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A New Composite Model including metabolic syndrome, Alanine aminotransferase and Cytokeratin-18 for the Diagnosis of Non-Alcoholic Steatohepatitis in Morbidly Obese Patients

Abstract : Background and aims: Non invasive approaches are useful to differentiate simple steatosis from non-alcoholic steatohepatitis (NASH) in obese and morbidly obese patients. The aim of this study was to develop a new scoring system to diagnose definitive NASH. Methods: Preoperative clinical and biological data including serum caspase 3-generated cytokeratin-18 fragments (CK18) and peroperative liver biopsies were obtained from 464 morbidly obese patients who had undergone bariatric surgery. The cohort was divided into two groups: training group (n=310) and validation group (n=154). Definitive NASH was defined according to Kleiner's classification with a NAFLD Activity Score (NAS) ≥5. Results: Alanine aminotransferase (ALT), CK18 fragments and the presence of metabolic syndrome (MS) were independent predictors for discriminating patients with NAS ≥5 in the training group. These three parameters were used to carry out a scoring system for the prediction of NAS ≥5. Whereas serum CK18 fragment alone had an Area under the Receiver Operating Characteristic (AUROC) curve = 0.74, AUROC curves of the scoring system were 0.88 and 0.83 in the training and in the validation group respectively. Conclusion: A simple and non invasive composite model including MS, ALT and CK18 fragments was able to accurately predict NAS ≥5 in morbidly obese subjects.
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Submitted on : Thursday, April 7, 2011 - 2:51:51 AM
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Rodolphe Anty, Antonio Iannelli, Stéphanie Patouraux, Stephanie Bonnafous, Vanessa Lavallard, et al.. A New Composite Model including metabolic syndrome, Alanine aminotransferase and Cytokeratin-18 for the Diagnosis of Non-Alcoholic Steatohepatitis in Morbidly Obese Patients. Alimentary Pharmacology and Therapeutics, Wiley, 2010, 32 (11-12), pp.1315. ⟨10.1111/j.1365-2036.2010.04480.x⟩. ⟨hal-00583896⟩

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