Combination of Aspartate Aminotranferase and Tumor Necrosis Factor-a as Non Invasive Diagnostic Tools for Non Alcoholic Steatohepatitis (NASH)

ABSTRACT: to develop a non-invasive diagnostic test for non-alcoholic steatohepatitis NASH. Methods: this is a cross-sectional study on non-alcoholic fatty liver disease (NAFLD) subjects. Sample was taken by consecutive sampling method. Diagnostic criteria of NAFLD were confrmed by liver biopsy. Clinical variables include metabolic syndrome, aspartate aminotransferase (AST), alanine aminotransferase (ALT), adiponectine, TNF-a, insulin, homeostatic model assessment insulin resistance (HOMA-IR) index and liver biopsy. Patients were divided into two groups based on their liver biopsy, group 1: Non-NASH (NAFLD activity score <3) and group 2: NASH (NAFLD activity score of >4). Statistical analyses were performed using Student’s t-test, Mann Whitney U, chi-square, the ROC curve, sensitivity and specifcity test. Results: ffty NAFLD patients were recruited, 30 males and 20 females. Among these patients, 12 (24%) had type 2 diabetes, 36 (72%) had metabolic syndrome, the remaining 2 (4%) did not fulflled metabolic syndrome. Liver biopsy confrmed 21 (42%) non- NASH and 29 (58%) NASH respectively. Level of AST and ALT, plasma level of adiponectine and TNF-a were statistically different between two groups. The AST level (>25 U/L) in combination with TNF-a (>3.28 pg/cc) demonstrated a good diagnostic accuracy for NASH (Accuracy 82%, Sensitivity 76%, Specifcity 90%, PPV 92%, and NPV 73%). Conclusion: the combined diagnostic tests of AST and TNF-a plasma levels demonstrated a good accuracy for the detection of NASH among NAFLD patients. This combination test can be used as a noninvasive method to diagnose NASH.
Key words: AST, TNF-a, diagnostic test, NASH
Author: Hery D. Purnomo, Farmaditya EP. Mundhofr, Kasno, Eddy Sudijanto, Darmono, Daldiyono, R. Djokomoeljanto, Sultana MH. Faradz
Journal Code: jpkedokterangg150259