Potential use of non-invasive methods for non-alcoholic fatty liver disease
Michaela Fedelešová1, Viera Kupčová1, Mária Szántová1, Jozef Bulas2, Ladislav Turecký3
1 III. Interná klinika LF UK a UN Bratislava, Slovenská republika
2 I. interná klinila LF UK a UN Bratislava, Slovenská republika
3 Ústav lékarskej chémie, biochémie a klinickej biochémie, LF UK Bratislava, Slovenská republika
Non-alcoholic fatty liver disease (NAFLD) represents a range of disorders including simple steatosis, non-alcoholic steatohepatitis (NASH), and progression to liver cirrhosis. It is the most frequent chronic liver disease worldwide. Its prevalence continues to rise and it is likely to become the most common indication for liver transplantation in the future. As this disease affects much of the population and liver biopsy is an invasive diagnostic tool, the development of non-invasive diagnostic and screening tools is needed. Markers of inflammation, oxidative stress, apoptosis, fibrogenesis, scoring models for detecting hepatic steatosis, and fibrosis are important for the diagnostics of NAFLD. As isolated biochemical parameters are not specific or sensitive enough to predict the presence of NASH and fibrosis, there is a tendency to use various markers and combine them into mathematical algorithms. Several predictive models and scoring systems have been developed. Current data suggest that panels of markers (NAFLD fibrosis score, FIB-4 score, and BARD score) are useful diagnostic modalities to minimize the number of liver biopsies. Imaging methods (ultrasound, transient elastography, real-time elastography, dynamic shear waves elastography, and acoustic radiation force impuls elastography) are important in the diagnostics of NAFLD. Actual tendencies of non-invasive diagnostics are constantly being discussed and their clinical applicability is being evaluated. The review summarizes current biochemical and imaging methods and concentrates on the evaluation of their diagnostic accuracies and suitability in clinical practice.
Keywordsfibrosis, non-alcoholic steatohepatitis, non-alcoholic fatty liver disease, non-invasive diagnosis, serological methods, steatosis
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