Non-Invasive Biomarkers vs Liver Biopsy in Diagnosing & Staging NAFLD

Abstract

Introduction: Non-alcoholic fatty liver disease (NAFLD) encompasses a spectrum of disease ranging from simple steatosis to inflammatory steatohepatitis (NASH) with increasing levels of fibrosis and ultimately cirrhosis. It has been considered the most common liver disease and the most frequent cause of elevated aminotransferases and cryptogenic cirrhosis. Aims and Objectives: To evaluate the role of non invasive biomarkers and compare them with liver biopsy in diagnosis and staging of Non Alcoholic Fatty Liver Disease. Material and Methods: This study was conducted at Pt. B D Sharma, PGIMS, Rohtak. A total of forty consecutive patients of nonalcoholic fatty liver disease underwent liver biopsy, in addition to non-invasive biomarkers. P value of 0.05 was taken as non-significant. Results: The patients were in age group of 22-70 years with mean age of 44-35 years. Seventy percent were females and 30% were male. Impaired fasting glucose levels were seen in 37.5% cases, obesity and hypertension was present in 35% and 45% cases respectively. Out of 40 cases, features of definite NASH were seen in 65% cases and 35% cases showed features of probable NASH. Fibrosis stage I was seen in 80% cases, while both stage II and III fibrosis cases were 10% each. Conclusion: The simple noninvasive scoring systems have a role in assessment of fibrosis and can identify patients with NAFLD at higher risk for development of liver related complications and higher overall mortality. The major advantage of using any of these simple scoring systems is that they are derived from readily available clinical and laboratory indices. Furthermore, a combination of these simple noninvasive markers may perform better than each alone. However, this needs to be assessed in future studies with larger sample size.