A novel pathophysiological-based panel of biomarkers for the diagnosis of nonalcoholic steatohepatitis

Non-invasive biochemical markers are useful to distinguish between nonalcoholic steatohepatitis (NASH) and simple steatosis. The aim of this study was to test the diagnostic value of a panel of biomarkers derived from the pathophysiological events involved in the development of NASH. A total of 79 p...

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Published inJournal of physiology and pharmacology : an official journal of the Polish Physiological Society Vol. 63; no. 4; p. 347
Main Authors Grigorescu, M, Crisan, D, Radu, C, Grigorescu, M D, Sparchez, Z, Serban, A
Format Journal Article
LanguageEnglish
Published Poland 01.08.2012
Subjects
Adiponectin - blood
Adult
Alanine Transaminase - blood
Biomarkers - blood
Fatty Liver - blood
Fatty Liver - diagnosis
Fatty Liver - pathology
Female
Humans
Insulin Resistance
Interleukin-6 - blood
Keratin-18 - blood
Male
Middle Aged
Non-alcoholic Fatty Liver Disease
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Summary:Non-invasive biochemical markers are useful to distinguish between nonalcoholic steatohepatitis (NASH) and simple steatosis. The aim of this study was to test the diagnostic value of a panel of biomarkers derived from the pathophysiological events involved in the development of NASH. A total of 79 patients: 20 not-NASH and 59 NASH were included in the study. Definitive NASH was defined according to Kleiner's classification. In all subjects, parameters of the metabolic syndrome, insulin resistance (HOMA-IR), adiponectin, interleukin-6 (IL-6) and total cytokeratin-18 (M65 antigen) were determined. Univariate and multivariate analysis were used to identify independent predictors of NASH. In multivariate analysis three markers were independently predictors of NASH: adiponectin, IL-6 and M65 levels. In decreasing order, the independent predictors of NASH (NAS≥5) were M65 with an AUROC of 0.791, IL-6 with an AUROC of 0.727 and adiponectin with an AUROC of 0.709. The combination of two biomarkers yelded an AUROC of 0.828 for M65 and IL-6, 0.841 for adiponectin and M65 and 0.852 for adiponectin and IL-6. The best value was obtained by triple combination: adiponectin, M65 and IL-6 with and AUROC of 0.903, Sp=85.7% (PPV=94.2%) and Se=84.5% (NPV=66.7%). In conclusion, a novel pathophysiological - based panel of biomarkers combining total CK-18, IL-6 and adiponectin may be useful to predict NASH.
ISSN:1899-1505