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- W2914449075 abstract "Purpose: Nonalcoholic fatty liver disease (NAFLD) is extremely common among patients undergoing bariatric surgery. Liver disease may progress in these patients despite surgical weight loss. Previously, we demonstrated that plasma concentration of cytokeratin 18 (CK-18) fragments accurately differentiated NASH from simple steatosis and was predictive of stage of fibrosis in patients with NAFLD. The aim of this study was to assess the usefulness of this biomarker in determining NASH in the bariatric surgery population. Methods: Our cohort consisted of 99 consecutive patients who underwent liver biopsy at the time of bariatric surgery. Of these, CK-18 levels were measured in 86 patients who had plasma available within one week prior to surgery using a sandwich immunoELISA specific for CK-18 fragments. Histology was scored by experienced hepatopathologists according to the NAFLD NIDDK activity score. Results: Plasma levels of CK-18 fragments ranged from 103 to 1000 U/L (Median (Q25, Q75): 226 U/L (177, 298)). Compared to either subjects with no NAFLD, simple steatosis or borderline diagnosis, CK-18 levels were significantly higher in subjects with NASH (median (Q25, Q75): 196 (158, 245) vs. 217 (154, 228) vs. 200 (176, 274) vs. 389 (275, 839), respectively; P < 0.0001). CK-18 levels were significantly higher in subjects with moderate to severe fibrosis than in those with mild fibrosis (median (Q25, Q75): 334.5 (240.5, 896) vs. 207 (175, 275), respectively; P= 0.007)). For every 50 U/L increase in the plasma level of CK-18, the likelihood of having NASH as opposed to simple steatosis increased 2.45 times (OR (95% CI): 2.45 (1.20, 5.00)). The area under the ROC curve was estimated to be 0.88 (95% CI: 0.77, 0.99). The values with the best combination of sensitivity and specificity were 252 U/L (sensitivity = 82% and specificity = 77%) and 275 U/L (sensitivity = 77% and specificity = 100%). Conclusion: These results demonstrate that determination of CK-18 fragments in the blood accurately differentiates NASH from simple steatosis and predicts stage of fibrosis in bariatric surgery patients, supporting the potential usefulness of this test in clinical practice as a noninvasive NASH biomarker." @default.
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- W2914449075 date "2007-09-01" @default.
- W2914449075 modified "2023-10-18" @default.
- W2914449075 title "Cytokeratin 18 Levels as a Noninvasive Biomarker for Nonalcoholic Steatohepatitis in Bariatric Surgery Patients" @default.
- W2914449075 doi "https://doi.org/10.14309/00000434-200709002-00288" @default.
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