Screening for liver disease using non‐invasive biomarkers (FibroTest, SteatoTest and NashTest) in patients with hyperlipidaemia

• Published in: Alimentary pharmacology & therapeutics Vol. 25; no. 2; pp. 207 - 218
• Main Authors: RATZIU, V., GIRAL, P., MUNTEANU, M., MESSOUS, D., MERCADIER, A., BERNARD, M., MORRA, R., IMBERT‐BISMUT, F., BRUCKERT, E., POYNARD, T.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 15.01.2007; Blackwell
• Subjects: Biological and medical sciences; Biomarkers - blood; Diagnosis, Differential; Digestive system; Disorders of blood lipids. Hyperlipoproteinemia; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Hyperlipidemias - complications; Liver Diseases - diagnosis; Liver Diseases - etiology; Liver Function Tests - standards; Male; Mass Screening; Medical sciences; Metabolic diseases; Middle Aged; Pharmacology. Drug treatments; Risk Factors; Human; Screening; Non invasive method; Biological marker; Digestive diseases; Metabolic diseases; Hepatic disease; Lipids; Hyperlipemia; Dyslipemia; Medical screening
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/j.1365-2036.2006.03182.x

Summary Background Mortality related to complications of cirrhosis is increasing in patients with insulin‐resistance factors. Hyperlipidaemic patients have multiple risk factors of insulin resistance. It is impossible to perform liver biopsy in such a large number of hyperlipidaemic patients to identify patients with advanced liver fibrosis or with steatohepatitis (non‐alcoholic steatohepatitis, NASH). Aims To use the non‐invasive biomarkers, FibroTest (FT), SteatoTest and NashTest, and to assess the prevalence of advanced liver disease in a large population of hyperlipidaemic patients. Methods A consecutive cohort of hyperlipidaemic patients was followed prospectively in a lipid centre and the sera were analysed retrospectively. Results A total of 2834 subjects were included: 1909 hyperlipidaemic patients and 925 blood donors (BD). Advanced fibrosis was identified by FT in 53/1909 (2.8%) hyperlipidaemic patients vs. 0/925 BD (0%) (P < 0.0001); advanced steatosis in 569/1893 hyperlipidaemic patients (30.1%) vs. 8/164 (4.9%) BD (P < 0.0001) and NASH in 132/1893 (7%) vs. 0/164 (0%), respectively (P < 0.0001). There was a highly significant and linear association between the number of metabolic syndrome factors and liver disease prevalence – the highest being for type 2 diabetics: advanced steatosis 66%, NASH 24% and advanced fibrosis 6%. Conclusions The prevalence of fibrosis, steatosis and NASH in hyperlipidaemic patients appears to be high (3%, 30% and 7%, respectively). Biomarkers could be useful for screening of advanced fibrosis and NASH in patients with several metabolic syndrome factors, to prevent liver mortality.