Published October 18, 2023 | Version v1
Journal article Open

In the Diagnosis of Liver Fibrosis Developing in Nonalcoholic Fatty Liver Patients; Could Serum Fetuin A Be a Candidate Biomarker?

Creators

  • 1. Department of Gastroenterology, Samsun University Faculty of Medicine, Samsun, Turkiye.

Description

Abstract

Previous studies have reported in the literature that fetuin A, released from the liver, may be a useful serum biomarker in the diagnosis of nonalcoholic fatty liver disease (NAFLD). However, results are not consistent in predicting nonalcoholic steatohepatitis (NASH) and fibrosis, which are indicative of progressive NAFLD patients. The aim of this study was to investigate the importance of serum fetuin A in detecting NASH and fibrosis, which are determinants of morbidity, in patients with liver biopsy-proven NAFLD. This observational case-control study included 40 NAFLD patients diagnosed by liver biopsy and 25 healthy volunteer controls. The demographic characteristics of the patients and healthy volunteers were recorded, biochemical tests were done, and the serum fetuin A levels of the participants were determined by the enzyme-linked immunosorbent assay method. Serum fetuin A levels were significantly higher in both the nonalcoholic fatty liver (NAFL) (608.30 μg/mL; p<0.001) and NAFLD (536.58 μg/mL; p=0.008) groups compared to the control group (345.07 μg/mL). However, no significant difference was detected in the NASH group (417.06 μg/mL; p=0.740). When patients with and without fibrosis were compared, the mean serum fetuin A levels of patients with fibrosis were significantly lower (708 μg/mL and 380 μg/mL, respectively; p<0.001). When receiver operating characteristic (ROC) analysis was performed, the best cut-off point for patients with fibrosis was 510.98 μg/mL with 94.7% sensitivity and 66.7% specificity (p<0.001). Serum fetuin A may be a useful biomarker in the diagnosis of NAFLD patients and in predicting liver fibrosis.

Özet

Esas olarak karaciğerden salınan fetuin A'nın nonalkolik yağlı karaciğer hastalığının (nonalcoholic fatty liver disease, NAFLD) tanısında faydalı bir serum biyomarkerı olabileceği önceki çalışmalarda bildirilmiştir. Ancak ilerleyici NAFLD hastalarının göstergesi olan nonalkolik karaciğer yağlanması (nonalcoholic steatohepatitis, NASH) ve fibrozisin tahmininde sonuçlar tutarlı değildir. Bu çalışmanın amacı karaciğer biyopsisi ile kanıtlanmış NAFLD hastalarında, morbiditenin belirleyicisi olan NASH ve fibrozisin saptanmasında serum fetuin A'nın önemini araştırmaktır. Bu gözlemsel vaka kontrol çalışmasına karaciğer biyopsisi ile tanı almış 40 NAFLD hastası ve 25 sağlıklı gönüllüden oluşan kontrol grubu dahil edildi. Hastaların ve sağlıklı gönüllülerin demografik özellikleri kaydedildi, biyokimyasal testler yapıldı ve katılımcıların serum fetuin A düzeyleri enzim-bağlı immünosorbent assay yöntemi ile belirlendi. Serum fetuin A düzeyleri kontrol grubu (345.07 μg/mL) ile kıyaslandığında hem nonalkolik yağlı karaciğer (nonalcoholic fatty liver, NAFL) (608.30 μg/mL; p<0.001) hem de NAFLD (536.58 μg/mL; p=0.008) grubunda anlamlı olarak yüksek idi. Ancak NASH grubunda (417.06 μg/mL; p=0.740) anlamlı bir fark saptanmadı. Fibrozisi olan ve olmayan hastalar kıyaslandığında, fibrozisi olan hastaların serum fetuin A ortalama düzeyleri anlamlı olarak düşük idi (sırasıyla 708 μg/mL ve 380 μg/mL; p<0.001). ROC analizi yapıldığında, Fibrozisi olan hastalar için en iyi kesim noktası; 94.7% sensitivite ve 66.7% spesifite ile 510.98 μg/mL idi (p<0.001). Serum fetuin A, NAFLD hastalarının tanısında ve karaciğer fibrozisini öngörmede yararlı bir biyomarker olabilir.

Notes

Nonalkolik Yağlı Karaciğer Hastalarında Gelişen Karaciğer Fibrozisinin Tanısında; Serum Fetuin A Biyomarker Olabilir mi?

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