Background: Transient elastography is very sensitive noninvasive tool to assess liver fibrosis in NAFLD patients. But it is costly and not widely available There are also seromarkers (APRI & FBI4) for ruling out significant liver fibrosis. This study intends to compare between seromakers & transient elastography result for assessment of significant liver fibrosis (SF) in NAFDL patients. Methods: This was an observational cross sectional study done in Sheikh Russel National Gastroliver Institute & Hospital from April 2019 to December 2019. A total 111 patients were selected by purposive sampling method. Demographic, clinical and biochemical data were collected. Liver fibrosis was assessed by transient elastography. Aspertate transaminase (ASI) to platelet ratio index (APRI) & FIB-4 score were compared among the non-significant fibrosis (F2-F4) patients. Result: The total number of study population was 111, among them 39 (35.3%) had significant liver fibrosis (Kpa>7.2; F0 to F1). There was significant difference in between SF & non SF groups in terms of mean serum ALT, AST, albumin and platelet count. APRT and FIB-4 were significantly higher in SF group. APRI had better accuracy (area under the receiver operating characteristics curve=0.925) than FIB-4) 0.885) in ruling out SF. Conclusion: Seromarkers are comparable to transient elastography in assessment of significant liver fibrosis in NAFLD patients. Among them APRI is more accurate in determining significant fibrosis.
Published in | International Journal of Gastroenterology (Volume 6, Issue 1) |
DOI | 10.11648/j.ijg.20220601.11 |
Page(s) | 1-4 |
Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
Copyright |
Copyright © The Author(s), 2022. Published by Science Publishing Group |
Transient Elastography, NAFLD, Significant Fibrosis, Non-significant Fibrosis, Seromakers
[1] | A. Schweitzer, J. Horn, R. T. Mikolajczyk, G. Krause, and J. J. Ott, “Estimations of worldwide prevalence of chronic hepatitis B virus infection. a systematic review of data published between 1965 and 2013,” The Lancet, vol. 386, no. 10003, pp. 1546–1555, 2015. |
[2] | Z. M. Younossi, A. B. Koenig, D. Abdelatif, Y. Fazel, L. Henry, and M. Wymer, “Global epidemiology of nonalcoholic fatty liver disease-meta-analytic assessment of prevalence, incidence, and outcomes,” Hepatology, vol. 64, no. 1, pp. 73-84, 2016. |
[3] | F.-S. Wang, J.-G. Fan, Z. Zhang, B. Gao, and H.-Y. Wang, “The global burden of liver disease. The major impact of China,” Hepatology, vol. 60, no. 6, pp. 2099-2108, 2014. |
[4] | S. Singh, A. M. Allen, Z. Wang, L. J. Prokop, M. H. Murad, and R. Loomba, “Fibrosis progression in nonalcoholic fatty liver vs Nonalcoholic steatohepatitis. a systematic review and meta- analysis of paired-biopsy studies,” Clinical Gastroenterology and Hepatology, vol. 13, no. 4, pp. 643-654, 2015. |
[5] | C.-W. Lin, X.-L. Huang, H.-L. Liu, and Y. Wang, “Interactions of hepatitis B virus infection with nonalcoholic fatty liver disease. Possible mechanisms and clinical impact,” Digestive Diseases and Sciences, vol. 60, no. 12, pp. 3513-3524, 2015. |
[6] | P. Charatcharoenwitthaya, A. Pongpaibul, U. Kaosombatwat- tana et al., “The prevalence of steatohepatitis in chronic hepatitis B patients and its impact on disease severity and treatment response,” Liver International, vol. 37, no. 4, pp. 542–551, 2017. |
[7] | A. W. Chan, G. L. Wong, H. Chan et al., “Concurrent fatty liver increases risk of hepatocellular carcinoma among patients with chronic hepatitis B,” Journal of Gastroenterology and Hepatology, vol. 32, no. 3, pp. 667-676, 2017. |
