BACKGROUND & AIMS: It is difficult to determine the different stages of non-alcoholic fatty liver disease without the use of invasive liver biopsy. In this study we investigated five non-invasive biomarkers used previously to detect hepatic fibrosis and determined the level of agreement between them in order to inform future research. METHODS: In the Edinburgh Type 2 Diabetes Study, a population-based cohort aged 60-74 years with type 2 diabetes, 831 participants underwent ultrasound assessment for fatty liver and had serum aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT), aspartate to platelet ratio index (APRI), European Liver Fibrosis panel (ELF), Fibrosis-4 Score (FIB4) and liver stiffness measurement (LSM) measured. RESULTS: Literature based cut-offs yielded marked differences in the proportions of the cohort with probable liver fibrosis in the full cohort. Agreement between the top 5% of the distribution for each biomarker pair was poor. APRI and FIB4 had the best positive agreement at 76.4%, but agreement for all of the other serum biomarker pairs was between 18% and 34%. Agreement with LSM was poor (9-16%). CONCLUSIONS: We found poor correlation between the five biomarkers of liver fibrosis studied. Using the top 5% of each biomarker resulted in good agreement on the absence of advanced liver disease but poor agreement on the presence of advanced disease. Further work is required to validate these markers against liver biopsy and to determine their predictive value for clinical liver-related endpoints, in a range of different low and high risk population groups.
BACKGROUND & AIMS: It is difficult to determine the different stages of non-alcoholic fatty liver disease without the use of invasive liver biopsy. In this study we investigated five non-invasive biomarkers used previously to detect hepatic fibrosis and determined the level of agreement between them in order to inform future research. METHODS: In the Edinburgh Type 2 Diabetes Study, a population-based cohort aged 60-74 years with type 2 diabetes, 831 participants underwent ultrasound assessment for fatty liver and had serum aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT), aspartate to platelet ratio index (APRI), European Liver Fibrosis panel (ELF), Fibrosis-4 Score (FIB4) and liver stiffness measurement (LSM) measured. RESULTS: Literature based cut-offs yielded marked differences in the proportions of the cohort with probable liver fibrosis in the full cohort. Agreement between the top 5% of the distribution for each biomarker pair was poor. APRI and FIB4 had the best positive agreement at 76.4%, but agreement for all of the other serum biomarker pairs was between 18% and 34%. Agreement with LSM was poor (9-16%). CONCLUSIONS: We found poor correlation between the five biomarkers of liver fibrosis studied. Using the top 5% of each biomarker resulted in good agreement on the absence of advanced liver disease but poor agreement on the presence of advanced disease. Further work is required to validate these markers against liver biopsy and to determine their predictive value for clinical liver-related endpoints, in a range of different low and high risk population groups.
Authors: Audrey L French; Anna Hotton; Mary Young; Marek Nowicki; Michael Augenbraun; Kathryn Anastos; Eric Seaberg; William Rosenberg; Marion G Peters Journal: J Acquir Immune Defic Syndr Date: 2016-07-01 Impact factor: 3.731
Authors: Srinevas K Reddy; Colleen Reilly; Min Zhan; Ayse L Mindikoglu; Yixing Jiang; Barton F Lane; H Richard Alexander; William J Culpepper; Samer S El-Kamary Journal: Med Oncol Date: 2014-05-06 Impact factor: 3.064
Authors: Anna E Garcia; Nader Kasim; Robyn A Tamboli; Raul S Gonzalez; Joseph Antoun; Emily A Eckert; Pamela A Marks-Shulman; Julia Dunn; Julia Wattacheril; Taylor Wallen; Naji N Abumrad; Charles Robb Flynn Journal: PLoS One Date: 2015-11-23 Impact factor: 3.240
Authors: Thomas Karlas; Arne Dietrich; Veronica Peter; Christian Wittekind; Ralf Lichtinghagen; Nikita Garnov; Nicolas Linder; Alexander Schaudinn; Harald Busse; Christiane Prettin; Volker Keim; Michael Tröltzsch; Tatjana Schütz; Johannes Wiegand Journal: PLoS One Date: 2015-11-03 Impact factor: 3.240