Evaluation of the Role of Hyaluronic Acid as a Potential Marker for Diagnosis of Non-Alcoholic Fatty Liver Disease

Abstract

onalcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease worldwide, ranging from simple steatosis and nonalcoholic steatohepatitis (NASH) to liver cirrhosis, with its complications including hepatocellular carcinoma (HCC). The majority of subjects with NAFLD are clinically asymptomatic during the pre-cirrhotic stage. As the disease progresses, clinical features of liver decompensation can develop. The diagnosis of NAFLD requires evidence of hepatic steatosis; in the absence of other causes of liver fat accumulation. Liver Biopsy remains the most diagnostic and golden method for diagnosing NAFLD. But is invasive and expensive and cannot be used for screening suspected patients. Imaging techniques to diagnose NAFLD include Ultrasonography, which is recommended as the first-line diagnostic method in assessing steatosis and MRI. But these are costly, time-consuming, and device dependent, this makes it difficult to achieve widespread application. Many noninvasive and chemical parameters are used in combination to diagnose NAFLD and the extent of fibrosis in the form of mathematical algorithms or scores. The most reliable scores are Fib-4, Apri, NAFLD fibrosis score and Bard score. However, these scores have limited ability to detect early stages and they carry a high false positive rate in advanced fibrosis.