Iria Cebreiros López1, Florentina Guzmán Aroca2, Maria Dolores Frutos Bernal3, Juan Antonio Luján Mompeán3, Águeda Bas Bernal4, Antonio Miguel Hernández Martínez5, Enrique Martínez Barba4, Jose Antonio Noguera Velasco6, Pascual Parilla Paricio3. 1. Department of Clinical Analysis, Clinic University Hospital Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, 30120, Murcia, Spain. iriacebreiros@hotmail.com. 2. Department of Radiology, Clinic University Hospital Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, 30120, Murcia, Spain. 3. Department of Surgery, Clinic University Hospital Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, 30120, Murcia, Spain. 4. Department of Pathology, Clinic University Hospital Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, 30120, Murcia, Spain. 5. Department of Endocrinology and Nutrition, Clinic University Hospital Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, 30120, Murcia, Spain. 6. Department of Clinical Analysis, Clinic University Hospital Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, 30120, Murcia, Spain.
Abstract
BACKGROUND: Morbid obese patients have a high rate of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). NASH is related to the progression and poor evolution of chronic hepatopathy in NAFLD, so that its detection makes it possible to identify the subjects who are most at risk in order to prioritize treatment. The ELF test (Enhanced Liver Fibrosis test; Siemens Diagnostics, NY, USA) has been assessed for its capacity to detect fibrosis in patients with NAFLD, but its capacity for diagnosing NASH has not been checked. AIMS: Our objective is to determine the utility of the ELF test for detecting NASH in morbid obese patients with suspected NAFLD. METHODS: ELF values were determined in a cohort of obese patients who underwent bariatric surgery with suspected NAFLD. Liver biopsy was used as the reference standard. RESULTS: The values of ELF were significantly higher in patients with NASH (p = 0.002) and in those who presented with metabolic syndrome (p = 0.047). An ELF cut-off point of 8.72 allows the detection of patients with NASH with a sensitivity of 71.4% and a specificity of 74.1% (AUC = 0.742, p = 0.002). CONCLUSIONS: The ELF test is efficient for the identification of obese patients with NAFLD and early signs of steatohepatitis and fibrosis.
BACKGROUND: Morbid obesepatients have a high rate of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). NASH is related to the progression and poor evolution of chronic hepatopathy in NAFLD, so that its detection makes it possible to identify the subjects who are most at risk in order to prioritize treatment. The ELF test (Enhanced Liver Fibrosis test; Siemens Diagnostics, NY, USA) has been assessed for its capacity to detect fibrosis in patients with NAFLD, but its capacity for diagnosing NASH has not been checked. AIMS: Our objective is to determine the utility of the ELF test for detecting NASH in morbid obesepatients with suspected NAFLD. METHODS: ELF values were determined in a cohort of obesepatients who underwent bariatric surgery with suspected NAFLD. Liver biopsy was used as the reference standard. RESULTS: The values of ELF were significantly higher in patients with NASH (p = 0.002) and in those who presented with metabolic syndrome (p = 0.047). An ELF cut-off point of 8.72 allows the detection of patients with NASH with a sensitivity of 71.4% and a specificity of 74.1% (AUC = 0.742, p = 0.002). CONCLUSIONS: The ELF test is efficient for the identification of obesepatients with NAFLD and early signs of steatohepatitis and fibrosis.
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