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Utility of the ELF Test for Detecting Steatohepatitis in Morbid Obese Patients with Suspicion of Nonalcoholic Fatty Liver Disease

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Abstract

Background

Morbid obese patients have a high rate of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). NASH is related to the progression and poor evolution of chronic hepatopathy in NAFLD, so that its detection makes it possible to identify the subjects who are most at risk in order to prioritize treatment. The ELF test (Enhanced Liver Fibrosis test; Siemens Diagnostics, NY, USA) has been assessed for its capacity to detect fibrosis in patients with NAFLD, but its capacity for diagnosing NASH has not been checked.

Aims

Our objective is to determine the utility of the ELF test for detecting NASH in morbid obese patients with suspected NAFLD.

Methods

ELF values were determined in a cohort of obese patients who underwent bariatric surgery with suspected NAFLD. Liver biopsy was used as the reference standard.

Results

The values of ELF were significantly higher in patients with NASH (p = 0.002) and in those who presented with metabolic syndrome (p = 0.047). An ELF cut-off point of 8.72 allows the detection of patients with NASH with a sensitivity of 71.4% and a specificity of 74.1% (AUC = 0.742, p = 0.002).

Conclusions

The ELF test is efficient for the identification of obese patients with NAFLD and early signs of steatohepatitis and fibrosis.

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Acknowledgments

We would like to thank the patients for their voluntary and disinterested participation in the study. Our thanks to Siemens® for the free use of the material for the evaluation of the ELF test.

Author information

Authors and Affiliations

  1. Department of Clinical Analysis, Clinic University Hospital Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, 30120, Murcia, Spain

    Iria Cebreiros López & Jose Antonio Noguera Velasco

  2. Department of Radiology, Clinic University Hospital Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, 30120, Murcia, Spain

    Florentina Guzmán Aroca

  3. Department of Surgery, Clinic University Hospital Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, 30120, Murcia, Spain

    Maria Dolores Frutos Bernal, Juan Antonio Luján Mompeán & Pascual Parilla Paricio

  4. Department of Pathology, Clinic University Hospital Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, 30120, Murcia, Spain

    Águeda Bas Bernal & Enrique Martínez Barba

  5. Department of Endocrinology and Nutrition, Clinic University Hospital Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, 30120, Murcia, Spain

    Antonio Miguel Hernández Martínez

Authors
  1. Iria Cebreiros López
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  2. Florentina Guzmán Aroca
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  3. Maria Dolores Frutos Bernal
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  4. Juan Antonio Luján Mompeán
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  5. Águeda Bas Bernal
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  6. Antonio Miguel Hernández Martínez
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  7. Enrique Martínez Barba
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  8. Jose Antonio Noguera Velasco
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  9. Pascual Parilla Paricio
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Corresponding author

Correspondence to Iria Cebreiros López.

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Conflict of Interest

The authors declare that they have no conflicts of interest. Iria Cebreiros reports grants from Spanish Association of Pharmaceutical Analysts (AEFA), and nonfinancial support from Siemens Healthcare Diagnostics Inc.

Statement of Informed Consent

Informed consent was obtained from all the participants.

Statement of Human Rights

The study was approved by our hospital’s Ethics and Clinical Research Committee.

Additional information

Iria Cebreiros holds a research grant from the Spanish Association of Pharmaceutical Analysts (AEFA).

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López, I.C., Aroca, F.G., Bernal, M.D.F. et al. Utility of the ELF Test for Detecting Steatohepatitis in Morbid Obese Patients with Suspicion of Nonalcoholic Fatty Liver Disease. OBES SURG 27, 2347–2353 (2017). https://doi.org/10.1007/s11695-017-2606-9

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  • DOI: https://doi.org/10.1007/s11695-017-2606-9

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