Non-invasive diagnosis of non-alcoholic steatohepatitis and liver fibrosis

In their Article, Harrison and colleagues 1 Harrison SA Ratziu V Boursier J et al. A blood-based biomarker panel (NIS4) for non-invasive diagnosis of non-alcoholic steatohepatitis and liver fibrosis: a prospective derivation and global validation study. Lancet Gastroentrol Hepatol. 2020; 5: 970-985 Summary Full Text Full Text PDF PubMed Scopus (37) Google Scholar reported a blood-based biomarker panel (NIS4) for the non-invasive diagnosis of non-alcoholic steatohepatitis (NASH) and liver fibrosis. They showed that the NIS4 score (which consisted of four biomarkers: miR-34a-5p, alpha-2 macroglobulin [A2M], YKL-40, and glycated haemoglobin [HbA1c]) provided an effective way to non-invasively rule in or out patients who were at-risk of NASH with metabolic risk factors and suspected disease. They established that NIS4 is not influenced by patients’ age, sex, body–mass index (BMI), or aminotransferase concentrations. 1 Harrison SA Ratziu V Boursier J et al. A blood-based biomarker panel (NIS4) for non-invasive diagnosis of non-alcoholic steatohepatitis and liver fibrosis: a prospective derivation and global validation study. Lancet Gastroentrol Hepatol. 2020; 5: 970-985 Summary Full Text Full Text PDF PubMed Scopus (37) Google Scholar However, other potential confounding factors associated with these individual biomarkers do not seem to have been considered. A blood-based biomarker panel (NIS4) for non-invasive diagnosis of non-alcoholic steatohepatitis and liver fibrosis: a prospective derivation and global validation studyNIS4 is a novel blood-based diagnostic that provides an effective way to non-invasively rule in or rule out at-risk NASH in patients with metabolic risk factors and suspected disease. Use of NIS4 in clinical trials or in the clinic has the potential to greatly reduce unnecessary liver biopsies in patients with lower risk of disease progression. Full-Text PDF Non-invasive diagnosis of non-alcoholic steatohepatitis and liver fibrosisThere is an urgent need to identify patients who are at risk of developing non-alcoholic steatohepatitis (NASH), defined using liver histology as a non-alcoholic fatty liver disease (NAFLD) activity score of 4 or more and a fibrosis stage of 2 or more. Traditional, non-invasive tests have been developed to identify either NASH or advanced fibrosis, such as cytokeratin-18 (CK-18) fragments M30 and M65, the enhanced liver fibrosis score, the fibrosis-4 score, and the NAFLD fibrosis score. However, these tests do not accurately detect patients who are at risk of NASH. Full-Text PDF