Biomarkers in nonalcoholic fatty liver disease-the emperor has no clothes?

Table 1 Some of these panels depend on a dozen or more variables to derive the scores while others depend only on three or four parameters

Noninvasive test	Parameters	Disease	AUC	Ref.
APRI	AST, platelet count	Fibrosis, cirrhosis in mixed patient population	0.82	Adler et al[40], Hepatology (2008)
Enhanced liver fibrosis (ELF) test	Hyaluronic acid, tissue inhibitor of matrix metalloproteinase-1, amino terminal propeptide of procollagen type III	NAFLD in children	0.92 to 0.99	Nobili et al[50], Gastroenterology (2009)
		Chronic liver disease	0.80	Nobili et al[50], Gastroenterology (2009)
HAIR	Hypertension, ALT, IR index	NAFLD	0.90	Dixon et al[31], Gastroenterology (2001)
NashTest	Alpha2-macroglobulin, haptoglobin, apolipoprotein A1, total bilirubin, GGT, fasting glucose, triglycerides, cholesterol, ALT, AST, age, gender, weight, height	NAFLD	0.79	Poynard et al[34], BMC Gastroenterology (2006)
A commercial panel from Biopredictive, France
FIB-4	Platelets, ALT, AST and age	HCV fibrosis	0.76	Vallet-Pichard et al[38], Hepatology 2006
		NAFLD fibrosis	0.80	Shah et al[39], Clinical Gastroenterology and Hepatology (2009)
FibroTest/FibroSure	α2-macroglobulin , apolipoprotein A1, haptoglobin, total bilirubin, GGT	NAFLD fibrosis	0.86	Ratziu et al[37], BMC gastroenterology (2006)
A commercial panel from Biopredictive, France
	Age, AST, platelet	HCV fibrosis	0.783	Hsieh et al[41], Chang Gung Med J (2009)
FibroQ	Count, PT-INR	(F2-4)
Lok index	Platelet count, PT-INR, AST, ALT	HCV fibrosis	0.78	Lok et al[42], Hepatology (2005)
Forns Score	Age, platelet count,	HCV fibrosis	0.86	Forns X et al, Hepatology (2002)
	GGT, cholesterol	Fibrosis from all causes	0.76	Adler et al[40], Hepatology (2008)
BARD Score	Body-mass index, AST/ALT ratio, type 2 diabetes mellitus	NAFLD fibrosis	0.67	Ruffillo et al[47], Journal of Hepatology (2011)
NAFLD fibrosis score	Age, hyperglycemia, body mass index, platelet count, albumin, and AST/ALT ratio	NAFLD fibrosis	0.82	Angulo et al[45], Hepatology (2007)
			0.68	Ruffillo et al[47], Journal of Hepatology (2011)
Fibrometer	Platelets, prothrombin index, aspartate aminotransferase, α2-macroglobulin (A2M), hyaluronate, urea, and age	Viral and alcoholic chronic liver diseases fibrosis	0.883	Calès et al[43], Hepatology (2005)
		NAFLD	0.943	Calès et al[44], Journal of Hepatology (2009)

NashTest, FibroTest/FibroSure. SteatoTest and FibroMax are products from Biopredictive, France. FibroMax is the combination of NashTest, FibroTest/FibroSure and SteatoTest. AUC: Area under the curve; APRI: AST-to-platelet ratio index; AST: Aspartate transaminase; ALT: Alanine transaminase; NAFLD: Nonalcoholic fatty liver disease; GGT: Gamma-glutamyl transpeptidase; HCV: Hepatitis C virus.