Diagnostic value of biochemical markers (NashTest) for the prediction of non alcoholo steato hepatitis in patients with non-alcoholic fatty liver disease.
Diagnostic value of biochemical markers (NashTest) for the prediction of non alcoholo steato hepatitis in patients with non-alcoholic fatty liver disease.
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DOI：
10.1186/1471-230x-6-34
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发表时间：
2006-11-10
影响因子：
2.4
通讯作者：
CYTOL study group
中科院分区：
文献类型：
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作者：
Poynard T;Ratziu V;Charlotte F;Messous D;Munteanu M;Imbert-Bismut F;Massard J;Bonyhay L;Tahiri M;Thabut D;Cadranel JF;Le Bail B;de Ledinghen V;LIDO Study Group;CYTOL study group
肝活检被认为是评估非酒精性脂肪性肝病（NAFLD）组织学病变的金标准。目的是开发和验证一种新的非酒精性脂肪性肝炎（NASH）生物标志物NASH test （NT）在NAFLD患者中的应用。160例NAFLD患者前瞻性纳入训练组，97例纳入多中心验证组，383例对照组。组织学诊断采用Kleiner等人的评分系统，NASH分为3类：“非NASH”、“边缘性NASH”、“NASH”。评估ROC曲线下面积（AUROC）、敏感性（Se）、特异性（Sp）、阳性预测值和阴性预测值（PPV、NPV）。NT采用专利算法开发，结合13个参数：年龄、性别、身高、体重、甘油三酯、胆固醇、α 2巨球蛋白、载脂蛋白A1、接触珠蛋白、γ -谷氨酰转肽酶、转氨酶ALT、AST和总胆红素的血清水平。训练组和验证组NT诊断NASH的auroc分别为0.79 （95%CI 0.69-0.86）和0.79 (95%CI 0.67-0.87, P = 0.94)；诊断边缘型NASH分别为0.69 （95%CI 0.60-0.77）和0.69 (95%CI 0.57-0.78, P = 0.98)，诊断非NASH分别为0.77 （95%CI 0.68-0.84）和0.83 （95%CI 0.67-0.90, P = 0.34）。当两组合并时，NASH的NashTest Sp = 94% (PPV = 66%), Se = 33% (NPV = 81%)；对于边缘型NASH或NASH， Sp = 50% (PPV = 74%), Se = 88% （NPV = 72%）。在非酒精性脂肪性肝病患者中，NASH test是一种简单且无创的生物标志物，可可靠地预测NASH的存在与否。
Liver biopsy is considered the gold standard for assessing histologic lesions of non-alcoholic fatty liver disease (NAFLD). The aim was to develop and validate a new biomarker of non alcoholic steato hepatitis (NASH) the NashTest (NT) in patients with NAFLD. 160 patients with NAFLD were prospectively included in a training group, 97 were included in a multicenter validation group and 383 controls. Histological diagnoses used Kleiner et al's scoring system, with 3 classes for NASH: "Not NASH", "Borderline", "NASH"). The area under the ROC curves (AUROC), sensitivity (Se), specificity (Sp), and positive and negative predictive values (PPV, NPV) were assessed. NT was developed using patented algorithms combining 13 parameters: age, sex, height, weight, and serum levels of triglycerides, cholesterol, alpha2macroglobulin, apolipoprotein A1, haptoglobin, gamma-glutamyl-transpeptidase, transaminases ALT, AST, and total bilirubin. AUROCs of NT for the diagnosis of NASH in the training and validation groups were, respectively, 0.79 (95%CI 0.69–0.86) and 0.79 (95%CI 0.67–0.87; P = 0.94); for the diagnosis of borderline NASH they were: 0.69 (95%CI 0.60–0.77) and 0.69 (95%CI 0.57–0.78; P = 0.98) and for the diagnosis of no NASH, 0.77 (95%CI 0.68–0.84) and 0.83 (95%CI 0.67–0.90; P = 0.34). When the two groups were pooled together the NashTest Sp for NASH = 94% (PPV = 66%), and Se = 33% (NPV = 81%); for borderline NASH or NASH Sp = 50% (PPV = 74%) and Se = 88% (NPV = 72%). In patients with non-alcoholic fatty liver disease, NashTest, a simple and non-invasive biomarker reliably predicts the presence or absence of NASH.