To Evaluate Efficacy of Non-invasive Markers of Fibrosis in Determining Liver Fibrosis Vis-à-vis Liver Biopsy, in Patients of Nonalcoholic Fatty Liver Disease

Background&Purpose: Non-alcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease&liver transplantation and its incidence is increasing even in Asian countries. The gold standard for assessing hepatic fibrosis is liver histology but due to its limitations, noninvasive tests to assess hepatic fibrosis which can be used as alternative to liver biopsy have been developed, such the AST-to-platelet ratio index (APRI), Forns test, FibroTest, transient elastography, fibrometer and hepascore. Methods: In a cross-sectional study, 25 diagnosed NAFLD patients underwent detailed laboratory investigations including the specific non-invasive markers of fibrosis namely, haptoglobin, alpha-2 macroglobulin, apolipoprotein- A1 levels and insulin resistance was calculated by homoeostasis model assessment (HOMA), then patients were subjected to liver biopsy. Results. Out of 25 patients, 19(76%) were male and 6(24%) were females. Nine patients (36%) were diabetic and 21 (84%) were dyslipidaemic. Metabolic syndrome was present in 18(72%), body mass index was increased in 22 patients and waist hip ratio was altered in 22 patients (88%). Using SPSS 10, p value was significant (p = 0.04) for correlation between steatosis and waist/hip ratio and HOMA-IR with inflammation and fibrosis (p = 0.03) but non-invasive markers were not significant in predicting hepatic fibrosis on histology. Conclusion. The non-invasive markers were not significant in predicting hepatic fibrosis on histology in present study. The limitation of the study was small sample size and majority of patients had steatosis only.