[8] | A. A. Bravo, S. G. Sheth, and S. Chopra, “Liver biopsy,” The New England Journal of Medicine, vol. 344, no. 7, pp. 4958-500, 2001. |
[9] | P. Bedossa, D. Darge`re, and V. Paradis, “Sampling variability of liver fibrosis in chronic hepatitis C,” Hepatology, vol. 38, no. 6, pp. 1449-1457, 2003. |
[10] | J. Zheng, H. Guo, J. Zeng et al., “Two-dimensional shear-wave elastography and conventional us. The optimal evaluation of liver fibrosis and cirrhosis,” Radiology, vol. 275, no. 1, pp. 290- 300, 2015. |
[11] | J.-H. Wang, C.-S. Changchien, C.-H. Hung et al., “FibroScan and ultrasonography in the prediction of hepatic fibrosis in patients with chronic viral hepatitis,” Journal of Gastroenterol- ogy, vol. 44, no. 5, pp. 439-446, 2009. |
[12] | European Association for Study of Liver and Asociacion Lati- noamericana para el Estudio del Higado, “EASL-ALEH Clinical Practice Guidelines. non-invasive tests for evaluation of liver disease severity and prognosis,” Journal of Hepatology, vol. 63, no. 1, pp. 237-264, 2015. |
[13] | S. Singh, A. J. Muir, D. T. Dieterich, and Y. T. Falck-Ytter, “American gastroenterological association institute technical review on the role of elastography in chronic liver diseases,” Gastroenterology, vol. 152, no. 6, pp. 1544-1577, 2017. |
[14] | Y.-F. Liaw, J.-H. Kao, T. Piratvisuth et al., “Asian-Pacific consen- sus statement on the management of chronic hepatitis B. a 2012 update,” Hepatology International, vol. 6, no. 3, pp. 531-561, 2012. |
[15] | G. L. Zhang, D. Y. Xie, B. L. Lin et al., “Imbalance of interleukin- 17-producing CD4 T cells/regulatory T cells axis occurs in remission stage of patients with hepatitis B virus-related acute- on-chronic liver failure,” Journal of Gastroenterology and Hepa- tology, vol. 28, no. 3, pp. 513-521, 2013. |
[16] | J. C. Cohen, J. D. Horton, and H. H. Hobbs, “Human fatty liver disease. old questions and new insights,” Science, vol. 332, no. 6037, pp. 1519-1523, 2011. |
[17] | E. M. Brunt, D. E. Kleiner, L. A. Wilson, P. Belt, and B. A. Neuschwander- Tetri, “Nonalcoholic fatty liver disease (NAFLD) activity score and the histopathologic diagnosis in NAFLD. distinct clinicopathologic meanings,” Hepatology, vol. 53, no. 3, pp. 810-820, 2011. |
[18] | G. C. Farrell, S. Chitturi, G. K. K. Lau, and J. D. Sollano, “Guide- lines for the assessment and management of non-alcoholic fatty liver disease in the Asia-Pacific region. executive summary,” Journal of Gastroenterology and Hepatology, vol. 22, no. 6, pp. 775-777, 2007. |
[19] | P. R. Spradling, L. Bulkow, E. H. Teshale et al., “Prevalence and causes of elevated serum aminotransferase levels in a population-based cohort of persons with chronic hepatitis B virus infection,” Journal of Hepatology, vol. 61, no. 4, pp. 785-791, 2014. |
[20] | G. L.-H. Wong, V. W.-S. Wong, P. C.-L. Choi et al., “Metabolic syndrome increases the risk of liver cirrhosis in chronic hepati- tis B,” Gut, vol. 58, no. 1, pp. 111-117, 2009. |
[21] | G. L.-H. Wong, H. L.-Y. Chan, Z. Yu et al., “Coincidental metabolic syndrome increases the risk of liver fibrosis pro- gression in patients with chronic hepatitis B - A prospective cohort study with paired transient elastography examinations,” Alimentary Pharmacology & Therapeutics, vol. 39, no. 8, pp. 883- 893, 2014. |
[22] | Y. Li, Y.-S. Huang, Z.-Z. Wang et al., “Systematic review with meta-analysis. The diagnostic accuracy of transient elastogra- phy for the staging of liver fibrosis in patients with chronic hepatitis B,” Alimentary Pharmacology & Therapeutics, vol. 43, no. 4, pp. 458-469, 2016. |
