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Copyright ©2010 Baishideng Publishing Group Co.
World J Gastroenterol. Oct 14, 2010; 16(38): 4784-4791
Published online Oct 14, 2010. doi: 10.3748/wjg.v16.i38.4784
Table 1 Clinical features of nonalcoholic fatty liver disease
SymptomsSigns
NoneHepatomegaly (50% of patients)
FatigueObesity
Right upper quadrant discomfortHypertension
Table 2 Noninvasive diagnosis of non-alcoholic fatty liver disease (adapted from Lewis et al[45]) (%)
ImagingSensitivitySpecificityPPVNPV
Ultrasound91-10093-10062-8994
Ultrasound (levovist)10095-100N/AN/A
Ultrasound (elasticity)91844797
CT93N/A76N/A
MRIN/AN/AN/AN/A
MR (spectroscopy)N/AN/AN/AN/A
MR (elastography)85867394
Table 3 Serological markers for nonalcoholic steatohepatitis and fibrosis
Serological markersAdvantageDisadvantage
C reactive protein[53]Independent risk factor for progression of NAFLDLack of specificity for NASH
Plasma pentraxin 3[54]Can differentiate between NASH and non progressive NAFLDLack of specificity for NASH
Fibrosis marker in NAFLD
Hyaluronic acid[34]Identify fibrosis at a cut-off value of 45 ng/mLCannot differentiate NASH from simple steatosis
Tissue inhibitor of metalloproteinases[34]Fibrosis markerCannot differentiate NASH from simple steatosis
Cytokeratin 18[3]Marker of hepatocyte apoptosisLimited utility in clinical practice
Independent predictor of NASH and severity of disease
Polypeptide specific antigen[57]Marker in differentiating NASH from pure fatty liverMarker for various cancers
Endothelin 1[59]Can differentiate NASH from simple steatosisLack of specificity for NASH