scholarly journals Cytokeratin 18 as a non invasive marker in diagnosis of NASH and its usefulness in correlation with disease severity in Egyptian patients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M Maher ◽  
H Abdelaziz ◽  
T yossif ◽  
M Ossama

Abstract Background Non-alcoholic fatty liver disease (NAFLD) is one of the types of fatty liver which occurs when exceeive fat is deposited in the liver due to causes other than excessive alcohol use, NAFLD is subdivided into non alcoholic fatty liver (NAFLD) and nonalcoholic steatohepatitis (NASH). In NAFLD, hepatic steatosis is present without evidence of significant inflammation, whereas in NASH, hepatic steatosis is associated with hepatic inflammation Aims To evaluate the role of CK-18 as a non invasive marker in diagnosis of NASH and its usefulness in correlation with disease severity in Egyptian patients. Patients and Methods 60 subjects were divided into 2 groups: group I: including 30 patients with NAFLD, group II: including 30 matched healthy controls Diagnosis of NASH and its discrimination from NAFL was done by fibroscan. CK-18 level in plasma was measured for all subjects using ELISA. Results CK-18 was significantly elevated in patients of group I in comparison to group II, with mean ± SD: 460 ± 279, 167 ± 56 and 149 ± 57, respectively, and P value: 0.001. with mean ±SD: 59.6± 28, when compared with control group (with 23±8) P value < 0.001. ROC curve between Cases and Control regard CK18 with Area Under the Curve (AUC): 0.925. Cutoff > 30 ug/l With Sensitivity: 86.67% & Specificity: 83.33%. Ck-18 was found to correlate with steatosis and fibrosis assessed by fibroscan with P value< 0.001. Conclusion Measurement of serum cytokeratin 18 fragment levels (CK18) correlate with the Fibroscan (Transient Elastograph) as a non invasive tests in diagnosis & prognosis of non alcoholic fatty liver diseases (NAFLD).

2015 ◽  
Vol 16 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Mohsen M. Maher ◽  
Wesam A. Ibrahim ◽  
Shereen A. Saleh ◽  
Lobna Shash ◽  
Hoda Abou Gabal ◽  
...  

2019 ◽  
Vol 9 (1) ◽  
pp. 70-78
Author(s):  
Reham M. Gameaa ◽  
Nehad Hawash ◽  
Rehab Badawi ◽  
Sherief Abd-Elsalam ◽  
Gamal K. Kasem ◽  
...  

Background & Aim: Simple hepatic steatosis is a benign condition, but it may cause serious liver damage as it may lead to steatohepatitis, fibrosis and cirrhosis. The Controlled Attenuation Parameter (CAP) of fibroscan assesses hepatic steatosis. The aim of this work was to assess hepatic steatosis in patients with chronic hepatitis B infection using FibroScan and to detect its relation to insulin resistance. Methods: Seventy-seven patients with chronic HBV were enrolled in this study. Body mass index, complete lipid profile, fasting insulin, HOMA-IR, pelviabdominal ultrasound and fibroscan were assessed in all patients. Results: According to the presence of significant steatosis, seventy-seven patients enrolled in this study were divided into different groups, such as group I 47 patients (61.04%) with CHB virus infection with non-significant steatosis and group II 30 patients (38.96%) with CHB infection with significant steatosis. There was a statistically significant increase in fasting insulin and HOMA-IR in group II (p-value <0.001). CAP results ranged from 100-396 db/m with no significant difference in liver stiffness measurements in two studied groups (P value= 0.886). There was a significant positive correlation between the degree of hepatic steatosis measured by fibroscan and fasting insulin blood level, HOMA-IR, serum cholesterol and LDL. At cutoff > 222 db/m steatosis measured by fibroscan had a sensitivity of 63.33% and specificity of 82.35% for the detection of insulin resistance. Conclusion: In CHB infected patients, steatosis measurement by fibroscan was a strong predictor of Insulin Resistance (IR) and vice versa.


