Role of Circulating Endocan as a Biomarker in Non-Alcoholic Fatty Liver Disease

Abstract

Abstract Background Nonalcoholic fatty liver disease (NAFLD) has a prevalence of 25% worldwide and is described as the leading cause of chronic liver disease. Liver disease was found to be the third leading cause of death among persons with NAFLD. Its prevalence is increasing in conjunction with metabolic syndrome due to engaged risk factors, which include high body mass index and abdominal obesity, type 2 diabetes, dyslipidemia (high triglycerides and/or low high-densitylipoproteins), age, male sex, and alcohol consumption. Aim of the Work The aim of this study is to study serum level of Endocan in patients with nonalcoholic Fatty Liver disease (NAFLD) to detect its relation to the incidence and severity of nonalcoholic Fatty Liver Disease (NAFLD). Patients and Methods This study was conducted at Ain Shams University hospitals to evaluate the role of serum endocan as a diagnostic biomarker for NAFLD. We included a total of 100 subjects who were divided into two equal groups; Group 1 included 50 patients with NAFLD, and Group 2 included 50 healthy controls. Results Both BMI and waist circumference showed a significant increase in cases compared to controls. The prevalence of DM in the NAFLD group was 36% which was statistically significantly higher as compared with the control group. The mean SBP was statistically significantly higher in the NAFLD group, while DBP showed comparable findings. The mean liver size as detected by US was statistically significantly higher in the NAFLD group as compared with the control group, while spleen size didn’t reveal a statistically significant difference between the two groups. The mean fasting blood glucose, mean HbA1C, mean post-prandial glucose, mean cholesterol level, mean TGs, mean LDL, mean ALT and mean AST, mean ALP, mean GGT and mean ferritin level were statistically significantly higher in the NAFLD group as compared with the control group. The mean HDL level was statistically significantly lower in the NAFLD group as compared with the control group. Other laboratory variables were comparable between the two groups. The mean serum endocan level was statistically significantly higher in the NAFLD group as compared with the control group (54.58 ± 18.61 and 30.69 ± 6.49 respectively). Each of APRI, FIB-4 and NAFLD scores showed significant difference between the two groups. Conclusion Based on the previous findings, one can conclude that: Serum endocan may act as a surrogate marker for the diagnosis of NAFLD as it was significantly elevated in cases compared to controls. As well as detection of disease severity as it has a positive correlation with APRI, FIB-4 score yet still further studies on larger scales are required. This confirms the state of endothelial dysfunction associated with this disease NAFLD is associated with impaired lipid profile, impaired liver functions, and higher incidence of diabetes compared to controls.