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).
Value of Cytokeratin-18 as a non-invasive diagnostic biomarker of nonalcoholic steatohepatitis (NASH)