ELF检测在疑似非酒精性脂肪性肝病的病态肥胖患者中检测脂肪性肝炎的效用
Utility of the ELF Test for Detecting Steatohepatitis in Morbid Obese Patients with Suspicion of Nonalcoholic Fatty Liver Disease.
作者信息
López Iria Cebreiros, Aroca Florentina Guzmán, Bernal Maria Dolores Frutos, Mompeán Juan Antonio Luján, Bernal Águeda Bas, Martínez Antonio Miguel Hernández, Barba Enrique Martínez, Velasco Jose Antonio Noguera, Paricio Pascual Parilla
机构信息
Department of Clinical Analysis, Clinic University Hospital Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, 30120, Murcia, Spain.
Department of Radiology, Clinic University Hospital Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, 30120, Murcia, Spain.
出版信息
Obes Surg. 2017 Sep;27(9):2347-2353. doi: 10.1007/s11695-017-2606-9.
BACKGROUND
Morbid obese patients have a high rate of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). NASH is related to the progression and poor evolution of chronic hepatopathy in NAFLD, so that its detection makes it possible to identify the subjects who are most at risk in order to prioritize treatment. The ELF test (Enhanced Liver Fibrosis test; Siemens Diagnostics, NY, USA) has been assessed for its capacity to detect fibrosis in patients with NAFLD, but its capacity for diagnosing NASH has not been checked.
AIMS
Our objective is to determine the utility of the ELF test for detecting NASH in morbid obese patients with suspected NAFLD.
METHODS
ELF values were determined in a cohort of obese patients who underwent bariatric surgery with suspected NAFLD. Liver biopsy was used as the reference standard.
RESULTS
The values of ELF were significantly higher in patients with NASH (p = 0.002) and in those who presented with metabolic syndrome (p = 0.047). An ELF cut-off point of 8.72 allows the detection of patients with NASH with a sensitivity of 71.4% and a specificity of 74.1% (AUC = 0.742, p = 0.002).
CONCLUSIONS
The ELF test is efficient for the identification of obese patients with NAFLD and early signs of steatohepatitis and fibrosis.
背景
病态肥胖患者中非酒精性脂肪性肝病（NAFLD）和非酒精性脂肪性肝炎（NASH）的发生率很高。NASH与NAFLD中慢性肝病的进展及不良转归相关，因此对其进行检测有助于识别高危患者，从而确定治疗的优先级。ELF检测（增强肝纤维化检测；美国纽约西门子诊断公司）已被评估用于检测NAFLD患者纤维化的能力，但其诊断NASH的能力尚未得到验证。
目的
我们的目标是确定ELF检测在疑似NAFLD的病态肥胖患者中检测NASH的效用。
方法
对一组接受减重手术且疑似NAFLD的肥胖患者测定ELF值。肝活检用作参考标准。
结果
NASH患者（p = 0.002）及患有代谢综合征的患者（p = 0.047）的ELF值显著更高。ELF临界值为8.72时，检测NASH患者的灵敏度为71.4%，特异度为74.1%（AUC = 0.742，p = 0.002）。
结论
ELF检测在识别患有NAFLD及有脂肪性肝炎和纤维化早期迹象的肥胖患者方面是有效的。
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