[23] | F. S. Macaluso, M. Maida, C. Camma` et al., “Steatosis affects the performance of liver stiffness measurement for fibrosis assessment in patients with genotype 1 chronic hepatitis C,” Journal of Hepatology, vol. 61, no. 3, pp. 523-529, 2014. |
[24] | S. Petta, M. Maida, F. S. Macaluso et al., “The severity of steatosis influences liver stiffness measurement in patients with nonalcoholic fatty liver disease,” Hepatology, vol. 62, no. 4, pp. 1101-1110, 2015. |
[25] | Y.-J. Cai, J.-J. Dong, X.-D. Wang et al., “A diagnostic algorithm for assessment of liver fibrosis by liver stiffness measurement in patients with chronic hepatitis B,” Journal of Viral Hepatitis, vol. 24, no. 11, pp. 1005-1015, 2017. |
[26] | S. Gaia, S. Carenzi, A. L. Barilli et al., “Reliability of transient elastography for the detection of fibrosis in Non-Alcoholic Fatty Liver Disease and chronic viral hepatitis,” Journal of Hepatology, vol. 54, no. 1, pp. 64-71, 2011. |
[27] | S. A. Liangpunsakul and N. Chalasani, “What should we recommend to our patients with NAFLD regarding alcohol use,” American Journal of Gastroenterology, vol. 107, no. 7, pp. 976- 978, 2012. |
[28] | N. Chalasani, Z. Younossi, and J. E. Lavine, “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 Amer- ican Gastroenterological Association,” Hepatology, vol. 55, no. 6, pp. 2005-2023, 2012. |
[29] | European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD), and European Association for the Study of Obesity (EASO), “EASL-EASD–EASO Clinical Practice Guidelines for the man- agement of non-alcoholic fatty liver disease,” Journal of Hepa- tology, vol. 64, no. 6, pp. 1388-1402, 2016. |
[30] | V. W.-S. Wong, W. C.-W. Chu, G. L.-H. Wong et al., “Prevalence of non-alcoholic fatty liver disease and advanced fibrosis in Hong Kong Chinese. A population study using proton-magnetic resonance spectroscopy and transient elastography,” Gut, vol. 61, no. 3, pp. 409-415, 2012. |
APA Style
Md. Nuruzzaman, Sanjoy Kumar Saha, Mohammad Ashaduzzaman, Mohammed Obayedur Rahman, Amitav Saha, et al. (2022). Comparison Between Seromarkers and Transient Elastography for Assessment of Significant Liver Fibrosis in NAFLD Patients. International Journal of Gastroenterology, 6(1), 1-4. https://doi.org/10.11648/j.ijg.20220601.11
ACS Style
Md. Nuruzzaman; Sanjoy Kumar Saha; Mohammad Ashaduzzaman; Mohammed Obayedur Rahman; Amitav Saha, et al. Comparison Between Seromarkers and Transient Elastography for Assessment of Significant Liver Fibrosis in NAFLD Patients. Int. J. Gastroenterol. 2022, 6(1), 1-4. doi: 10.11648/j.ijg.20220601.11
AMA Style
Md. Nuruzzaman, Sanjoy Kumar Saha, Mohammad Ashaduzzaman, Mohammed Obayedur Rahman, Amitav Saha, et al. Comparison Between Seromarkers and Transient Elastography for Assessment of Significant Liver Fibrosis in NAFLD Patients. Int J Gastroenterol. 2022;6(1):1-4. doi: 10.11648/j.ijg.20220601.11
@article{10.11648/j.ijg.20220601.11, author = {Md. Nuruzzaman and Sanjoy Kumar Saha and Mohammad Ashaduzzaman and Mohammed Obayedur Rahman and Amitav Saha and Sajalendu Biswas and Touhidul Karim Majumder and Faruque Ahmed and Nadia Farha and Dr. Suparna Pramanik}, title = {Comparison Between Seromarkers and Transient Elastography for Assessment of Significant Liver Fibrosis in NAFLD Patients}, journal = {International Journal of Gastroenterology}, volume = {6}, number = {1}, pages = {1-4}, doi = {10.11648/j.ijg.20220601.11}, url = {https://doi.org/10.11648/j.ijg.20220601.11}, eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijg.20220601.11}, abstract = {Background: Transient elastography is very sensitive noninvasive tool to assess liver fibrosis in NAFLD patients. But