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Thai Journal of Gastroenterology

Thai Journal of Gastroenterology

2016 Vol.17 No.2

Article :
Controlled Attenuation Parameter with Serum High Sensitivity-CRP Measurement for Differentiating Non-alcoholic Steatohepatitis from Simple Steatosis in Patients with Non-alcoholic Fatty Liver Disease

Author :
Ruenrom V
Sutthivana C
Luasiripanthu T
Polmanee P

Abstract :
Background: Non-alcoholic fatty liver disease (NAFLD) is a disorder which ranges over a spectrum extending from simple steatosis to non-alcoholic steatohepatitis (NASH). The latter could progress to liver cirrhosis. Liver biopsy is the gold standard to help differentiate between simple steatosis and NASH. Controlled attenuation parameter (CAP) is a recent non-invasive method for the detection and quantification of hepatic steatosis, while serum high sensitivity C-reactive protein (hs-CRP) is a reliable inflammatory marker. Objective: To assess whether CAP and hs-CRP could differentiate between simple steatosis and NASH in patients with NAFLD. Method: Patients with chronic hepatitis and suspected NAFLD were performed liver biopsy. All patients were measured CAP, serum hs-CRP, and basic laboratorys parameters. History and physical examination were obtained. Data were analyzed using SPSS statistic. Results: Seventy-seven NAFLD patients were included for study, 28 with simple steatosis and 49 with NASH. Baseline characteristics and basic laboratory values were not different between the two groups. The optimal cut-off value of CAP and serum hs-CRP in differentiating simple steatosis from NASH, as assessed by ROC analysis, were 292 dB/m (sensitivity 87.8%, specificity 96.4%, and accuracy 90.9%) and 0.92 mg/L (sensitivity 100%, specificity 53.6%, and accuracy 83.1%), respectively. In multivariate analysis, CAP increased 1 dB/m (OR=1.05, 95% CI; 1.02-1.1 p=0.006) and serum hs-CRP increased 1 mg/L (OR=7.91, 95% CI; 1.62-38.6 p=0.011) Conclusions: In NAFLD patients, CAP and serum hs-CRP appeared useful non-invasive tool for differentiating between simple steatosis and NASH.

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