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• W2045348897 abstract "BACKGROUND: The challenge fi.~r the clinician in assessing the patients with nonalcoholic laity liver disease (NAFLD) is to diflerentiate those with steatosis alone from those with progressive liver disease. At the present time, liver biopsy remains as the gold standard in staging hepatic fibrosis OBJECTIVES: To assess the role of serum YKL-40 and HA in differentiating patients with fibrotie nonalcohohc steatohepatitis(NASH) from those with simple steatosis. METHODS We perfbrnmd a cross sectional analysis of 60 consecutive patients unth NAFLD Vanons clinical and biochemical data were obtained including estimation of insulin resistance using homeostasis model assessment (HOMA), Serum levels of YKL-40 and F24 were measured by ELISA and compared to histological staging of biopsies by Brunt Score and Computerized in,age Analysis. RESULTS: Thirty-one patients had simple steatosls and 29 patients were found to have steatosls plus fibrosis. Our univariate analysis showed that the fibrosis group consisted of more &abetics(21.7 % vs. 0%, p = 0.02), higher insulin resistance based on HOMA index (5.99 vs. 3.47, p = 001) and higher AST/ALT ratio (0.73 vs 0 .55 p = 001). Fnere were no significant difli'rences in mean age, number of females, body mass index (BMI) and totaI cholesterol levels between the two groups. The mean of serum YKL-40 w~ls significantly higher (142 vs 72 ng/ml, p < 0.05) in patients with fibrosis (stage 1-4) than snnple steatosis. Tbere was a trend towards higher serum levels of hyalurunic acid in the fibrosis group (61 vs. 36.3 U/ml, p=0.06) but this did not reach statistical significarme with currant sample size. However, when we compared simple steatosts to stage 2 to 4 librosis, both serum markers were sigulficandy higher in the fibrosis group. A mcewer operator cupee (ROC) curve for serum YKL-40 revealed a sensitivity of 75% and a specihcity of 90% in detecnng fibrosis stage greater than or equal to Stage 2 when cutofl concentration was 116 ng/mh Hyaluronic acid had sensitivity of 50% and specificity ot 95% in detecting patients with fibrosis stage greater than or equal to Stage 2 when cntoft concentration was 84.6 U/mL When two serum fibrosis markers are combined to detect hbrosLs stage greater than or equal to 2, the sensitivity was 100% and specificity was 50%. CONCLUSIONS: Serum YKL-40 and HA are useful markers m differentiating patients with simple steatosis ti'mn NASH patients with fibrosis stage greater than or equal to 2. in asmciation with clinical parameters, they may identify suitable patients fur liver biopsy." @default.
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• W2045348897 date "2003-04-01" @default.
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• W2045348897 title "Non-invasive markers of fibrotic nonalcoholic steatohepatitis" @default.
• W2045348897 doi "https://doi.org/10.1016/s0016-5085(03)83752-6" @default.
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