it is costly and not widely available There are also seromarkers (APRI & FBI4) for ruling out significant liver fibrosis. This study intends to compare between seromakers & transient elastography result for assessment of significant liver fibrosis (SF) in NAFDL patients. Methods: This was an observational cross sectional study done in Sheikh Russel National Gastroliver Institute & Hospital from April 2019 to December 2019. A total 111 patients were selected by purposive sampling method. Demographic, clinical and biochemical data were collected. Liver fibrosis was assessed by transient elastography. Aspertate transaminase (ASI) to platelet ratio index (APRI) & FIB-4 score were compared among the non-significant fibrosis (F2-F4) patients. Result: The total number of study population was 111, among them 39 (35.3%) had significant liver fibrosis (Kpa>7.2; F0 to F1). There was significant difference in between SF & non SF groups in terms of mean serum ALT, AST, albumin and platelet count. APRT and FIB-4 were significantly higher in SF group. APRI had better accuracy (area under the receiver operating characteristics curve=0.925) than FIB-4) 0.885) in ruling out SF. Conclusion: Seromarkers are comparable to transient elastography in assessment of significant liver fibrosis in NAFLD patients. Among them APRI is more accurate in determining significant fibrosis.}, year = {2022} }
TY - JOUR T1 - Comparison Between Seromarkers and Transient Elastography for Assessment of Significant Liver Fibrosis in NAFLD Patients AU - Md. Nuruzzaman AU - Sanjoy Kumar Saha AU - Mohammad Ashaduzzaman AU - Mohammed Obayedur Rahman AU - Amitav Saha AU - Sajalendu Biswas AU - Touhidul Karim Majumder AU - Faruque Ahmed AU - Nadia Farha AU - Dr. Suparna Pramanik Y1 - 2022/02/09 PY - 2022 N1 - https://doi.org/10.11648/j.ijg.20220601.11 DO - 10.11648/j.ijg.20220601.11 T2 - International Journal of Gastroenterology JF - International Journal of Gastroenterology JO - International Journal of Gastroenterology SP - 1 EP - 4 PB - Science Publishing Group SN - 2640-169X UR - https://doi.org/10.11648/j.ijg.20220601.11 AB - Background: Transient elastography is very sensitive noninvasive tool to assess liver fibrosis in NAFLD patients. But it is costly and not widely available There are also seromarkers (APRI & FBI4) for ruling out significant liver fibrosis. This study intends to compare between seromakers & transient elastography result for assessment of significant liver fibrosis (SF) in NAFDL patients. Methods: This was an observational cross sectional study done in Sheikh Russel National Gastroliver Institute & Hospital from April 2019 to December 2019. A total 111 patients were selected by purposive sampling method. Demographic, clinical and biochemical data were collected. Liver fibrosis was assessed by transient elastography. Aspertate transaminase (ASI) to platelet ratio index (APRI) & FIB-4 score were compared among the non-significant fibrosis (F2-F4) patients. Result: The total number of study population was 111, among them 39 (35.3%) had significant liver fibrosis (Kpa>7.2; F0 to F1). There was significant difference in between SF & non SF groups in terms of mean serum ALT, AST, albumin and platelet count. APRT and FIB-4 were significantly higher in SF group. APRI had better accuracy (area under the receiver operating characteristics curve=0.925) than FIB-4) 0.885) in ruling out SF. Conclusion: Seromarkers are comparable to transient elastography in assessment of significant liver fibrosis in NAFLD patients. Among them APRI is more accurate in determining significant fibrosis. VL - 6 IS - 1 ER -