التقييم التشخيصي لمجموعة اختبار الفايبرو كمؤشرات حيوية للتنبؤ بمرض الكبد الدهني

Diagnostic Evaluation Of Fibrotest Panel As A Biomarkers For The Prediction Of Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD) is a potentially progressive disorder, representing a wide spectrum of disease from simple steatosis and different degrees of fibrosis to non-alcoholic steatohepatitis (NASH), and eventually cirrhosis. With a global prevalence of approximately 25%, NAFLD is now the leading cause of chronic liver disease worldwide and a growing challenge to public health. Haptoglobin, alpha2macroglobulin(A2M) , apolipoprotein A1 (Apoa1), play main roles in liver diseases, which can be analysed via blood tests which It is considered noninvasive method and replacement of liver fibro scan or biopsy. There are several drawbacks in using liver biopsy and Fibroscan for this purpose. This study is to identify simple and widely available biomarkers that correlate well with liver Fibrosis stage and are suitable for detect advanced fibrosis and fibrosis progression in patients with NAFLD in everyday clinical practice, and reduce exposure to complication.
A few accuracy studies have evaluated the performance of the former markers in detecting different stages of fibrosis. Therefore, this study was aimed to evaluate the level of α2-macroglobulin (A2M), apolipoprotein A1, haptoglobin, total bilirubin, and γ-glutamyl- transpeptidase (GGT) in patients with Non-alcoholic fatty liver disease (NAFLD). Find the association levels of these markers in different fibrosis stages according to fibro scan diagnosis. Also, to study the variable performance levels (sensitivity & specificity) toward detection of fibrosis stages.
A case control study for a total of (90) patient samples, including NAFLD patients which were diagnosed using abdominal ultrasounds, biochemical tests, and clinical examination by physicians. the range of Fibrosis stages was assessed using Fibro Scan. The main endpoint was discriminating patients with severe fibrosis (F3, F4) from those with early or no fibrosis (F0, F1, F2) using a combination of relevant biomarkers. Serum biomarkers level were measured using enzyme linked immunoassay (ELISA) technique. The association between the biochemical markers and the disease severity was evaluated. The efficiency of the predicting value was assessed using receiver operating characteristic (ROC) curve.
Bilirubin level was increased markedly with progression of NFLD stage namely (F3). Alpha-2-Macroglobulin was estimated to have great variability in early-stage groups. Patients with different stage of fatty liver were showed a decreasing level of Apolipoprotein A1. The levels of GGT & Haptoglobin were showed a clear increasing difference with increasing the stage of fibrosis. Results were indicated that higher body mass index (BMI) levels were significantly more prevalent in subjects with fibrosis levels of ≥F2 compared to subjects with minimal or no fibrosis, P < 0.001. ROC analysis results were indicated that Alpha 2M was demonstrated the most interesting significant prediction about F3 cases.
In conclusion, serum markers included haptoglobin and Alpha 2 macroglobulin, indicated a good sensitivity toward diagnosis of NAFLD cases. Alpha 2 macroglobulin test might be used as a diagnostic threshold of non-invasive models for liver fibrosis.