Fibro-scan Based Score and novel noninvasive serum marker, FGF-21, to assess Liver Fibrosis in Morbidly Obese Patients with Nonalcoholic Fatty Liver Disease

Abstract

Non-alcoholic fatty liver disease (NAFLD) is currently the most common cause of liver disease in the Western world, affecting up to 20-30% of the general adult population. It is a growing public health problem, because of the increasing prevalence of the pathologies that contribute to its development such as obesity and inflammation status. In fact, 25% of the world’s population is currently thought to have NAFLD. The clinical spectrum of NAFLD ranges from a relatively benign fatty infiltration to non-alcoholic steatohepatitis (NASH) that can progress to liver cirrhosis, liver cell failure, or HCC. The evaluation of liver fibrosis severity has become the main issue to verify the prognosis of NAFLD patients, and liver biopsy has long been regarded as the gold standard in this aspect. But the value of a liver biopsy for the diagnosis of NAFLD in routine clinical practice is controversial, especially in the presence of a generally good prognosis for most patients with NAFLD, the lack of an established form of effective therapy, and the risks and costs associated with the liver biopsy, so it is necessary the identification of alternative non-invasive tools to replace liver biopsy in diagnosis and prognostication of NAFLD patients. Non-invasive laboratory and radiological assessment methods for hepatic steatosis and fibrosis in NAFLD have evolved during the past decade, and these methods may be able to overcome the limitations of liver biopsy. These methods include scores such as AST/platelet ratio index (APRI) score, fibrosis-4 (FIB-4) score, NAFLD fibrosis score (NFS), and fatty liver index (FLI).