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Non-Invasive Detection of Fibrotic NASH in NAFLD Patients with Low or Intermediate FIB-4

Background: Non-alcoholic steatohepatitis (NASH) and fibrosis are the main prognostic factors in non-alcoholic fatty liver disease (NAFLD). The FIB-4 score has been suggested as an initial test for the exclusion of progressed fibrosis. However, increasing evidence suggests that also NASH patients wi...

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Autores principales: John, Katharina, Franck, Martin, Al Aoua, Sherin, Rau, Monika, Huber, Yvonne, Schattenberg, Joern M., Geier, Andreas, Bahr, Matthias J., Wedemeyer, Heiner, Schulze-Osthoff, Klaus, Bantel, Heike
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9369177/
https://www.ncbi.nlm.nih.gov/pubmed/35956017
http://dx.doi.org/10.3390/jcm11154394
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author John, Katharina
Franck, Martin
Al Aoua, Sherin
Rau, Monika
Huber, Yvonne
Schattenberg, Joern M.
Geier, Andreas
Bahr, Matthias J.
Wedemeyer, Heiner
Schulze-Osthoff, Klaus
Bantel, Heike
author_facet John, Katharina
Franck, Martin
Al Aoua, Sherin
Rau, Monika
Huber, Yvonne
Schattenberg, Joern M.
Geier, Andreas
Bahr, Matthias J.
Wedemeyer, Heiner
Schulze-Osthoff, Klaus
Bantel, Heike
author_sort John, Katharina
collection PubMed
description Background: Non-alcoholic steatohepatitis (NASH) and fibrosis are the main prognostic factors in non-alcoholic fatty liver disease (NAFLD). The FIB-4 score has been suggested as an initial test for the exclusion of progressed fibrosis. However, increasing evidence suggests that also NASH patients with earlier fibrosis stages are at risk of disease progression, emphasizing the need for improved non-invasive risk stratification. Methods: We evaluated whether the apoptosis biomarker M30 can identify patients with fibrotic NASH despite low or intermediate FIB-4 values. Serum M30 levels were assessed by ELISA, and FIB-4 was calculated in an exploration (n = 103) and validation (n = 100) cohort of patients with histologically confirmed NAFLD. Results: The majority of patients with low FIB-4 (cut-off value < 1.3) in the exploration cohort revealed increased M30 levels (>200 U/L) and more than 80% of them had NASH, mostly with fibrosis. NASH was also detected in all patients with intermediate FIB-4 (1.3 to 2.67) and elevated M30, from which ~80% showed fibrosis. Importantly, in the absence of elevated M30, most patients with FIB-4 < 1.3 and NASH showed also no fibrosis. Similar results were obtained in the validation cohort. Conclusions: The combination of FIB-4 with M30 enables a more reliable identification of patients at risk for progressed NAFLD and might, therefore, improve patient stratification.
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spelling pubmed-93691772022-08-12 Non-Invasive Detection of Fibrotic NASH in NAFLD Patients with Low or Intermediate FIB-4 John, Katharina Franck, Martin Al Aoua, Sherin Rau, Monika Huber, Yvonne Schattenberg, Joern M. Geier, Andreas Bahr, Matthias J. Wedemeyer, Heiner Schulze-Osthoff, Klaus Bantel, Heike J Clin Med Article Background: Non-alcoholic steatohepatitis (NASH) and fibrosis are the main prognostic factors in non-alcoholic fatty liver disease (NAFLD). The FIB-4 score has been suggested as an initial test for the exclusion of progressed fibrosis. However, increasing evidence suggests that also NASH patients with earlier fibrosis stages are at risk of disease progression, emphasizing the need for improved non-invasive risk stratification. Methods: We evaluated whether the apoptosis biomarker M30 can identify patients with fibrotic NASH despite low or intermediate FIB-4 values. Serum M30 levels were assessed by ELISA, and FIB-4 was calculated in an exploration (n = 103) and validation (n = 100) cohort of patients with histologically confirmed NAFLD. Results: The majority of patients with low FIB-4 (cut-off value < 1.3) in the exploration cohort revealed increased M30 levels (>200 U/L) and more than 80% of them had NASH, mostly with fibrosis. NASH was also detected in all patients with intermediate FIB-4 (1.3 to 2.67) and elevated M30, from which ~80% showed fibrosis. Importantly, in the absence of elevated M30, most patients with FIB-4 < 1.3 and NASH showed also no fibrosis. Similar results were obtained in the validation cohort. Conclusions: The combination of FIB-4 with M30 enables a more reliable identification of patients at risk for progressed NAFLD and might, therefore, improve patient stratification. MDPI 2022-07-28 /pmc/articles/PMC9369177/ /pubmed/35956017 http://dx.doi.org/10.3390/jcm11154394 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
John, Katharina
Franck, Martin
Al Aoua, Sherin
Rau, Monika
Huber, Yvonne
Schattenberg, Joern M.
Geier, Andreas
Bahr, Matthias J.
Wedemeyer, Heiner
Schulze-Osthoff, Klaus
Bantel, Heike
Non-Invasive Detection of Fibrotic NASH in NAFLD Patients with Low or Intermediate FIB-4
title Non-Invasive Detection of Fibrotic NASH in NAFLD Patients with Low or Intermediate FIB-4
title_full Non-Invasive Detection of Fibrotic NASH in NAFLD Patients with Low or Intermediate FIB-4
title_fullStr Non-Invasive Detection of Fibrotic NASH in NAFLD Patients with Low or Intermediate FIB-4
title_full_unstemmed Non-Invasive Detection of Fibrotic NASH in NAFLD Patients with Low or Intermediate FIB-4
title_short Non-Invasive Detection of Fibrotic NASH in NAFLD Patients with Low or Intermediate FIB-4
title_sort non-invasive detection of fibrotic nash in nafld patients with low or intermediate fib-4
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9369177/
https://www.ncbi.nlm.nih.gov/pubmed/35956017
http://dx.doi.org/10.3390/jcm11154394
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