Non-alcoholic fatty liver disease laboratory findings
Non-Alcoholic Fatty Liver Disease Microchapters |
Differentiating Non-Alcoholic Fatty Liver Disease from other Diseases |
---|
Diagnosis |
Treatment |
Case studies |
Non-alcoholic fatty liver disease laboratory findings On the Web |
American Roentgen Ray Society Images of Non-alcoholic fatty liver disease laboratory findings |
FDA on Non-alcoholic fatty liver disease laboratory findings |
CDC on Non-alcoholic fatty liver disease laboratory findings |
Non-alcoholic fatty liver disease laboratory findings in the news |
Blogs on Non-alcoholic fatty liver disease laboratory findings |
Directions to Hospitals Treating Non-alcoholic fatty liver disease |
Risk calculators and risk factors for Non-alcoholic fatty liver disease laboratory findings |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]
Overview
There are no specific diagnostic laboratory findings associated with non alcoholic fatty liver disease. Laboratory findings include abnormal liver function tests but are unspecific. Other laboratory tests are generally performed to rule out other diagnosis.
Laboratory Findings
- There is no specific laboratory findings diagnostic for non alcoholic fatty liver disease.[1][2]
- Liver function tests
- Evaluation for alternative causes of liver disease should be performed.
- These include HCV serology, serologies for autoimmune hepatitis, and copper studies including serum ceruloplasmin and 24-hour urinary copper if Wilson disease is suspected.
- Fasting plasma glucose testing following an overnight fast is important to look for hyperglycemia, which is an indicator of insulin resistance.
- Fasting insulin levels can confirm hyperinsulinemia and insulin resistance
- Lipid levels ( serum cholesterol and fasting triglycerides ) should be evaluated
- Dyslipidemia, beside being a very common finding in NAFLD, is a risk factor that can be modified by dietary and/or pharmacologic intervention.
- Iron studies (in particular elevated ferritin and transferring saturation) are often abnormal in NAFLD
- Some patients with NAFLD may have low titers of autoimmune antibodies.
- Biomarkers
- CK18 represents a promising biomarker for evaluation of the presence of NASH.
- A defining characteristic of NASH is cellular death, and serum CK18 levels had been shown to correlate with steatohepatitis.
Non-alcoholic fatty liver disease, especially if with cirrhosis, may be associated with thrombocytopenia[3][4].
Fibrosis score
A fibrosis score can be obtained via:
- Liver biopsy. Various scoring systems exist including the Ishak; however, Ishak deems cirrhosis at a score of 5 or 6[5].
- F0. No fibrosis
- F1. Fibrous portal expansion
- F2. Few septa
- F3. Bridging fibrosis. Numerous septa
- F4. Cirrhosis
- Nonivasive serological liver fibrosis score such as AST to platelet ratio (APRI), and proprietary tests such as: FibroTest, FibroSure, Hepascore, and FibroSpect. An example is based on the "serum hyaluronic acid, procollagen type III N-terminal peptide, and tissue inhibitor of metalloproteinase 1"[6].
- A score > "9.8 indicates a moderate risk of advanced fibrosis"<ref name="pmid33185364">/
- A score > "11.3 denotes a high risk of advanced fibrosis"[6]
- Noninvasive imaging scores such as the Fibroscan.
References
- ↑ "Nonalcoholic fatty liver disease: Indications for liver biopsy and noninvasive biomarkers - Noureddin - 2012 - Clinical Liver Disease - Wiley Online Library".
- ↑ "Nonalcoholic fatty liver disease (NAFLD), including nonalcoholic steatohepatitis (NASH)".
- ↑ Rivera-Álvarez M, Córdova-Ramírez AC, Elías-De-La-Cruz GD, Murrieta-Álvarez I, León-Peña AA, Cantero-Fortiz Y; et al. (2021). "Non-alcoholic fatty liver disease and thrombocytopenia IV: its association with granulocytopenia". Hematol Transfus Cell Ther. doi:10.1016/j.htct.2021.06.004. PMID 34312112 Check
|pmid=
value (help). - ↑ Panke CL, Tovo CV, Villela-Nogueira CA, Cravo CM, Ferreira FC, Rezende GFM; et al. (2020). "Evaluation of thrombocytopenia in patients with non-alcoholic fatty liver disease without cirrhosis". Ann Hepatol. 19 (1): 88–91. doi:10.1016/j.aohep.2019.05.011. PMID 31575467.
- ↑ Ishak K, Baptista A, Bianchi L, Callea F, De Groote J, Gudat F; et al. (1995). "Histological grading and staging of chronic hepatitis". J Hepatol. 22 (6): 696–9. doi:10.1016/0168-8278(95)80226-6. PMID 7560864.
- ↑ 6.0 6.1 Newsome PN, Buchholtz K, Cusi K, Linder M, Okanoue T, Ratziu V; et al. (2021). "A Placebo-Controlled Trial of Subcutaneous Semaglutide in Nonalcoholic Steatohepatitis". N Engl J Med. 384 (12): 1113–1124. doi:10.1056/NEJMoa2028395. PMID 33185364 Check
|pmid=
value (help).