Correlation between FibroScan and AST/ALT ratio and splenic size in NASH patients in a tertiary care center

Abstract

Background: Non-Alcoholic Steatohepatitis (NASH) is an aggressive form of Non-Alcoholic Fatty Liver disease (NAFLD), with liver inflammation and scarring. Due to a lack of clinical biomarkers and asymptomatic nature, NASH is often under-diagnosed. It is the most common cause of chronic liver disease in the USA. Liver biopsy is the gold standard to diagnose NASH, but it is invasive and life-threatening and histologic evaluation of a liver biopsy sample is imperfect as a reference because of sampling variability due to the irregular distribution of fibrosis. Aim: Validating AST/ALT ratio as a stand-alone scoring system in NASH is scarce and so this study aims to establish a correlation between FibroScan values and AST/ALT ratio. Methodology: All NASH patients, who underwent FibroScan were included. Their demographics, FibroScan, AST, ALT values were recorded in M S Excel and Pearson correlation between FibroScan values and AST/ALT ratios of 150 NASH patients was calculated using SPSS. Results: Out of 150 NASH patients, 72% were males and 57.33% belonged to 40-50 years age group. FibroScan values and AST/ALT ratio showed positive Pearson correlation of 0.245, (p value=0.003). FibroScan values and splenic size also showed a positive Pearson correlation of 0.289 (p value<0.001). Conclusion: Males of 40-50 years age group had higher distribution of NASH, so middle aged males should be screened routinely as they are at a higher risk. FibroScan value with AST/ALT ratio and splenic size showed a positive correlation, thus showing that AST/ALT ratio and splenic size increases with increase in liver stiffness.