Salman Ahmed Abd Allah, Aboelfadl Soheir Abd Elfattah, Heagzy Mona Abd Elmenem
Cairo University, Faculty of Medicine - Internal Medicine, Cairo, Egypt.
Open Access Maced J Med Sci. 2016 Sep 15;4(3):348-352. doi: 10.3889/oamjms.2016.092. Epub 2016 Sep 1.
Liver histology remains the gold standard for assessing non-alcoholic fatty liver disease (NAFLD). Noninvasive serological markers and radiological methods have been developed to evaluate steatosis to avoid biopsy.
To put cutoff value for liver enzymes that could predict non-alcoholic steatohepatitis (NASH).
This study was conducted on 54 patients (with NAFLD diagnosed by the US). Patients were subjected to history, physical, anthropometric measurements, investigations including liver enzymes, abdominal US, and liver biopsy. According to biopsy results, patients were subdivided according to NASH development. Also, biopsy results were correlated to the levels of liver enzymes.
Forty-seven patients who were suspected to have NAFLD by sonar were confirmed by biopsy. There was a significant correlation between steatosis degree in biopsy and sonar. Correlation study between steatosis in biopsy and ALT level showed highly significant positive correlation. Correlation study between steatosis in biopsy on one side & AST and GGT on the other side showed significant positive correlation. Cutoff value for detection of NASH using ALT & AST & and GGT were 50.5, 56, 60.5 respectively with sensitivity = 95.5, 90.5, 86.4 % and specificity = 93.8, 100, 87.5%.
Cut off values of liver enzymes can be combined with abdominal sonar to predict NASH.
肝脏组织学仍是评估非酒精性脂肪性肝病（NAFLD）的金标准。已开发出非侵入性血清学标志物和放射学方法来评估脂肪变性，以避免进行活检。
确定可预测非酒精性脂肪性肝炎（NASH）的肝酶临界值。
本研究对54例患者（经超声诊断为NAFLD）进行。对患者进行病史、体格检查、人体测量、包括肝酶检查、腹部超声和肝活检在内的各项检查。根据活检结果，根据NASH的发展情况对患者进行细分。此外，将活检结果与肝酶水平进行关联。
47例经超声怀疑患有NAFLD的患者经活检确诊。活检中的脂肪变性程度与超声检查结果之间存在显著相关性。活检中的脂肪变性与ALT水平的相关性研究显示出高度显著的正相关。活检中的脂肪变性与AST及GGT的相关性研究显示出显著正相关。使用ALT、AST和GGT检测NASH的临界值分别为50.5、56、60.5，敏感性分别为95.5%、90.5%、86.4%，特异性分别为93.8%、100%、87.5%。
肝酶临界值可与腹部超声相结合来预测NASH。
