Role Of Circulating Endocan as a Biomarker in Non-alcoholic Fatty Liver Disease

Abstract

Nonalcoholic fatty liver disease (NAFLD) has a prevalence of 25% worldwide and is described as the leading cause of chronic liver disease. Liver disease was found to be the third leading cause of death among persons with NAFLD. Its prevalence is increasing in conjunction with metabolic syndrome due to engaged risk factors, which include high body mass index and abdominal obesity, type 2 diabetes, dyslipidemia (high triglycerides and/or low high-density-lipoproteins), age, male sex, and alcohol consumption. Although ultrasound and magnetic resonance are helpful for the diagnosis of NAFLD, liver biopsy is still the gold standard. New insights and diagnostic improvements in NAFLD such as transient elastography and FibroScan are exciting alternatives. However, we targeted focusing on noninvasive, cheap, and useful biomarkers in clinical practice. In this way, the role of circulating biomarkers related to endothelial dysfunction and the severity of underlying liver disease need to be investigated. Endocan is a proteoglycan with increased expression in endothelial cells during even the first stage of atherosclerosis, which makes this biomarker a convenient parameter of atherosclerosis risk. Not only that it is secreted by endothelial cells, but endocan also stimulates these cells to secrete other inflammation markers (i.e. cytokines), contributes