Non-Invasive Detection of Fibrotic NASH in NAFLD Patients with Low or Intermediate FIB-4

Abstract:
        Background: Non-alcoholic steatohepatitis (NASH) and fibrosis are the main prognostic factors in non-alcoholic fatty liver disease (NAFLD). The FIB-4 score has been suggested as an initial test for the exclusion of progressed fibrosis. However, increasing evidence suggests that also NASH patients with earlier fibrosis stages are at risk of disease progression, emphasizing the need for improved non-invasive risk stratification. Methods: We evaluated whether the apoptosis biomarker M30 can identify patients with fibrotic NASH despite low or intermediate FIB-4 values. Serum M30 levels were assessed by ELISA, and FIB-4 was calculated in an exploration (n = 103) and validation (n = 100) cohort of patients with histologically confirmed NAFLD. Results: The majority of patients with low FIB-4 (cut-off value < 1.3) in the exploration cohort revealed increased M30 levels (>200 U/L) and more than 80% of them had NASH, mostly with fibrosis. NASH was also detected in all patients with intermediate FIB-4 (1.3 to 2.67) and elevated M30, from which ~80% showed fibrosis. Importantly, in the absence of elevated M30, most patients with FIB-4 < 1.3 and NASH showed also no fibrosis. Similar results were obtained in the validation cohort. Conclusions: The combination of FIB-4 with M30 enables a more reliable identification of patients at risk for progressed NAFLD and might, therefore, improve patient stratification.

SEEK ID: https://seek.lisym.org/publications/442

DOI: 10.3390/jcm11154394

Projects: C-TIP-HCC network

Publication type: Journal

Journal: Journal of Clinical Medicine

Citation: JCM 11(15):4394

Date Published: 1st Aug 2022

Registered Mode: by DOI

Authors: Katharina John, Martin Franck, Sherin Al Aoua, Monika Rau, Yvonne Huber, Joern M. Schattenberg, Andreas Geier, Matthias J. Bahr, Heiner Wedemeyer, Klaus Schulze-Osthoff, Heike Bantel

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John, K., Franck, M., Al Aoua, S., Rau, M., Huber, Y., Schattenberg, J. M., Geier, A., Bahr, M. J., Wedemeyer, H., Schulze-Osthoff, K., & Bantel, H. (2022). Non-Invasive Detection of Fibrotic NASH in NAFLD Patients with Low or Intermediate FIB-4. In Journal of Clinical Medicine (Vol. 11, Issue 15, p. 4394). MDPI AG. https://doi.org/10.3390/jcm11154394
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Created: 24th Mar 2025 at 12:34

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