Kempiński Radosław, Neubauer Katarzyna, Wieczorek Szymon, Dudkowiak Robert, Jasińska Maria, Poniewierka Elżbieta
Department of Gastroenterology and Hepatology, Wroclaw Medical University, Poland.
Department of Internal and Occupational Diseases and Hypertension, Wroclaw Medical University, Poland.
Adv Clin Exp Med. 2016 Jan-Feb;25(1):77-81. doi: 10.17219/acem/60878.
Non-alcoholic fatty liver disease (NAFLD) is a very common chronic liver condition which may potentially develop into fibrosis and cirrhosis. Liver biopsy is still the gold standard for liver fibrosis detection in these patients. However, non-invasive tools for liver assessment in NAFLD patients, like the (13)C-methacetin breath test, may be useful.
The aim of the study was to evaluate the utility of the (13)C-methacetin breath test in NAFLD patients, especially in predicting significant fibrosis.
Thirty three patients (24 male and 9 female (average age 47.9)) with histologically proven NAFLD had the (13)C-methacetin breath test performed.
Different forms of NAFLD were found during the histology phase, from simple steatosis to advanced fibrosis. Simple steatosis (SS) was found in 18 subjects (54.5%), in another 15 (45.5%) signs of inflammation and fibrosis (NASH) were observed. However, more than half of the patients with liver fibrosis had only minimal changes described (0/1). The sensitivity of the test was highest for cumulative recovery after 10 min of the test and for a combination of two parameters (the cumulative recovery after 40 min and the time of maximal momentary recovery). The positive predictive value was low for all the parameters under consideration, but the negative predictive value was over 0.8 in significant fibrosis detection.
The (13)C-methacetin breath test could be a promising noninvasive tool for excluding at least F1 fibrosis in NAFLD patients.
非酒精性脂肪性肝病（NAFLD）是一种非常常见的慢性肝脏疾病，可能会发展为纤维化和肝硬化。肝活检仍是这些患者肝纤维化检测的金标准。然而，用于NAFLD患者肝脏评估的非侵入性工具，如（13）C-美沙西汀呼气试验，可能会有帮助。
本研究旨在评估（13）C-美沙西汀呼气试验在NAFLD患者中的效用，尤其是在预测显著纤维化方面。
对33例经组织学证实为NAFLD的患者（24例男性和9例女性，平均年龄47.9岁）进行了（13）C-美沙西汀呼气试验。
在组织学阶段发现了不同形式的NAFLD，从单纯性脂肪变性到晚期纤维化。18名受试者（54.5%）出现单纯性脂肪变性（SS），另外15名（45.5%）观察到炎症和纤维化（NASH）迹象。然而，超过一半的肝纤维化患者仅有轻微变化（0/1）。该试验的敏感性在试验10分钟后的累积回收率以及两个参数的组合（40分钟后的累积回收率和最大瞬间回收率的时间）方面最高。所有考虑的参数的阳性预测值都较低，但在显著纤维化检测中阴性预测值超过0.8。
（13）C-美沙西汀呼气试验可能是一种有前景的非侵入性工具，可用于排除NAFLD患者至少F1级纤维化。
