Clinical and laboratory markers for predicting liver fibrosis in individuals with non-alcoholic fatty liver disease

Abstract

Objective: To increase the effectiveness of prediction and diagnosis of fibrosis in patients with non-alcoholic fatty liver disease. Materials and Methods: We conducted an open-type case-control study involving 149 patients with NAFLD and a different stage of fibrosis determined with elastometry and histological examination of the liver biopsy specimen (group 1 - without signs of liver fibrosis (n = 40), group 2 - fibrosis 1 (n = 43), group 3-2 (n = 34) and group 4-3 stages (n = 32)). General clinical and laboratory methods of examination were conducted. In addition, noninvasive markers of fibrosis in the blood serum were studied: the concentration of insulin, leptin, adiponectin, matrix metalloproteinase-9 (MMP-9) and its inhibitors - tissue inhibitor of matrix metalloproteinase-1 and 2 (TIMP-1, TIMP-2). The polymorphism PNPLA3 148M / I (rs738409) was studied by the PCR method as a potential marker of the progression of liver fibrosis in NAFLD. Results: We identified clinical and laboratory signs demonstrating informativeness in the formation of progressive stages of fibrosis. It was studied that patients with NAFLD have hyperleptiemia and hyperinsulinemia. Evaluation of various types of leptinresistance allows to differentiate patients of high risk group for the progression of fibrosis. The nature of fat tissue distribution (abdominal obesity) is a highly informative criteria of high-stage liver fibrosis. Polymorphism of the PNPLA3 gene 148M/I has prognostic significance in the formation and progression of liver fibrosis in patients with NAFLD. The level of leptin, its soluble receptor in the serum, the biochemical activity of the disease (NASH), the waist are clinical and laboratory markers for the formation and progression of liver fibrosis in patients with NAFLD. This markers were included in the mathematical model. Conclusion: Complex quantitative analysis of clinical, instrumental and laboratory indicators allows predicting the formation and progression of liver fibrosis in individuals with non-alcoholic fatty disease.