Gudowska Monika, Wojtowicz Ewa, Cylwik Bogdan, Gruszewska Ewa, Chrostek Lech
Department of Biochemical Diagnostics, Medical University in Białystok, Poland.
Novencia Pharma, Warszawa, Poland.
Adv Clin Exp Med. 2015 Sep-Oct;24(5):823-7. doi: 10.17219/acem/28485.
The diagnosis of alcoholic liver diseases is based on the history of alcohol abuse, clinical evidence of liver disease and laboratory abnormalities. The new non-invasive biomarkers have higher sensitivity to quantify and predict steatosis and fibrosis than ultrasonography.
The aim of this study was to evaluate the prevalence of liver diseases in alcoholics by means of FibroMax.
A total of 142 consecutive alcoholics were enrolled in the study. The prevalence of liver diseases was assayed by means of non-invasive biomarkers: fibrosis by FibroTest, steatosis by SteatoTest, steatohapatitis by AshTest (alcoholic origin) and NashTest (non-alcoholic origin) and necroinflammatory activity by ActiTest.
38.7% of alcoholics do not have fibrosis, 38%--steatosis, 94.1%--alcoholic steatohepatitis, 56.6%--non-alcoholic steatohepatitis and 33.6%--necroinflammatory activity. The insignificant fibrosis (F<2) is present in 37.2%, advanced (F≥2)--15.3% and cirrhosis (F4)--in 8.8%. Insignificant steatosis (S<2) is observed in 31.3% and advanced (S≥2) in 30.5%. Minimal alcoholic steatohepatitis (H1) exists in 5.2% patients, moderate (H2) in none of the patient and severe (H3) in only one patient (0.7%). The distribution of NashTest scores is as following: N0--56.6%, N1--38.2% and N2--5.1%. Insignificant inflammatory activity (A<2) is present in 40.8% of alcoholic patients but significant (A≥2) in 25.5%. The frequency of severe steatosis (F3) and necroinflammatory activity (A3) in patients with cirrhosis (F4) is 50% for each of them.
The prevalence of advanced fibrosis and cirrhosis evaluated by means of FibroMax in alcoholics is higher than in alcoholic liver disease (ALD) and lower than in mixed, alcoholic and non-alcoholic ones. This may indicate the presence of non-alcoholic liver disease in alcoholics.
酒精性肝病的诊断基于酒精滥用史、肝病的临床证据和实验室异常。新型非侵入性生物标志物在量化和预测脂肪变性及纤维化方面比超声检查具有更高的敏感性。
本研究旨在通过FibroMax评估酗酒者肝病的患病率。
本研究共纳入142例连续的酗酒者。通过非侵入性生物标志物检测肝病的患病率：用FibroTest检测纤维化，用SteatoTest检测脂肪变性，用AshTest（酒精性起源）和NashTest（非酒精性起源）检测脂肪性肝炎，用ActiTest检测坏死性炎症活动。
38.7%的酗酒者无纤维化，38%有脂肪变性，94.1%有酒精性脂肪性肝炎，56.6%有非酒精性脂肪性肝炎，33.6%有坏死性炎症活动。轻度纤维化（F<2）占37.2%，重度（F≥2）占15.3%，肝硬化（F4）占8.8%。轻度脂肪变性（S<2）占31.3%，重度（S≥2）占30.5%。轻度酒精性脂肪性肝炎（H1）在5.2%的患者中存在，中度（H2）在无患者中存在，重度（H3）仅在1例患者中存在（0.7%）。NashTest评分分布如下：N0占56.6%，N1占38.2%，N2占5.1%。40.8%的酗酒患者有轻度炎症活动（A<2），但25.5%有显著炎症活动（A≥2）。肝硬化（F4）患者中重度脂肪变性（F3）和坏死性炎症活动（A3）的频率均为50%。
通过FibroMax评估，酗酒者中重度纤维化和肝硬化的患病率高于酒精性肝病（ALD），低于混合性酒精性和非酒精性肝病。这可能表明酗酒者中存在非酒精性肝病。
