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World J Gastroenterol. Oct 14, 2010; 16(38): 4784-4791
Published online Oct 14, 2010. doi: 10.3748/wjg.v16.i38.4784
Noninvasive investigations for non alcoholic fatty liver disease and liver fibrosis
Carmen Fierbinteanu-Braticevici, Ion Dina, Ana Petrisor, Laura Tribus, Lucian Negreanu, Catalin Carstoiu
Carmen Fierbinteanu-Braticevici, Ana Petrisor, Laura Tribus, Lucian Negreanu, Catalin Carstoiu, Medical Clinic II and Gastroenterology, University Hospital Bucharest, 7001 Bucharest, Romania
Ion Dina, Department of Gastroenterology, St John’s Hospital 7001 Bucharest, Romania
Author contributions: Fierbinteanu-Braticevici C and Dina I contributed equally to this work and wrote the paper; Petrisor A, Tribus L, Negreanu L and Carstoiu C contributed to the bibliographic research and to the text corrections.
Correspondence to: Carmen Fierbinteanu-Braticevici, Associate Professor, Medical Clinic II and Gastroenterology, University Hospital Bucharest, 7001 Bucharest, Romania. cfierbinteanu@yahoo.com
Telephone: +40-21-3180571 Fax: +40-21-3180571
Received: May 8, 2010
Revised: June 28, 2010
Accepted: July 5, 2010
Published online: October 14, 2010
Abstract

Non-alcoholic fatty liver disease (NAFLD) includes a spectrum of diseases that have insulin resistance in common and are associated with metabolic conditions such as obesity, type 2 diabetes mellitus, and dyslipidemia. NAFLD ranges from simple liver steatosis, which follows a benign course, to nonalcoholic steatohepatitis (NASH), a more severe entity, with necroinflammation and fibrosis, which can progress to cryptogenic cirrhosis and end-stage liver disease. Liver biopsy remains the gold standard for evaluating the degree of hepatic necroinflammation and fibrosis; however, several noninvasive investigations, such as serum biomarkers, have been developed to establish the diagnosis and also to evaluate treatment response. These markers are currently neither available in all centers nor validated in extensive studies. Examples include high-sensitivity C reactive protein and plasma pentraxin 3, which are associated with extensive liver fibrosis in NASH. Interleukin-6 correlates with inflammation, and cytokeratin-18 represents a marker of hepatocyte apoptosis (prominent in NASH and absent in simple steatosis). Tissue polypeptide specific antigen seems to have a clinical utility in the follow-up of obese patients with NASH.

Keywords: Non-alcoholic fatty liver disease; Biomarkers; Necroinflammation; Liver fibrosis