Key result
A novel discriminant score based on serum adiponectin, visfatin, IL-6, and TNF-a accurately differentiated NAFLD from healthy controls with a sensitivity of 91%, specificity of 83%, and an AUC of 94%.
Why the study?
Does a panel of serum adipokines accurately discriminate NAFLD from healthy individuals and NASH from simple steatosis?
Case-Control (n=108)
No
Does a panel of serum adipokines accurately discriminate NAFLD from healthy individuals and NASH from simple steatosis?
Effect estimate: AUC 94% (95% CI 90-98)
Absolute Event Rate: 91% vs 83%
A novel panel of serum adipokines can accurately differentiate NAFLD from healthy controls and NASH from simple steatosis, offering a potential non-invasive screening tool.
Adipokine panels may aid noninvasive NAFLD/NASH discrimination; leaves open clinical utility pending prospective validation.
Considering limitations of liver biopsy for diagnosis of nonalcoholic liver disease (NAFLD), biomarkers' panels were proposed. The aims of this study were to establish models based on serum adipokines for discriminating NAFLD from healthy individuals and nonalcoholic steatohepatitis (NASH) from simple steatosis.This case-control study was conducted in patients with persistent elevated serum aminotransferase levels and fatty liver on ultrasound. Individuals with evidence of alcohol consumption, hepatotoxic medication, viral hepatitis, and known liver disease were excluded. Liver biopsy was performed in the remaining patients to distinguish NAFLD/NASH. Histologic findings were interpreted using "nonalcoholic fatty liver activity score." Control group consisted of healthy volunteers with normal physical examination, liver function tests, and liver ultrasound. Binary logistic regression analysis was applied to ascertain the effects of independent variables on the likelihood that participants have NAFLD/NASH.Decreased serum adiponectin and elevated serum visfatin, IL-6, TNF-a were associated with an increased likelihood of exhibiting NAFLD. NAFLD discriminant score was developed as the following: [(-0.298 × adiponectin) + (0.022 × TNF-a) + (1.021 × Log visfatin) + (0.709 × Log IL-6) + 1.154]. In NAFLD discriminant score, 86.4% of original grouped cases were correctly classified. Discriminant score threshold value of (-0.29) yielded a sensitivity and specificity of 91% and 83% respectively, for discriminating NAFLD from healthy controls. Decreased serum adiponectin and elevated serum visfatin, IL-8, TNF-a were correlated with an increased probability of NASH. NASH discriminant score was proposed as the following: [(-0.091 × adiponectin) + (0.044 × TNF-a) + (1.017 × Log visfatin) + (0.028 × Log IL-8) - 1.787] In NASH model, 84% of original cases were correctly classified. Discriminant score threshold value of (-0.22) yielded a sensitivity and specificity of 90% and 66% respectively, for separating NASH from simple steatosis.New discriminant scores were introduced for differentiating NAFLD/NASH patients with a high accuracy. If verified by future studies, application of suggested models for screening of NAFLD/NASH seems reasonable.
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Jamali et al. (2016) conducted a case-control in Nonalcoholic Fatty Liver Disease (NAFLD) (n=108). Serum adipokine panel (adiponectin, visfatin, IL-6, TNF-a) vs. Healthy controls was evaluated on Discrimination of NAFLD from healthy controls using a discriminant score (AUC 94%, 95% CI 90-98). A novel discriminant score based on serum adiponectin, visfatin, IL-6, and TNF-a accurately differentiated NAFLD from healthy controls with a sensitivity of 91%, specificity of 83%, and an AUC of 94%.
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