FibroScan and non-invasive indices for the diagnosis of non-alcoholic fatty liver disease

Yu.M. Stepanov, N.V. Nedzvetskaya, V.B. Yagmur, D.V. Popok, L.M. Shendrik

Abstract


Background. Non­-alcoholic fatty liver disease (NAFLD), an independent nosological entity, is cha­racterized by fat accumulation in hepatocytes not associated with alcohol abuse, and includes a wide spectrum of disorders: from fatty liver, non­-alcoholic steatohepatitis to fibrosis with possible outcome in liver cirrhosis. Given the prevalence of this disease, the deterioration of the quality of life of patients, increased mortality from complications, there is a growing interest in developing techniques for accurate and timely assessment of fibrosis. Objective: comparative characteristics of the results of transient elastometry (FibroScan) and non-­invasive laboratory indices in the determination of fibrotic transformation of the liver in patients with non­-alcoholic fatty liver disease. Materials and methods. The study included patients with NAFLD, who underwent diagnostics and treatment in the department of liver and pancreas of the SI “Institute of Gastroenterology of the NAMS of Ukraine”. Results. We have examined 42 patients with NAFLD, among which 18 (45 %) men and 24 (55 %) women. All patients underwent calculation of non-­invasive markers of liver fibrosis: aspartate aminotransferase to platelet ratio index (APRI), fibrosis­4 index, aspartate aminotransferase/alanine aminotransferase ratio, the measurement of liver stiffness using the FibroScan apparatus. Conclusions. Our results are consistent with most studies indicating that the most effective non-­invasive index is APRI. The combination of transient elasto­graphy (FibroScan) and the APRI may provide a more effective approach to the diagnosis of liver fibrosis in patients with NAFLD.


Keywords


non-alcoholic fatty liver disease; liver fibrosis; non-invasive diagnostic methods; transient elastography

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References


European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD), European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016 Jun;64(6):1388-402. doi: 10.1016/j.jhep.2015.11.004.

Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of non-alcoholic fatty liver disease: practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology. 2012 Jun;55(6):2005-23. doi: 10.1002/hep.25762.

Soderberg C, Stal P, Askling J, et al. Decreased survival of subjects with elevated liver function tests during a 28-year follow-up. Hepatology. 2010 Feb;51(2):595-602. doi: 10.1002/hep.23314.

Li H, Wang YJ, Tan K, et al. Prevalence and risk factors of fatty liver disease in Chengdu, Southwest China. Hepatobiliary. Hepatobiliary Pancreat Dis Int. 2009 Aug;8(4):377-82. PMID: 19666406.

Machado MV, Cortez-Pinto H. Non-invasive diagnosis of non-alcoholic fatty liver disease. A critical appraisal. J Hepatol. 2013 May;58(5):1007-19. doi: 10.1016/j.jhep.2012.11.021.

Friedrich-Rust M, Romen D, Vermehren J, et al. Acoustic radiation force impulse-imaging and transient elastography for non-invasive assessment of liver fibrosis and steatosis in NAFLD. Eur J Radiol. 2012 Mar;81(3):e325-31. doi: 10.1016/j.ejrad.2011.10.029.

Ying HY, Lu LG, Jing DD, Ni XS. Accuracy of transient elastography in the assessment of chronic hepatitis C-related liver cirrhosis. Clin Invest Med. 2016 Oct 14;39(5):E150-E160. PMID: 27805898.

Calès P, Boursier J, Lebigot J, et al. Liver fibrosis diagnosis by blood test and elastography in chronic hepatitis C: agreement or combination? Aliment Pharmacol Ther. 2017 Apr;45(7):991-1003. doi: 10.1111/apt.13954.

Fitzpatrick E, Dhawan A. Noninvasive biomarkers in non-alcoholic fatty liver disease: Current status and a glimpse of the future. World J Gastroenterol. 2014 Aug 21;20(31):10851-63. doi: 10.3748/wjg.v20.i31.10851.

Kruger FC, Daniels CR, Kidd M, et al. APRI: a simple bedside marker for advanced fibrosis that can avoid liver biopsy in patients with NAFLD/NASH. S Afr Med J. 2011 Jun 27;101(7):477-80. PMID: 21920102.

Shah AG, Lydecker A, Murray K, et al. Nash Clinical Research Network. Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol. 2009 Oct;7(10):1104-12. doi: 10.1016/j.cgh.2009.05.033.

McPherson S, Stewart SF, Henderson E, Burt AD, Day CP. Simple non-invasive fibrosis scoring systems can reliably exclude advanced fibrosis in patients with non-alcoholic fatty liver disease. Gut. 2010 Sep;59(9):1265-9. doi: 10.1136/gut.2010.216077.

Calès P, Lainé F, Boursier J, et al. Comparison of blood tests for liver fibrosis specific or not to NAFLD. J Hepatol. 2009 Jan;50(1):165-73. doi: 10.1016/j.jhep.2008.07.035.




DOI: https://doi.org/10.22141/2308-2097.51.3.2017.112634

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