2021 ◽  
Author(s):  
Katarzyna Kozlowska-Petriczko ◽  
Ewa Wunsch ◽  
Jan Petriczko ◽  
Wing-Kin Syn ◽  
Piotr Milkiewicz

Abstract Background & Aims: In view of limited reliability of the biopsy in the assessment of liver fat, a non-invasive, trustworthy and more accessible method estimating a degree of steatosis is urgently needed. While controlled attenuation parameter (CAP) is used to quantify hepatic fat, its availability in routine practice is limited. Therefore, the aim of this study was to compare the diagnostic accuracy of biomarker- and ultrasound-based techniques for the diagnosis and grading of hepatic steatosis. Methods: This was a prospective study of 167 adults with and without non-alcoholic fatty liver disease. As measured against CAP, we assessed Hamaguchi’s score and the hepatorenal index (HRI), and the following biochemical measures: the fatty liver index, hepatic steatosis index and lipid accumulation product scores during a single out-patient visit. Area under the receiver operating curve (AUROC) analyses were used to evaluate the diagnostic accuracy of each test and to calculate optimal thresholds for the ultrasound techniques. Results: All non-invasive methods displayed high accuracy in detecting steatosis (mean AUC value ≥ 0.90), with Hamaguchi’s score and the HRI as the most precise. These two tests also had the highest sensitivity and specificity (82.2% and 100%; 86.9% and 94.8%, respectively). We propose new thresholds for Hamaguchi’s score and HRI for hepatic steatosis grading, indicated by optimal sensitivity and specificity. Conclusion: Ultrasound-based techniques are the most accurate for assessing liver steatosis compared to other non-invasive tests. Given the accessibility of ultrasonography, this finding is of practical importance for the assessment of liver steatosis in clinical settings.


2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Benash Altaf ◽  
Anam Rehman ◽  
Shireen Jawed ◽  
Abdul Raouf

Objective: To investigate the association of gold standard liver biomarkers with serum cytokeratin 18 (CK18), serum Alanine aminotransferase (ALT) and serum aspartate (AST). Methods: This was cross sectional study. It was conducted at Mayo Hospital from January 2016 to December 2017. It comprised of 148 non-alcoholic fatty liver disease subjects of age 40-60 years. After written informed consent, study anthropometric measurements (age, height, waist circumference and hip circumference) were taken and serum AST, ALT and CK-18 were estimated by sandwiched ELISA technique. Data was analyzed using SPSS 21.0. Descriptive were presented as mean and standard deviation. Association between CK18, serum AST and ALT were analyzed by regression analysis and are presented as beta coefficient. P-value ≤ 0.05 was taken as significant. Results: Study comprised of 148 subjects with mean age 44.81±6.2. Of total population 29.1% were male and 70.9% were female. Significant positive association of CK18 was found with serum ALT (P-value 0.005*). However, no association was found between AST and serum CK18. (P-value 0.29). Conclusion: Significant positive association was found between Serum CK18 and serum ALT. doi: https://doi.org/10.12669/pjms.36.3.1674 How to cite this:Altaf B, Rehman A, Jawed S, Raouf A. Association of liver biomarkers and cytokeratin-18 in Nonalcoholic fatty liver disease patients. Pak J Med Sci. 2020;36(3):---------. doi: https://doi.org/10.12669/pjms.36.3.1674 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ahmed M. F. Mansour ◽  
Essam M. Bayoumy ◽  
Ahmed M. ElGhandour ◽  
Mohamed Darwish El-Talkawy ◽  
Sameh M. Badr ◽  
...  

