Noninvasive investigations for non alcoholic fatty liver disease and liver fi brosis  

作　　者：Carmen Fierbinteanu-Braticevici Ion Dina Ana Petrisor Laura Tribus Lucian Negreanu Catalin Carstoiu 

机构地区：[1]Carmen Fierbinteanu-Braticevici,Ana Petrisor,Laura Tribus,Lucian Negreanu,Catalin Carstoiu,Medical Clinic Ⅱ and Gastroenterology, University Hospital Bucharest [2]Department of Gastroenterology,St John’s Hospital 7001 Bucharest [3]Carmen Fierbinteanu-Braticevici,Ana Petrisor,Laura Tribus,Lucian Negreanu,Catalin Carstoiu,Medical Clinic Ⅱ and Gastroenterology,University Hospital Bucharest

出　　处：《World Journal of Gastroenterology》2010年第38期4784-4791,共8页世界胃肠病学杂志（英文版）

摘　　要：Non-alcoholic fatty liver disease (NAFLD) includes a spectrum of diseases that have insulin resistance in common and are associated with metabolic conditions such as obesity, type 2 diabetes mellitus, and dyslipidemia. NAFLD ranges from simple liver steatosis, which follows a benign course, to nonalcoholic steatohepatitis (NASH), a more severe entity, with necroinflmmation and f ibrosis, which can progress to cryptogenic cirrhosis and end-stage liver disease. Liver biopsy remains the gold standard for evaluating the degree of hepatic necroinflammation and f ibrosis; however, several noninvasive investigations, such as serum biomarkers, have been developed to establish the diagnosis and also to evaluate treatment response. These markers are currently neither available in all centers nor validated in extensive studies. Examples include high-sensitivity C reactive protein and plasma pentraxin 3, which are associated with extensive liver f ibrosis in NASH. Interleukin-6 correlates with inflammation, and cytokeratin-18 represents a marker of hepatocyte apoptosis (prominent in NASH and absent in simple steatosis). Tissue polypep-tide specif ic antigen seems to have a clinical utility in the follow-up of obese patients with NASH.Non-alcoholic fatty liver disease (NAFLD) includes a spectrum of diseases that have insulin resistance in common and are associated with metabolic conditions such as obesity, type 2 diabetes mellitus, and dyslipidemia. NAFLD ranges from simple liver steatosis, which follows a benign course, to nonalcoholic steatohepatitis (NASH), a more severe entity, with necroinflmmation and f ibrosis, which can progress to cryptogenic cirrhosis and end-stage liver disease. Liver biopsy remains the gold standard for evaluating the degree of hepatic necroinflammation and f ibrosis; however, several noninvasive investigations, such as serum biomarkers, have been developed to establish the diagnosis and also to evaluate treatment response. These markers are currently neither available in all centers nor validated in extensive studies. Examples include high-sensitivity C reactive protein and plasma pentraxin 3, which are associated with extensive liver f ibrosis in NASH. Interleukin-6 correlates with inflammation, and cytokeratin-18 represents a marker of hepatocyte apoptosis (prominent in NASH and absent in simple steatosis). Tissue polypep-tide specif ic antigen seems to have a clinical utility in the follow-up of obese patients with NASH.

关 键 词：Non-alcoholic fatty liver disease Biomarkers NECROINFLAMMATION Liver fibrosis 

分 类 号：R575.5[医药卫生—消化系统]