Histological Evaluation of Non-alcoholic Fatty Liver Disease and Its Correlation with Different Noninvasive Scoring Systems with Special Reference to Fibrosis: A Single Center Experience

详细信息    查看全文

• 作者：Mitali M. Rath^* ; Manas K. Panigrahi^&dagger ; ; Kaumudee Pattnaik^&Dagger ; ; Pallavi Bhuyan^&Dagger ; ; Sanjib K. Kar^§ ; ; Bijay Misra^§ ; ; Debasis Misra^§ ; ; Chudamani Meher^¶ ; ; Omprakash Agrawal^¶ ; ; Jayshree Rath^&Dagger ; ; Shivaram P. Singh^§ ; ; ^{scb_gastro_dept@hotmail.com}
• 关键词：ALT ; alanine aminotransferase ; APRI ; aspartate aminotransferase (AST)-to-platelet ratio index ; AST ; aspartate aminotransferase ; BMI ; body mass index ; DM ; diabetes mellitus ; NAFLD ; non-alcoholic fatty liver disease ; NASH ; non-alcoholic steatohepatitis ; NAS ; NAFLD fibrosis score ; NPV ; negative predictive value ; PPV ; positive predictive value ; ROC ; receiver operating characteristic ; SGOT ; serum glutamic oxaloacetic transaminases ; SGPT ; serum glutamic pyruvate transaminases ; TPC ; total platelet coun
• 刊名：Journal of Clinical and Experimental Hepatology
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：6
• 期：4
• 页码：291-296
• 全文大小：317 K
• 卷排序：6

文摘

Although liver biopsy remains the gold standard for the diagnosis of non-alcoholic fatty liver disease [NAFLD], many non-invasive markers of liver fibrosis have recently been proposed and assessed as surrogates of liver biopsy.Aims and objectiveTo evaluate the degree of liver fibrosis by different non-invasive fibrosis scoring systems and to compare each non-invasive fibrosis scoring system with histological fibrosis stage.Materials and methodsThe study population consists of consecutive patients with biopsy proven NAFLD. Complete medical history was taken and physical examination was done in all patients along with appropriate biochemical evaluations. NAFLD fibrosis score, BARD score, BAAT score and APRI score were calculated and each score was compared with histological fibrosis staging.ResultsThe study population consisted of 60 patients having mean age 39.73 years (SD 9.62, range 17–63 years) including 51 (85%) males and 9 (15%) females. On histology fibrosis was present in 68.3% (41/60) patients. Out of 60 patients 41 had fibrosis and among them 17, 22, 2 patients had grade 1, 2, 3 fibrosis respectively and no one had grade 4 fibrosis. 61.67% (37/60) had definite NASH. Comparing the fibrosis of histology with the noninvasive scoring systems, the sensitivity and specificity of NAFLD fibrosis score were 5.56% and 100% respectively. BARD score had 45.83% sensitivity and 80.55% specificity. The sensitivities of BAAT score and APRI score were 0% and 29.16% respectively and the specificities were 100% and 97.22% respectively.ConclusionThe noninvasive scoring systems like NFS, BARD, BAAT, and APRI are not sensitive enough to detect fibrosis but highly specific to include fibrosis if scores are more than cut-off values in our cohort, however they cannot replace liver biopsy. Newer more efficient non-invasive scoring systems have to be devised for the Indian NAFLD population.