■肝脏脂肪变性伴炎症,膨胀的肝细胞,和潜在的纤维化定义非酒精性脂肪性肝炎(NASH),可能会导致肝硬化.虽然肝活检仍是诊断NASH的金标准,已经研究了许多非侵入性替代标记以减少对这种侵入性技术的需求。在这篇综述中,我们提出了几种目前评估的生物标志物,分数,和评估NASH的指标。
■在主要医学文献数据库中进行搜索。我们搜索了评估非侵入性标志物的观察性研究,分数,和面板预测NASH。
■几种促炎标志物,炎症和凋亡生物标志物,以及复杂模型在预测NASH方面的研究。促炎标志物包括C反应蛋白,铁蛋白,肿瘤坏死因子-α,白细胞介素-6,五聚素-3和中性粒细胞胞外陷阱。炎症和凋亡生物标志物包括细胞分裂素-18,脂肪细胞因子,脂质氧化面板,纤溶酶原激活剂抑制剂-1,以及自由基介导的亚油酸氧化产物。此外,几个研究的复杂模型,如纳什测试,NashTest-2,将CK18片段与其他生物标志物如ALT和MetS的存在配对,头发模型,acNASH,NAFIC得分,还研究了内脏脂肪指数。
■各种诊断小组显示出诊断NASH的良好预测值。然而,非侵入性替代标记目前无法取代肝活检。然而,其临床意义主要在于对患者进行肝活检,减少与程序相关的财务负担。
UNASSIGNED: Hepatic steatosis with inflammation, inflated hepatocytes, and potential fibrosis defines non-alcoholic steatohepatitis (NASH), which can possibly lead to liver cirrhosis. Although liver biopsy is still the gold standard for diagnosing NASH, numerous non-invasive surrogate markers have been investigated to reduce the need for this invasive technique. In this review we present several currently assessed biomarkers, scores, and indexes in assessing NASH.
UNASSIGNED: A search in the main medical literature databases was conducted. We searched for observational studies evaluating non-invasive markers, scores, and panels in predicting NASH.
UNASSIGNED: Several proinflammatory markers, inflammation and apoptosis biomarkers, as well as complex models have been studied in predicting NASH. Proinflammatory markers include C-reactive protein, ferritin, tumor necrosis factor-α, interleukin-6, pentraxin-3, and neutrophil extracellular traps. Inflammation and apoptosis biomarkers include cytokineratin-18, adipocytokines, lipid oxidation panels, plasminogen activator inhibitor-1, and products of free radical-mediated oxidation of linoleic acid. Moreover, several studied complex models such as NashTest, NashTest-2, pairing CK18 fragments with other biomarkers such as ALT and the presence of MetS, the HAIR model, acNASH, NAFIC score, Visceral Adiposity Index have also been studied.
UNASSIGNED: A variety of diagnostic panels have shown good predictive values for diagnosing NASH. Nevertheless, non-invasive surrogate markers are currently unable to replace liver biopsy. However, their clinical significance is mainly in triaging patients for liver biopsy, reducing the financial burden associated with the procedure.