Abstract
Liver-related mortality rates in patients with non-alcoholic steatohepatitis (NASH) increase with advancing liver fibrosis stage. The present study aimed to elucidate whether adding non-invasive liver fibrosis tests to a comprehensive health checkup system is useful for NASH screening. Both serum Mac-2-binding protein glycosylation isomer (M2BPGi) and point shear wave elastography (pSWE) using ultrasonography were performed for 483 health checkup subjects who consented to participate in this prospective study. Outcomes in positive subjects were surveyed 1 year later. Eighty-eight subjects (18%) showed positive results for at least one liver fibrosis test, with 63 subjects positive for pSWE, 33 subjects positive for M2BPGi, and 72 subjects showing no significant elevation of liver enzymes. The secondary consultation rate for positive subjects was 52% (46/88). However, as 15 of those 46 subjects visited a non-liver-specialist and could not undergo detailed examination, the secondary examination rate was only 35% (31/88). For the 31 subjects who received secondary examination, NASH was diagnosed in 14 subjects, other chronic liver disease (CLD) in 6 subjects, and no CLD in 11 subjects. Additional liver fibrosis tests using M2BPGi and pSWE appear useful in health checkups when screening for CLD, especially for NASH.
Highlights
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease around the world
Since serum transaminase levels are helpful in screening for NAFLD, Non-alcoholic steatohepatitis (NASH) is often detected during routine health checkups or clinical visits for other diseases [1]
The aim of the present study was to elucidate whether adding liver fibrosis tests of ultrasound-based shear wave elastography and Mac-2-binding protein glycosylation isomer (M2BPGi) to health checkup would prove useful for NASH screening
Summary
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease around the world. Non-alcoholic steatohepatitis (NASH) represents 10–20% of NAFLD, and can progress to cirrhosis or hepatocellular carcinoma [1]. Since serum transaminase levels are helpful in screening for NAFLD, NASH is often detected during routine health checkups or clinical visits for other diseases [1]. The stage of liver fibrosis represents the most useful predictor of mortality among NAFLD patients, and liver-related mortality rates increase exponentially as fibrosis stage advances, even at early stages [5]. Identification of NASH patients with liver fibrosis as early as possible in mass screenings such as health checkups is crucial, but must lead to appropriate medical care with liver specialists
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