Non-invasive diagnosis of non-alcoholic fatty liver disease: the available opportunities we have today
Journal Title: Сучасна гастроентерологія - Year 2019, Vol 0, Issue 4
Abstract
Non-alcoholic fatty liver disease (NAFLD) is becoming an increasingly common disease, it is currently diagnosed in more than a quarter of adult population worldwide, and its portion in the overweight patients with type 2 diabetes mellitus gains up to 90 %. The NAFLD spectrum includes steatosis, which usually has a benign course, and steatohepatitis, the progression of which leads to the development of fibrosis, cirrhosis, and hepatocellular carcinoma. The increase in the incidence of NAFLD requires an improved diagnosis to identify new cases of the disease. The differential diagnosis between steatosis and steatohepatitis is important for a patient’s prognosis. Currently, a liver biopsy remains the gold standard for the NAFLD diagnosis, but it has well-known limitations for use in wide clinical practice, including serious complications, contraindications for some groups of patients, the high cost of the study, the low availability of centers where a liver biopsy is performed, sampling errors, etc. The widespread prevalence of NAFLD requires the search for simple non-invasive tests to diagnose the disease at the primary care level, which is usually the case for patients with this problem. Such tests can be serum biomarkers, with which one can diagnose the presence, activity of the disease, determine the degree of steatosis and fibrosis. Serum markers of inflammation, apoptosis and oxidative stress, fibrosis are widely studied in patients with NAFLD. Imaging techniques such as transient elastography, magnetic resonance elastography, and acoustic radiation imaging are becoming increasingly popular as non-invasive methods for detecting steatosis and fibrosis in NAFLD. Further investigations will allow to find more efficious non-invasive biomarkers for the differential diagnosis of steatosis and steatohepatitis, assessment of fibrosis severity, which in combination with modern imaging methods will help to improve the NAFLD diagnosis.
Authors and Affiliations
T. A. Solomentseva
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