkers demonstrated poor diagnostic performance for the noninvasive diagnosis of liver steatosis and NASH. APRI and the cell death biomarkers had only moderate accuracy for diagnosing advanced fibrosis, as did the combination of FIB-4 and NFS with the cell death biomarkers. Further studies regarding serum biomarkers for all NAFLD stages are needed.
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spelling pubmed-88801542022-02-26 The Accuracy of Serum Biomarkers in the Diagnosis of Steatosis, Fibrosis, and Inflammation in Patients with Nonalcoholic Fatty Liver Disease in Comparison to a Liver Biopsy Mikolasevic, Ivana Domislovic, Viktor Krznaric-Zrnic, Irena Krznaric, Zeljko Virovic-Jukic, Lucija Stojsavljevic, Sanja Grgurevic, Ivica Milic, Sandra Vukoja, Ivan Puz, Petra Aralica, Merica Hauser, Goran Medicina (Kaunas) Article Background and Objective: This study was conducted to evaluate the diagnostic performance of various biomarkers for steatosis, fibrosis, and inflammation in comparison to a liver biopsy (LB) in patients with nonalcoholic fatty liver disease (NAFLD). Materials and Methods: This was a cross-sectional study that included 135 patients with biopsy-proven NAFLD. Fatty liver index (FLI), hepatic steatosis index (HSI), cell death markers (CK-18 M30 and CK-18 M65), FIB-4 index, NAFLD fibrosis score (NFS), BARD, and AST to platelet ratio index (APRI) were calculated and analysed. Results: FLI, HSI scores, and the cell death biomarkers showed poor diagnostic accuracy for steatosis detection and quantification, with an area under the curve (AUC) of <0.70. The cell death biomarkers likewise did not perform well for the detection of nonalcoholic steatohepatitis (NASH) (AUC < 0.7). As for the fibrosis staging, only APRI and the cell death biomarkers had moderate accuracy (AUC > 0.7) for advanced fibrosis, whereas FIB-4, BARD, and NFS scores demonstrated poor performance (AUC < 0.70). However, a combination of FIB-4 and NFS with the cell death biomarkers had moderate accuracy for advanced (≥F3) fibrosis detection, with an AUC of >0.70. Conclusions: In this first study on Croatian patients with NAFLD, serum biomarkers demonstrated poor diagnostic performance for the noninvasive diagnosis of liver steatosis and NASH. APRI and the cell death biomarkers had only moderate accuracy for diagnosing advanced fibrosis, as did the combination of FIB-4 and NFS with the cell death biomarkers. Further studies regarding serum biomarkers for all NAFLD stages are needed. MDPI 2022-02-08 /pmc/articles/PMC8880154/ /pubmed/35208576 http://dx.doi.org/10.3390/medicina58020252 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Mikolasevic, Ivana
Domislovic, Viktor
Krznaric-Zrnic, Irena
Krznaric, Zeljko
Virovic-Jukic, Lucija
Stojsavljevic, Sanja
Grgurevic, Ivica
Milic, Sandra
Vukoja, Ivan
Puz, Petra
Aralica, Merica
Hauser, Goran
The Accuracy of Serum Biomarkers in the Diagnosis of Steatosis, Fibrosis, and Inflammation in Patients with Nonalcoholic Fatty Liver Disease in Comparison to a Liver Biopsy
title The Accuracy of Serum Biomarkers in the Diagnosis of Steatosis, Fibrosis, and Inflammation in Patients with Nonalcoholic Fatty Liver Disease in Comparison to a Liver Biopsy
title_full The Accuracy of Serum Biomarkers in the Diagnosis of Steatosis, Fibrosis, and Inflammation in Patients with Nonalcoholic Fatty Liver Disease in Comparison to a Liver Biopsy
title_fullStr The Accuracy of Serum Biomarkers in the Diagnosis of Steatosis, Fibrosis, and Inflammation in Patients with Nonalcoholic Fatty Liver Disease in Comparison to a Liver Biopsy
title_full_unstemmed The Accuracy of Serum Biomarkers in the Diagnosis of Steatosis, Fibrosis, and Inflammation in Patients with Nonalcoholic Fatty Liver Disease in Comparison to a Liver Biopsy
title_short The Accuracy of Serum Biomarkers in the Diagnosis of Steatosis, Fibrosis, and Inflammation in Patients with Nonalcoholic Fatty Liver Disease in Comparison to a Liver Biopsy
title_sort accuracy of serum biomarkers in the diagnosis of steatosis, fibrosis, and inflammation in patients with nonalcoholic fatty liver disease in comparison to a liver biopsy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8880154/
https://www.ncbi.nlm.nih.gov/pubmed/35208576
http://dx.doi.org/10.3390/medicina58020252
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