Published online May 27, 2021. doi: 10.4254/wjh.v13.i5.571
Peer-review started: December 31, 2020
First decision: February 13, 2021
Revised: February 25, 2021
Accepted: April 22, 2021
Article in press: April 22, 2021
Published online: May 27, 2021
Non-alcoholic steatohepatitis has few symptoms until it progresses; thus, it is necessary to identify non-alcoholic fatty liver disease (NAFLD) patients who will show poor prognosis.
The limitations of liver biopsies, such as invasiveness, poor patient tolerance, sampling variability, and high costs, are well known. Thus, there is increasing interest in developing and validating non-invasive methods for measuring liver stiffness. However, many current methods involve instruments that are not available in many institutions.
Serum biomarkers that can assess the progression of liver fibrosis in patients with NAFLD may serve as important tools for identifying patients with advanced fibrosis. We aimed to investigate the efficacy of non-invasive biomarkers for predicting disease progression in patients with NAFLD.
We investigated biomarkers with predictable prognosis for NAFLD patients who underwent liver biopsy. All patients were followed-up for > 1 year.
The combination of three non-invasive biomarkers involved in NAFLD prognosis comprised platelet counts, albumin levels, and type IV collagen 7S. Our results indicate that patients with NAFLD who present with a combination of albumin levels < 3.5 g/dL, platelet counts < 15 × 104/µL, and type IV collagen 7S levels ≥ 5 ng/mL show poor prognosis. In particular, the 10-year survival rate was only 43% for patients who presented with all three factors.
The combination of platelet count, albumin level, and type IV collagen 7S was useful in further predicting the prognosis of NAFLD.
Studies conducted in the future should focus on assessing these biomarkers further and examining long-term prognosis.