Correlation Study Between Molecular Biomarkers and Liver Biopsy in Determining the Degree of Fibrosis in Cases of Non-alcoholic Fatty Liver Disease (NAFLD) and Non-alcoholic Steatohepatitis (NASH)

Murad Alfaqih

This study plans to examine the association between the serum level of the following cytokines, fatty acid binding protein 4 (FABP4), cytokeratin 18-M30 (CK 18-M30), and fibroblast growth factor 21 (FGF21) and the degree of fibrosis in the different stages of non-alcoholic fatty liver disease NAFLD. NAFLD is a spectrum of diseases that has simple steatosis at one end and full blown cirrhosis at the other.

To achieve this purpose, ninety patients with BMI > 30 who underwent bariatric surgery at Inova Fairfax Hospital, Fairfax, Virginia were recruited. The patients were divided into 3 cohorts according to the stage of their NAFLD and were matched for BMI and age. The histologic sections of liver biopsy are studied by morphometric imaging, and the serum biomarkers’ level is measured by immunoassay techniques. Several statistical methods including Mann-Whitney U test, multiple regression analysis and ROC curves are used to assess the degree of the sensitivity and the specificity of the association between the markers’ level and the extent of fibrosis. The results of the study are pending because the project is still in the preanalytic phase. We expect the results of these serum markers FABP4, CK 18-M30, and FGF21 to correlate significantly with the degree of fibrosis in these chronic liver conditions. If the results turn out as expected, this discovery will provide health care providers with non-invasive and efficient diagnostic tool that will enable clinicians to offer a timely intervention and management, while reducing the cost and risk associated with liver biopsies.