Frequency of Liver Fibrosis by Non Invasive Marker in Patients with Non-Alcohol Fatty Liver Diseases

Nonalcoholic fatty liver disease (NAFLD) is one of the most important causes of liver disease. NAFLD is commonly associated with obesity, insulin resistance and other metabolic abnormalities such as hypertriglyceridemia and hyperuricemia.  Patients with NAFLD can be properly rationalized and with early exploration and management of fatty liver the progression and complications of NAFLD in relation to liver fibrosis can be reduced on priority basis because the APRI is noninvasive and a simple calculation of two laboratorial variables. Objective: To determine the frequency of liver fibrosis by non-invasive marker in patients with non-alcohol fatty liver disease. Methods: This cross-sectional descriptive study was conducted upon 164 patients with NAFLD, presented at Department of Medicine, Liaquat University Hospital, Hyderabad. All the patients with NAFLD were evaluated and explored for liver fibrosis through APRI by taking 2cc venous blood sample in a sterilized syringe by principal investigator and send to laboratory for analysis to get the AST and platelet count. An APRI score greater than 0.7 was set cut off for significant hepatic fibrosis. The data were collected on pre-designed proforma.  The study lasted 6 months from 26th February 2020 to 31st August 2020. Results: The mean age of the patients was 48.15±11.13 years. Frequency of liver fibrosis by non-invasive marker in patients with non-alcohol fatty liver disease was 10.98% (18/164).  The mean APRI score was found to be 1.8±0.6. Conclusions: It was concluded that APRI is noninvasive and a simple calculation of two laboratory variables and can easily be used at the bedside or in an outpatient setting to assess the liver fibrosis. In this way, the management of NAFLD can be improved.  

[1]  L. Bolondi,et al.  Current guidelines for the management of non-alcoholic fatty liver disease: A systematic review with comparative analysis , 2018, World journal of gastroenterology.

[2]  A. Dassanayake Nonalcoholic Fatty Liver Disease: Identifying the Disease Burden in Sri Lanka , 2018, Euroasian journal of hepato-gastroenterology.

[3]  Xuchen Zhang,et al.  Non-alcoholic fatty liver disease: An expanded review , 2017, World journal of hepatology.

[4]  P. Newsome,et al.  Non-alcoholic fatty liver disease in 2016. , 2016, British medical bulletin.

[5]  Q. Anstee,et al.  Nonalcoholic Fatty Liver Disease: Pathogenesis and Disease Spectrum. , 2016, Annual review of pathology.

[6]  H. Yki-Järvinen Diagnosis of non-alcoholic fatty liver disease (NAFLD) , 2016, Diabetologia.

[7]  H. Cho Prevalence and Factors Associated with Nonalcoholic Fatty Liver Disease in a Nonobese Korean Population , 2016, Gut and liver.

[8]  W. Syn,et al.  Practical approach to non‐alcoholic fatty liver disease in patients with diabetes , 2015, Diabetic medicine : a journal of the British Diabetic Association.

[9]  E. Bjornsson,et al.  Liver Fibrosis, but No Other Histologic Features, Is Associated With Long-term Outcomes of Patients With Nonalcoholic Fatty Liver Disease. , 2015, Gastroenterology.

[10]  A. Burt,et al.  Evidence of NAFLD progression from steatosis to fibrosing-steatohepatitis using paired biopsies: implications for prognosis and clinical management. , 2015, Journal of hepatology.

[11]  H. A-Kader,et al.  Nonalcoholic fatty liver disease: a comprehensive review of a growing epidemic. , 2014, World journal of gastroenterology.

[12]  H. J. Yoo,et al.  Clinical and metabolic factors associated with development and regression of nonalcoholic fatty liver disease in nonobese subjects , 2014, Liver international : official journal of the International Association for the Study of the Liver.

[13]  Robert D. Goldin,et al.  The epidemiology, pathogenesis and histopathology of fatty liver disease , 2012, Histopathology.

[14]  K. Cusi,et al.  Corrigendum:The Diagnosis and Management of Non-alcoholic Fatty Liver Disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association , 2012, The American Journal of Gastroenterology.

[15]  K. Lindor,et al.  The Spontaneous Course of Liver Enzymes and Its Correlation in Nonalcoholic Fatty Liver Disease , 2012, Digestive Diseases and Sciences.

[16]  A. Baranova,et al.  Systematic review: the epidemiology and natural history of non‐alcoholic fatty liver disease and non‐alcoholic steatohepatitis in adults , 2011, Alimentary pharmacology & therapeutics.

[17]  M. Stepanova,et al.  Changes in the prevalence of the most common causes of chronic liver diseases in the United States from 1988 to 2008. , 2011, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[18]  G. Alexander,et al.  Enhanced liver fibrosis test can predict clinical outcomes in patients with chronic liver disease , 2010, Gut.

[19]  P. Angulo Long‐term mortality in nonalcoholic fatty liver disease: Is liver histology of any prognostic significance? , 2010, Hepatology.

[20]  I. Guha,et al.  Noninvasive markers of fibrosis in nonalcoholic fatty liver disease: Validating the European Liver Fibrosis Panel and exploring simple markers , 2007, Hepatology.

[21]  Khean-Lee Goh,et al.  How common is non‐alcoholic fatty liver disease in the Asia–Pacific region and are there local differences? , 2007, Journal of gastroenterology and hepatology.

[22]  J. Kalbfleisch,et al.  A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C , 2003, Hepatology.

[23]  S. Naqvi,et al.  Identification of Metabolic risk phenotypes predisposing to Non-Alcoholic Fatty Liver Disease in a Pakistani Cohort , 2017, Pakistan journal of medical sciences.

[24]  Joel Z Stengel,et al.  Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study. , 2011, Gastroenterology.