Diagnostic modalities for nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, and associated fibrosis
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- Zobair M. Younossi
- Department of Medicine and Betty and Guy Beatty Center for Integrated Research, Claude Moore,Inova Health Systems,Falls Church,VA
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- Rohit Loomba
- NAFLD Research Center,University of California at San Diego,La Jolla,CA
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- Quentin M. Anstee
- Northwestern University Feinberg School of Medicine,Chicago,IL
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- Mary E. Rinella
- University of Torino,Department of Medical Sciences,Torino,Italy
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- Elisabetta Bugianesi
- Università di Bologna,Bologna,Italy
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- Giulio Marchesini
- Division of Gastroenterology and Hepatology,Saint Louis University,St. Louis,MO
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- Brent A. Neuschwander‐Tetri
- Saint‐Antoine Hospital,Paris,France
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- Lawrence Serfaty
- University Hospitals of Geneva,Geneva,Switzerland
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- Francesco Negro
- Division of Gastroenterology and Hepatology,University of Virginia,Charlottesville,VA
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- Stephen H. Caldwell
- Institute of Cardiometabolim and Nutrition (ICAN) and Hospital Pitié Salpêtrière,de L'Hopital,Paris,France
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- Vlad Ratziu
- Massachusetts General Hospital,Cambridge,MA
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- Kathleen E. Corey
- Icahn School of Medicine at Mount Sinai,Division of Liver Diseases,New York,NY
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- Scott L. Friedman
- Division of Gastroenterology and Hepatology,Duke University,Durham,NC
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- Manal F. Abdelmalek
- Pinnacle Clinical Research,San Antonio,TX
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- Stephen A. Harrison
- Division of Gastroenterology,Virginia Commonwealth University,Richmond,VA
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- Arun J. Sanyal
- Department of Pediatrics,Columbia College of Physicians and Surgeons,New York,NY
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- Joel E. Lavine
- Hôpital Claude Huriez Rue Michel Polonowski,Lille,France
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- Philippe Mathurin
- Department of Medicine,University of Chicago,Chicago,IL
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- Michael R. Charlton
- Division of Gastroenterology and Hepatology,Indiana University School of Medicine,Indianapolis,IN
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- Zachary D. Goodman
- Department of Medicine and Betty and Guy Beatty Center for Integrated Research, Claude Moore,Inova Health Systems,Falls Church,VA
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- Naga P. Chalasani
- Institute of Cellular Medicine, Faculty of Medical Sciences,Newcastle University,Newcastle Upon Tyne,United Kingdom
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- Kris V. Kowdley
- Swedish Medical Center,Seattle,WA
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- Jacob George
- Storr Liver Centre, Westmead Institute for Medical Research,Westmead Hospital and University of Sydney,Sydney,Australia
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- Keith Lindor
- Arizona State University
Description
<jats:p>Nonalcoholic fatty liver disease (NAFLD) is a spectrum comprised of isolated steatosis, nonalcoholic steatohepatitis (NASH), advanced fibrosis, and cirrhosis. The majority of NAFLD subjects do not have NASH and do not carry a significant risk for liver‐related adverse outcomes (cirrhosis and mortality). Globally, the prevalence of NAFLD is approximately 25%. In Asia, a gradient of high to low prevalence rates is noted from urban to rural areas. Given the prevalence of NAFLD, the clinical and economic burden of NAFLD and NASH can be substantial. With increasing recognition of NASH as an important liver disease, the diagnosis of NASH still requires a liver biopsy that is suboptimal. Although liver biopsy is the most accurate modality to diagnose and stage the severity of NASH, this method suffers from being invasive, costly, associated with potential complications, and plagued with interobserver variability of individual pathological features. A number of noninvasive modalities to diagnose NASH and stage liver fibrosis are being developed. These modalities include predictive models (NAFLD fibrosis score) and serum biomarkers such as enhanced liver fibrosis (ELF). Other tests are based on radiological techniques, such as transient elastography (TE) or magnetic resonance elastography (MRE), which are used to estimate liver stiffness as a potential surrogate of hepatic fibrosis. Although a dynamic field of research, most of these diagnostic modalities have area under the curve ranging between 0.76 and 0.90%, with MRE having the best predictive performance. In summary, developing safe and easily accessible noninvasive modalities to accurately diagnose and monitor NASH and associated fibrosis is of utmost importance in clinical practice and clinical research. These tests are not only important to risk stratify subjects at the greatest risk for progressive liver disease, but also to serve as appropriate surrogate endpoints for therapeutic clinical trials of NASH. (H<jats:sc>epatology</jats:sc> 2018;68:349‐360).</jats:p>
Journal
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- Hepatology
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Hepatology 68 (1), 349-360, 2018-07
Ovid Technologies (Wolters Kluwer Health)
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Details 詳細情報について
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- CRID
- 1361699993757888512
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- ISSN
- 15273350
- 02709139
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- Data Source
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- Crossref