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.
Author: Hery D. Purnomo,
Farmaditya EP. Mundhofr, Kasno, Eddy Sudijanto, Darmono, Daldiyono, R.
Djokomoeljanto, Sultana MH. Faradz
Journal Code: jpkedokterangg150259
