Abstract :
Background: Non alcoholic fatty liver disease (NAFLD) is a common liver disease that comprises a
wide spectrum, ranging from fatty liver alone to steatohepatitis and progress to the end stage of liver disease.
Serum hyaluronic acid is a glycosaminoglycan produce from hepatic stellate cells which is responsible for liver fibrogenesis.
Objective: To evaluate clinical significant of serum hyaluronic acid as a non invasive marker for pre-
diction of liver fibrosis in NAFLD.
Methods: Twenty-seven patients with biopsy proven NAFLD were studied. Histopathology finding
were graded and staged. The concentration of serum hyaluronic acid was measured by radioimmunoassay method. BMI, fasting blood sugar, liver function test and lipid profiles were also measured.
Results: In twenty-seven patients with NAFLD, the mean age was 47.9 years. Diabetes mellitus was found in 7 patients (45.4%). Only 2 patients had normal BMI (<23 kg/m ), with a mean of 27.4 kg/m . Significant
liver fibrosis defined as fibrosis score F2, F3 or F4 were present in 9 patients (33.3%). Factors correlated with significant fibrosis were age, platelet count and serum hyaluronate but factor that not correlated with fibrosis was hypercholesterolnemia. Serum hyaluronic acid levels were significantly higher in fibrosis group (mean 373 +/- 184.7 ng/dl) than non significant fibrosis group (mean 156.7 +/- 64.6 ng/dl, p = 0.008). When a receiver operating characteristic analysis was performed, the cut off point that achieved the highest accuracy for predicting fibrosis was 218.5 ng/dl. With this concentration the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 77.78%, 88.89%, 85.18%, 77.78%, 88.89%, respectively.
Conclusions: The serum levels of hyaluronic acid were correlated well with the degree of liver fibrosis
in NAFLD. Thus, serum hyaluronic acid can be a useful marker for predicting liver fibrosis in NAFLD.
[Thai J Gastroenterol 2006; 7(2): 83-87] |
file/Thai-Journal-of-gastroenterology-vol-7-no-2-3864241.pdf