Clinical and Translational Research
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Apr 27, 2022; 14(4): 744-753
Published online Apr 27, 2022. doi: 10.4254/wjh.v14.i4.744
Correlation between Fibroscan and laboratory tests in non-alcoholic fatty liver disease/non-alcoholic steatohepatitis patients for assessing liver fibrosis
Layal Al Danaf, Mohammed Hussein Kamareddine, Emilie Fayad, Aniqa Hussain, Said Farhat
Layal Al Danaf, Department of Radiological Science, American University of Science and Technology, Faculty of Health Sciences, Beirut 1100, Lebanon
Mohammed Hussein Kamareddine, Department of Internal Medicine, Lankenau Medical Center, Philadelphia, PA 19131, United States
Emilie Fayad, Department of Radiology, Saint George Hospital University Medical Center, Beirut 1100, Lebanon
Aniqa Hussain, Faculty of Medicine, University of New South Wales, Sydney 2052, Australia
Said Farhat, Department of Gastroenterology, Saint George Hospital University Medical Center, Beirut 1100, Lebanon
Author contributions: All authors contributed equally to the drafting of the manuscript, development of key ideas, and subsequent revisions.
Institutional review board statement: The study was approved by the IRB/REC of University of Balamand/Saint George Hospital University Medical Center.
Informed consent statement: This study was given an informed consent waiver by IRB.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Said Farhat, MD, Associate Professor, Department of Gastroenterology, Saint George Hospital University Medical Center, El-achrafieh, Beirut 1100, Lebanon. saidfarhat@hotmail.com
Received: May 10, 2021
Peer-review started: May 10, 2021
First decision: July 6, 2021
Revised: July 14, 2021
Accepted: March 16, 2022
Article in press: March 16, 2022
Published online: April 27, 2022
Processing time: 347 Days and 5.7 Hours
Abstract
BACKGROUND

Non-alcoholic fatty liver disease (NAFLD) is a spectrum of disease ranging from simple steatosis to non-alcoholic steatohepatitis (NASH), through to advanced fibrosis and cirrhosis. Many patients with NAFLD remain undiagnosed and recognizing those at risk is very crucial. Although liver biopsy is the gold standard method for diagnosing and staging NAFLD, non-invasive imaging and lab modalities are also very promising in diagnosing these diseases.

AIM

To explore some of these non-invasive modalities in this context and assess how they hold up in terms of making a diagnosis while avoiding an invasive procedure like a liver biopsy.

METHODS

This study was conducted on NAFLD/NASH patients (n = 73) who underwent Fibroscan examinations at Saint George Hospital University Medical Center over 17 mo in order to assess liver fibrosis. Obtained Fibroscan results were correlated to laboratory tests and calculated aspartate transaminase (AST)/alanine transaminase (ALT) ratio, AST platelet ratio index (APRI) score and Fibrosis-4 score.

RESULTS

A significant age difference was observed across fibrosis stages of investigated patients. The mean stiffness score was 9.48 ± 11.77 KPa. A significant negative correlation was observed between ALT, AST, Albumin, gamma-glutamyl transferase, cholesterol, LDL, HDL, triglycerides, and ALP when compared across fibrosis stages. On the other hand, a significant positive correlation was found between Bilirubin, PT INR, partial thromboplastin time, glucose, and Platelet count when compared across fibrosis stages, in addition to AST/ALT ratio, APRI, and Fib-4 scores.

CONCLUSION

This study showed that Ultrasound alone is not efficient in the assessment of advancement of liver disease. Furthermore, the high positive relation between AST/ALT ratio, APRI and Fib-4 scores with fibrosis stages in NAFLD patients suggests that they could be used clinically in combination with Fibroscan to predict significant fibrosis and cirrhosis and to avoid liver biopsy.

Keywords: Non-alcoholic fatty liver disease, Non-alcoholic steatohepatitis, Fibroscan, Cirrhosis, Hepatology

Core Tip: In this paper, we report on the correlation between aspartate transaminase/alanine transaminase ratio, aspartate transaminase platelet ratio index and Fib-4 scores with fibrosis stages in non-alcoholic fatty liver disease patients, suggesting that they could be used in combination with Fibroscan to predict significant fibrosis and cirrhosis. This is significant as this could be helpful in avoiding liver biopsy to assess liver fibrosis.