Abstract Background Non-alcoholic fatty liver disease (NAFLD) is regarded as the most common liver disease in the twenty-first century, and a condition leaving individuals at increased risk of extra-hepatic morbidity. Liver biopsy has long been regarded as the gold standard for diagnosis and prognostication of patients with NAFLD. However, due to its invasive nature and potential complications (e.g., bleeding), other methods for non-invasive laboratory and radiological assessment of hepatic steatosis and fibrosis in NAFLD have evolved and include scores such as AST/Platelet Ratio Index (APRI), Fibrosis-4 (FIB-4) score, NAFLD fibrosis score (NFS), and fatty liver index (FLI), in addition to radiological methods such as transient elastography (TE), which is a well-validated non-invasive ultrasound-based technique for assessment of hepatic fibrosis. Recently, novel development of controlled attenuation parameter (CAP) in TE allowed simultaneous assessment of hepatic steatosis. This provided a chance to assess both hepatic fibrosis and steatosis in the same setting and without any unwanted complications. This study aimed at assessing the role of TE and CAP versus other non-invasive assessment scores for liver fibrosis and steatosis in patients with NAFLD. Results This study included 90 patients diagnosed with NAFLD based on abdominal ultrasonography, body mass index, and serum liver enzymes. All patients were assessed with TE and non-invasive scores (APRI score, FIB-4 score, NFS, and FLI). There was a highly significant positive correlation between fibrosis and steatosis grades assessed by TE and other non-invasive respective scores. Both TE and CAP achieved acceptable sensitivity and specificity compared to other non-invasive assessment methods. Conclusions TE with CAP can be used as a screening method for patients suspected with NAFLD or patients without a clear indication for liver biopsy. CAP allows a non-invasive method of assessment of hepatic steatosis in patients with NAFLD.


Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 699 ◽  
Author(s):  
Anika Nier ◽  
Yvonne Huber ◽  
Christian Labenz ◽  
Maurice Michel ◽  
Ina Bergheim ◽  
...  

(1) Background: The etiology of non-alcoholic fatty liver disease (NAFLD) is multifactorial. Dietary composition has been implicated as a factor modulating intestinal barrier and could affect disease severity. The aim of this study was to evaluate dietary intake and markers of intestinal permeability in patients with NAFLD. (2) Methods: We enrolled 63 patients with NAFLD and compared them to age-matched controls. (3) Results: body mass index (BMI) and leptin to adiponectin ratio—the latter being an indicator of abdominal fat accumulation—correlated with the degree of hepatic steatosis being accompanied with rising levels of fasting insulin. Furthermore, endotoxin plasma levels and markers of inflammation were significantly higher in NAFLD compared to controls and increased with the severity of hepatic steatosis. Despite comparable intake of total energy and macronutrients, intake of fiber was lower in all patients with NAFLD compared to controls and were negatively related to disease severity. (4) Conclusions: Taken together, results of the present study suggest that fiber intake in patients is negatively related to steatosis degree and bacterial endotoxin levels, further suggesting that dietary fiber intake may be a target in NAFLD treatment (NCT: 02366052 and 03482284).


2020 ◽  
Vol 3 (1) ◽  
pp. 19-22
Author(s):  
Y. Pavan Kumar Reddy ◽  
Suraj Uppalapati

Background: Non-alcoholic fatty liver disease (NAFLD) is a range of hepatic disorders associated with fatty deposits in liver, which occur in the absence of alcohol consumption or alcohol abuse. NAFLD. The present study assessed glutathione level in non-alcoholic fatty liver disease patients. Subjects and Methods: The present study was conducted in Department of Internal Medicine, Narayana Medical College & Hospital, Chintareddy Palem, Nellore, Andhra Pradesh. Duration of the study was from February 2018 to January 2019. 40 patients of NAFLD and 20 cases of fatty liver disease were recruited. Serum levels of 8-OHdG were measured using the highly sensitive 8-OHdG Check enzyme-linked immunosorbent assay (ELISA). Serum levels of GGT were measured using the Qualigent® GGT kit. Serum levels of glutathione (GSH) were measured using the GSH kit. Results: The mean total bilirubin in group I was 1.2 mg/dL and in group II was 0.7 mg/dL, aspartate transaminase was 58.2 U/l in group I and 62.6 U/l in group II, alanine transaminase in group I was 142.4 U/l in group I and 128.2 U/l in group II, alkaline phosphatase was 284.2 U/l in group I and 302.4 U/l in group II and γ-glutamyltranspeptidase in group I was 98.2 U/l and 118.4 U// in group II. The difference was non- significant (P> 0.05). The mean glutathione level in group I was 0.6 and in group II was 0.4 and which increased to 1.4 in group I and 1.2 in group II after 3 months. The difference within the group found to be significant (P< 0.05). Conclusion: Authors found that there was reduction in alanine transaminase, glutathione and gamma-glutamyltranspeptidase level. Antioxidant therapy with glutathione may reduce the pathological oxidative stress in the liver in NASH, preventing the progression from NAFLD to NASH cases.


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