Advances in Clinical and Experimental Medicine
2015, vol. 24, nr 5, September-October, p. 823–827
doi: 10.17219/acem/28485
Publication type: original article
Language: English
Download citation:
The Distribution of Liver Steatosis, Fibrosis, Steatohepatitis and Inflammation Activity in Alcoholics According to FibroMax Test
1 Department of Biochemical Diagnostics, Medical University in Białystok, Poland
2 Novencia Pharma, Warszawa, Poland
3 Department of Pediatric Laboratory Diagnostics, Medical University in Białystok, Poland
Abstract
Background. The diagnosis of alcoholic liver diseases is based on the history of alcohol abuse, clinical evidence of liver disease and laboratory abnormalities. The new non-invasive biomarkers have higher sensitivity to quantify and predict steatosis and fibrosis than ultrasonography.
Objectives. The aim of this study was to evaluate the prevalence of liver diseases in alcoholics by means of FibroMax.
Material and Methods. A total of 142 consecutive alcoholics were enrolled in the study. The prevalence of liver diseases was assayed by means of non-invasive biomarkers: fibrosis by FibroTest, steatosis by SteatoTest, steatohapatitis by AshTest (alcoholic origin) and NashTest (non-alcoholic origin) and necroinflammatory activity by ActiTest.
Results. 38.7% of alcoholics do not have fibrosis, 38% – steatosis, 94.1% – alcoholic steatohepatitis, 56.6% – non-alcoholic steatohepatitis and 33.6% – necroinflammatory activity. The insignificant fibrosis (F < 2) is present in 37.2%, advanced (F ≥ 2) – 15.3% and cirrhosis (F4) – in 8.8%. Insignificant steatosis (S < 2) is observed in 31.3% and advanced (S ≥ 2) in 30.5%. Minimal alcoholic steatohepatitis (H1) exists in 5.2% patients, moderate (H2) in none of the patient and severe (H3) in only one patient (0.7%). The distribution of NashTest scores is as following: N0 – 56.6%, N1 – 38.2% and N2 – 5.1%. Insignificant inflammatory activity (A < 2) is present in 40.8% of alcoholic patients but significant (A ≥ 2) in 25.5%. The frequency of severe steatosis (F3) and necroinflammatory activity (A3) in patients with cirrhosis (F4) is 50% for each of them.
Conclusion. The prevalence of advanced fibrosis and cirrhosis evaluated by means of FibroMax in alcoholics is higher than in alcoholic liver disease (ALD) and lower than in mixed, alcoholic and non-alcoholic ones. This may indicate the presence of non-alcoholic liver disease in alcoholics.
Key words
non-invasive biomarkers, alcoholic liver diseases, FibroMax
References (11)
- Gunneson TJ, Menon KV, Wiesner RH, Daniels JA, Hay JE, Charlton MR, Brandhagen DJ, Rosen CB, Porayko MK: Ultrasound-assisted percutaneous liver biopsy performed by a physician assistant. Am J Gastroenterol 2002, 97, 1472–1475.
- Cakmakci E, Caliskan KC, Tabakci ON, Tahtabasi M, Karpat Z: Percutaneous liver biopsies guided with ultrasonography: a case series. Iran J Radiol 2013, 10, 182–184.
- Wai CT, Grenson JK, Fontana RJ, Kalbfleisch JD, Marrero JA, Conjeevaram HS, Lok AS: A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology 2003, 38, 518–526.
- Corrao G, Ferrari P, Zambon A, Torchio P: Are the recent trends in liver cirrhosis mortality affected by the changes in alcohol consumption? Analysis of latency period in European countries. J Stud Alcohol 1997, 58, 486–494.
- O’Shea RS, Dasarathy S, McCullough AJ: Practice Guideline Committee of the American Association for the Study of Liver Diseases; Practice Parameters Committee of the American College of Gastroenterology. Alcoholic liver disease. Hepatology 2010, 51, 307–328.
- Lieber CS: Alcoholic fatty liver: its pathogenesis and mechanism of progression to inflammation and fibrosis. Alcohol 2004, 34, 9–19.
- Naveau S, Raynard B, Ratziu V, Abella A, Imbert-Bismut F, Messous D, Beuzen F, Capron E, Thabut D, Munteanu M, Chapul JC, Poynard T: Biomarkers for the prediction of liver fibrosis in patients with chronic alcoholic liver disease. Clin Gastroenterol Hepatol 2005, 3, 167–174.
- Dam-Larsen S, Franzmann MB, Christoffersen P, Larsen K, Becker U, Bendtsen F: Histological characteristics and prognosis in patients with fatty liver. Scand J Gastroenterol 2005, 40, 460–467.
- Scaglioni F, Ciccia S, Marino M, Bedogni G, Bellentani S: ASH and NASH. Dig Dis Sci 2011, 29, 202–210.
- Gao B, Bataller R: Alcoholic liver disease: pathogenesis and new therapeutic targets. Gastroenterology 2011, 141, 1572–1585.
- Poynard T, Lebray P, Ingiliz P, Varaut A, Varsat B, Ngo Y, Norha P, Munteanu M, Drane F, Messous D, Bismut FI, Carrau JP, Massard J, Ratziu V, Giordanella P: Prevalence of liver fibrosis and risk factors in a general population using non-invasive biomarkers (FibroTest). BMC Gastroenterology 2010, 10, 40.