ASSESSMENT OF LIVER STIFFNESS IN NONALCOHOLIC FATTY LIVER DISEASE

Introduction and aim: Several liver fibrosis markers which have been previously evaluated for the patients with viral hepatitis particularly HCV-infected patients. The combination of liver stiffness measurement by transient elastography (TE) and fibrosis scores like APRI, FIB -4 and NAFLD fibrosis score (NFS) are able to accurately diagnose or exclude the presence of severe liver fibrosis and they also reducing the number of needed diagnostic liver biopsies. The purpose of the present study was to assess liver stiffness severity in NAFLD patients by TE, and also to test diagnostic accuracy of FIB-4, NFS and APRI as simple noninvasive markers of liver stiffness in those patients. Method: This study included, 153 individuals who were divided into three groups according to fibrosis grade measured by TE, group I consisted of 62 subjects 32 were males (51.6%) and 30 females (48.4%), their mean age ± SD (44.29 ± 9.65 y), Whereas the group II consisted of 57 subjects, 22 males (38.6%) and 35 females (61.4%), their mean age ± SD (44.70 ± 9.12 y), As regard group III, it consists of 34 subjects, 13 males (38.2%) and 21 females (61.8%), their mean age ± SD (45.82 ± 9.65 y). Full history taking, thorough clinical examination and routine laboratory investigations together with different noninvasive fibrosis score and LSM was analyzed in three groups. Results: There was statistically significant difference between the three groups as regard FIB-4 and NF scores, while there was no statistically significant difference between the three groups as regard APRI. By post hoc analysis the most significant difference was between group I and III as well as group II and III. There was statistically significant positive correlation between fibrosis stage by TE and FIB4 score, glycated hemoglobin (HBA1c) and NF score. Conclusion; LSM by TE is easy, accurate way to anticipate advanced fibrosis together with other simple noninvasive measures like NFS and FIB-4 may lower the threshold for liver biopsies in NAFLD patients.