Aybike HASTURK, Coşkun YILDIZ, Özlem YENER, Hakan TURKON, Omur YILDIZ, Ayfer COLAK, Emine BİNNETOGLU, Burak TOPRAK

Diagnostic performances of serum liver enzymes and cytokines in non-alcoholic fatty liver disease

Amaç: Alkolik olmayan yağlı karaciğer hastalığı gittikçe artan prevalansla dünya çapında insanları etkilemektedir. Bu hastalığın tanısı ve evrelendirilmesi için invaziv olmayan testlere ihtiyaç vardır. Bu çalışmada rutin karaciğer enzimleri ve sitokinlerin alkolik olmayan yağlı karaciğer hastalığında tanısal performanslarını değerlendirmeyi amaçladık.Yöntemler: 20-62 yaşları arasında 88 kişi çalışmaya dahil edildi. Serum ALT, AST, GGT, trigliserid, TNF-alfa, IL-6 ve IL-8 düzeyleri 40 yağlı karaciğer hastası ve benzer VKİ ve demografik özellikleri olan 48 sağlıklı bireyde ölçüldü. Serum biyobelirteçlerinin yağlı karaciğer hastalığındaki tanısal performansları ROC analizi ile değerlendirildi.Bulgular: ALT ve AST tüm grupta yağlı karaciğer hastalığı olan bireyleri belirlemede iyi performans gösterdi (AUC=0,817; %95 CI[0,721-0,913], AUC=0,815; %95 CI[0,718-0,911] sırasıyla) ancak obez bireylerde ALT ve AST zayıf performans gösterdi (AUC=0,659; %95 CI[0,478-0,841], AUC=0,680; %95 CI[0,498-0,861] sırasıyla). Sitokinler arasında TNF-alfa yağlı karaciğer hastalığı tanısında tüm grupta ve obez hastalarda en iyi performansı gösterdi (AUC=0,892; %95 CI[0,824-0,959], AUC=0,858; %95 CI[0,739-0,977] sırasıyla). Tüm grupta TNF-alfa için en iyi cut-off değeri %75 sensitivite ve %93 spesifisite ile 10,65pg/mL bulundu. IL6 ve IL8 zayıf performans gösterdi.Sonuç: TNF-alfa alkolik olmayan yağlı karaciğer hastalarını tespit etmede iyi bir parametre olabilir

Serum karaciğer enzimleri ve sitokinlerin alkolik olmayan yağlı karaciğer hastalığında tanısal performansları

Objective: Non-alcoholic fatty liver disease (NAFLD) is affecting people worldwide with increasing prevalence. Non-invasive tests are required for both diagnosis and staging of the disease. We aimed to evaluate diagnostic accuracy of routine liver enzymes and cytokines in NAFLD.Methods: A total of 88 cases, aged between 20 and 62 years, were included in the study. Serum ALT, AST, GGT, triglyceride, TNF-alpha, IL-6 and IL-8 were measured in 40 patients with NAFLD and in 48 healthy control patients with similar BMI and demographic characteristics. Diagnostic performances of serum biomarkers for diagnosis of NAFLD were evaluated with ROC analysis.Results: ALT and AST showed good diagnostic performance in predicting patients with NAFLD in the overall group (AUC=0.817; 95% CI[0.721-0.913], AUC=0.815; 95% CI[0.718-0.911] respectively) but in obese subjects ALT and AST showed poor performance (AUC=0.659; 95% CI[0.478-0.841], AUC=0.680; 95% CI[0.498-0.861] respectively). Among cytokines TNF-alpha showed best performance in the diagnosis of NAFLD in both overall group and obese subjects (AUC=0.892; 95% CI[0.8240.959], AUC=0.858; 95% CI[0.739-0.977] respectively). The optimal cut off value for TNF-alpha was 10.65pg/ml with a sensitivity of 75% and a specificity of 93% in the overall group. IL-6 and IL-8 showed poor performance.Conclusion: TNF-alpha may be a good parameter for predicting patients with NAFLD. J Clin Exp Invest 2015; 6 (1): 16-20

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