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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 28, 2015; 21(24): 7427-7435
Published online Jun 28, 2015. doi: 10.3748/wjg.v21.i24.7427
Liver fibrosis markers of nonalcoholic steatohepatitis
Hirayuki Enomoto, Yukihiro Bando, Hideji Nakamura, Shuhei Nishiguchi, Masafumi Koga
Hirayuki Enomoto, Shuhei Nishiguchi, Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo 663-8501, Japan
Yukihiro Bando, Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui 918-8236, Japan
Hideji Nakamura, Department of Gastroenterology and Hepatology, Nissay Hospital, Osaka 550-0012, Japan
Masafumi Koga, Department of Internal Medicine, Kawanishi City Hospital, Hyogo 664-8533, Japan
Author contributions: Enomoto H and Koga M wrote and edited the manuscript; all authors participated in the studies and were involved in the manuscript revision and approved the final version of the manuscript.
Conflict-of-interest: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Masafumi Koga, MD, PhD, Department of Internal Medicine, Kawanishi City Hospital, Kawanishi, Hyogo 664-8533, Japan. m-koga@kawanishi-city-hospital.com
Telephone: +81-72-7942321 Fax: +81-72-7946321
Received: February 20, 2015
Peer-review started: February 22, 2015
First decision: April 13, 2015
Revised: April 27, 2015
Accepted: May 7, 2015
Article in press: May 7, 2015
Published online: June 28, 2015
Processing time: 129 Days and 7.4 Hours
Abstract

Nonalcoholic fatty liver disease (NAFLD) is one of the major causes of chronic liver injury. NAFLD includes a wide range of clinical conditions from simple steatosis to nonalcoholic steatohepatitis (NASH), advanced fibrosis, and liver cirrhosis. The histological findings of NASH indicate hepatic steatosis and inflammation with characteristic hepatocyte injury (e.g., ballooning degeneration), as is observed in the patients with alcoholic liver disease. NASH is considered to be a potentially health-threatening disease that can progress to cirrhosis. A liver biopsy remains the most reliable diagnostic method to appropriately diagnose NASH, evaluate the severity of liver fibrosis, and determine the prognosis and optimal treatment. However, this invasive technique is associated with several limitations in routine use, and a number of biomarkers have been developed in order to predict the degree of liver fibrosis. In the present article, we review the current status of noninvasive biomarkers available to estimate liver fibrosis in the patients with NASH. We also discuss our recent findings on the use of the glycated albumin-to-glycated hemoglobin ratio, which is a new index that correlates to various chronic liver diseases, including NASH.

Keywords: Nonalcoholic fatty liver disease; Nonalcoholic steatohepatitis; Liver fibrosis; Glycated albumin; Glycated hemoglobin

Core tip: Due to the increasing prevalence of obesity and diabetes, nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases. In particular, nonalcoholic steatohepatitis (NASH), a subgroup of NAFLD, has become a major health concern. A liver biopsy remains the gold standard method for the accurate diagnosis of NASH and the evaluation of the degree of liver fibrosis. However, due to the limitations associated with the performance of liver biopsies, noninvasive biomarkers have been proposed to estimate the degree of liver fibrosis. Recently, new approaches based on glycated proteins have been developed, and these methods may help to improve the management of NAFLD/NASH.