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Non-invasive estimation of liver fibrosis in non-alcoholic fatty liver disease using the 13 C-caffeine breath test.
- Source :
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Journal of gastroenterology and hepatology [J Gastroenterol Hepatol] 2011 Sep; Vol. 26 (9), pp. 1411-6. - Publication Year :
- 2011
-
Abstract
- Background and Aim: Fibrotic progression in non-alcoholic fatty liver disease (NAFLD) is associated with impaired hepatic function. The (13) C-caffeine breath test (CBT) is a non-invasive, quantitative test of liver function. We sought to determine the utility of the CBT in detecting hepatic fibrosis in NAFLD.<br />Methods: The CBT was applied to 48 patients with NAFLD. CBT results were compared to clinical, biochemical and histological data. Twenty-four healthy subjects served as controls.<br />Results: Patients with simple steatosis had similar CBT values (2.28 ± 0.71 Δ‰ per 100 mg caffeine) to controls (2.31 ± 0.85, P = 1.0). However, CBT was significantly reduced in patients with non-alcoholic steatohepatitis (1.59 ± 0.65, P = 0.005) and cirrhosis (1.00 ± 0.73, P < 0.001). CBT significantly correlated with Brunt's fibrosis score (r = -0.49, P < 0.001) but not with steatosis (P = 0.23) or inflammation (P = 0.08). CBT also correlated with international normalized ratio (r = -0.61, P < 0.001), albumin (r = 0.37, P = 0.009), aspartate aminotransferase/alanine aminotransferase (r = -0.34, P = 0.018) and platelets (r = 0.31, P = 0.03). On multivariate analysis, age (odds ratio 1.12, 95% confidence interval 1.042-1.203, P = 0.002) and CBT (OR 0.264, 95% CI 0.084-0.822, P = 0.02) were independent predictors of significant fibrosis (F ≥ 2). CBT yielded an area under the receiver operating characteristic curve of 0.86 for the diagnosis of cirrhosis.<br />Conclusions: The CBT reflects the extent of hepatic fibrosis in NAFLD and represents a non-invasive predictor of fibrosis severity in this condition.<br /> (© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Analysis of Variance
Biopsy
Case-Control Studies
Chi-Square Distribution
Cross-Sectional Studies
Female
Humans
Liver Cirrhosis etiology
Logistic Models
Male
Middle Aged
New South Wales
Non-alcoholic Fatty Liver Disease
Odds Ratio
Predictive Value of Tests
ROC Curve
Risk Assessment
Risk Factors
Severity of Illness Index
Young Adult
Breath Tests
Caffeine
Fatty Liver complications
Liver Cirrhosis diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1440-1746
- Volume :
- 26
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Journal of gastroenterology and hepatology
- Publication Type :
- Academic Journal
- Accession number :
- 21557768
- Full Text :
- https://doi.org/10.1111/j.1440-1746.2011.06760.x