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Zagazig University Medical Journal

Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease which includes simple steatosis and nonalcoholic steatohepatitis (NASH). The current study aimed to develop a non-invasive tool to predict NASH in patients with NAFLD. Patients and Methods: A cross-sectional study was carried on (80) patients presenting to the Hepatology /Internal Medicine Outpatient Clinic, Zagazig University Hospitals suffering from dyspeptic symptoms, fatigue and unexplained elevation of aminotransferases from July 2019 to January 2020. All patients were subjected to liver function tests, lipid profile, fasting blood sugar, serological markers, abdominal ultra-sonographic examination and Fibroscan evaluation. The new model score included the following clinical and laboratory parameters [body mass index (BMI), US of liver, Liver stiffness, low-density lipoproteins (LDL), high-density lipoprotein (HDL), triglyceride (TG), Alanine transferase (ALT), Aspartame transaminase (AST), AST/ALT ratio, Platelet, mean platelet volume (MPV), Ferritin and Fasting Blood Glucose] Results: current results showed a sensitivity of the new score in the detection of NASH (97.9%) versus 91.7% and 89.6% for NAFLD score and BARD score respectively, but GULAB score was associated with a 100% sensitivity, at a cutoff level of 1.5. The area under the curve for the new score was is 0.789 versus 0.921, 0.925, and 0.996 for NAFLD, BARD, and GULAB scores respectively. Conclusion: The new model score considered simple, non-invasive and low-cost tool and can be used as a good negative test to exclude NASH in the screening of high risk patients and markedly reduce the need for liver biopsies in NAFLD patients.

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