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Background: Nonalcoholic fatty liver disease (NAFLD) is a group of hepatic disorders ranging between simple form of accumulation of fat in hepatocytes (hepatic steatosis) and inflammation of liver internal tissues and injury of hepatocytes that is known as nonalcoholic steatohepatitis (NASH) with increasing levels of fibrosis and cirrhosis and hepatocellular carcinoma (HCC). The composition of one's gut microbiota has a role in both the onset and progression of chronic liver disorders. One indicator of intestinal permeability is zonulin. In this study, we aimed to detect the value of zonulin as a diagnostic and prognostic marker in patients with different degrees of nonalcoholic fatty liver disease (steatosis, steatohepatitis, cirrhosis). This case–control study was conducted on 60 subjects in Gastroenterology and Bariatric Surgery Departments at Ain Shams University Hospitals who were divided into 3 groups: Group A: 20 patients underwent bariatric surgery and have mild NASH, Group B: 20 patients underwent bariatric surgery and have moderate-to-severe NASH, and Group C: 20 healthy controls, during a period 1 of year. Results: There was high statistically significant difference between the studied groups; as regard zonulin concentration, zonulin showed high diagnostic accuracy in diagnosis of NASH among hepatic patients with total accuracy of 81.7%, sensitivity of 72.5%, and specificity of 100. Conclusion: Serum zonulin levels increase with steatosis severity in patients with NAFLD. This explains the high diagnostic accuracy of zonulin in diagnosis and prognosis of NASH among patients. [ABSTRACT FROM AUTHOR]

Background: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide, ranging from simple steatosis and non-alcoholic steatohepatitis (NASH) to cirrhosis, with its complications including hepatocellular carcinoma (HCC). The non-invasive diagnostic markers of NAFLD are gaining interest due to the invasive nature and potential side effects of liver biopsy, and are the current gold standard of diagnosis. Objective: This study aimed to evaluate hyaluronic acid (HA) as a potential non-invasive biomarker for diagnosis and prognosis of NAFLD and to compare it with the traditional non-invasive techniques. Patients and methods: This study included 63 subjects divided into 3 groups; including 21 patients with fatty liver, 21 patients with NASH, in addition to 21 healthy controls. Non-invasive assessment of liver fibrosis was done to all study subjects using aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 score (FIB4), in addition to measurement of HA serum levels. Results: As regard assessment of liver fibrosis, there was a highly significant statistical difference between groups as regard APRI and Fib4 scores. As for HA there was a highly significant statistical difference between study groups. HA receiver operating characteristics curves (ROC) achieved excellent diagnostic performance for fatty liver with 100% sensitivity and specificity at cutoff of 25 ng/ml for fatty liver, versus a sensitivity of 95.2% and specificity of 85.7% for NASH at cutoff of 110 ng/ml. Conclusion: HA can be used as an accurate and specific non-invasive biomarker for the diagnosis of NAFLD and staging of the severity of disease compared with the traditional known non-invasive scores. [ABSTRACT FROM AUTHOR]

Background: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide, ranging from simple steatosis and non-alcoholic steatohepatitis (NASH) to cirrhosis, with its complications including hepatocellular carcinoma (HCC). The non-invasive diagnostic markers of NAFLD are gaining interest due to the invasive nature and potential side effects of liver biopsy, and are the current gold standard of diagnosis. Objective: This study aimed to evaluate hyaluronic acid (HA) as a potential non-invasive biomarker for diagnosis and prognosis of NAFLD and to compare it with the traditional non-invasive techniques. Patients and methods: This study included 63 subjects divided into 3 groups; including 21 patients with fatty liver, 21 patients with NASH, in addition to 21 healthy controls. Non-invasive assessment of liver fibrosis was done to all study subjects using aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 score (FIB4), in addition to measurement of HA serum levels. Results: As regard assessment of liver fibrosis, there was a highly significant statistical difference between groups as regard APRI and Fib4 scores. As for HA there was a highly significant statistical difference between study groups. HA receiver operating characteristics curves (ROC) achieved excellent diagnostic performance for fatty liver with 100% sensitivity and specificity at cutoff of 25 ng/ml for fatty liver, versus a sensitivity of 95.2% and specificity of 85.7% for NASH at cutoff of 110 ng/ml. Conclusion: HA can be used as an accurate and specific non-invasive biomarker for the diagnosis of NAFLD and staging of the severity of disease compared with the traditional known non-invasive scores. [ABSTRACT FROM AUTHOR]