Serum Test Differentiates Between Minimal and Advanced Liver Fibrosis in NAFLD

Although degree of fibrosis is a key predictor of outcomes in patients with nonalcoholic fatty liver disease (NAFLD), determining liver fibrosis in this population is difficult. Biopsy is too expensive and invasive, and elastography requires specialized equipment (and its accuracy may be limited). Serum markers may be the most practical method.

This was a retrospective study of patients with biopsy-confirmed NAFLD. At the time of biopsy, serum samples were measured for alpha-2 macroglobulin, hyaluronic acid, and TIMP metallopeptidase inhibitor. An algorithm was developed that could discriminate between NAFLD patients with mild-to-moderate fibrosis (grades F0–F2) and those with advanced fibrosis (F3–F4). Two additional cohorts were used to va…