Clinical Research
Copyright ©2005 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jan 14, 2005; 11(2): 255-259
Published online Jan 14, 2005. doi: 10.3748/wjg.v11.i2.255
Clinical usefulness of biochemical markers of liver fibrosis in patients with nonalcoholic fatty liver disease
Hiroshi Sakugawa, Tomofumi Nakayoshi, Kasen Kobashigawa, Tsuyoshi Yamashiro, Tatsuji Maeshiro, Satoru Miyagi, Joji Shiroma, Akiyo Toyama, Tomokuni Nakayoshi, Fukunori Kinjo, Atsushi Saito
Hiroshi Sakugawa, Tomofumi Nakayoshi, Kasen Kobashigawa, Tsuyoshi Yamashiro, Tatsuji Maeshiro, Satoru Miyagi, Joji Shiroma, Akiyo Toyama, Tomokuni Nakayoshi, Fukunori Kinjo, Atsushi Saito, First Department of Internal Medicine, Faculty of Medicine, School of Medicine, University of the Ryukyus, Okinawa, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Hiroshi Sakugawa, M.D., First Department of Internal Medicine, University Hospital, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215 Japan. b987607@med.u-ryukyu.ac.jp
Telephone: +98-895-1144 Fax: +98-895-1414
Received: April 22, 2004
Revised: April 28, 2004
Accepted: June 18, 2004
Published online: January 14, 2005
Abstract

AIM: Nonalcoholic steatohepatitis (NASH) is a severe form of nonalcoholic fatty liver disease (NAFLD), and progresses to the end stage of liver disease. Biochemical markers of liver fibrosis are strongly associated with the degree of histological liver fibrosis in patients with chronic liver disease. However, data are few on the usefulness of markers in NAFLD patients. The aim of this study was to identify better noninvasive predictors of hepatic fibrosis, with special focus on markers of liver fibrosis, type VI collagen 7S domain and hyaluronic acid.

METHODS: One hundred and twelve patients with histologically proven NAFLD were studied.

RESULTS: The histological stage of NAFLD correlated with several clinical and biochemical variables, the extent of hepatic fibrosis and the markers of liver fibrosis were relatively strong associated. The best cutoff values to detect NASH were assessed by using receiver operating characteristic analysis: type VI collagen 7S domain ≥5.0 ng/mL, hyaluronic acid ≥43 ng/mL. Both markers had a high positive predictive value: type VI collagen 7S domain, 86% and hyaluronic acid, 92%. Diagnostic accuracies of these markers were evaluated to detect severe fibrosis. Both markers showed high negative predictive values: type VI collagen 7S domain (≥5.0 ng/mL), 84% and hyaluronic acid (≥50 ng/mL), 78%, and were significantly and independently associated with the presence of NASH or severe fibrosis by logistic regression analysis.

CONCLUSION: Both markers of liver fibrosis are useful in discriminating NASH from fatty liver alone or patients with severe fibrosis from patients with non-severe fibrosis.

Keywords: Liver fibrosis; Nonalcoholic fatty liver disease; Collagen type IV; Hyaluronic acid