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Non-invasive Diagnostic Approach to NASH: Biological Markers

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Non-Alcoholic Fatty Liver Disease

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Abstract

Non-alcoholic fatty liver disease (NAFLD) prevalence and incidence are dramatically increasing in parallel with the epidemics of both obesity and type 2 diabetes, accounting for the most growing cause of chronic liver disease, of hepatocellular carcinoma and of end-stage liver disease leading to liver transplantation. Natural history studies clearly demonstrated that among NAFLD population, those with non-alcoholic steatohepatitis (NASH) have a double risk of fibrosis progression, and that the severity of liver fibrosis is the main driver of hepatic and extrahepatic prognosis. Consistently, the availability of non-invasive markers to be used in NAFLD patients represents a relevant medical need. Non-invasive markers should be able to predict the presence of liver disease severity in terms of NASH and/or severity of fibrosis, the risk of liver disease progression and of hepatic and extrahepatic outcomes, and the response to treatments. To date, the diagnosis of NASH in clinical practice by using non-invasive scores is difficult due to the lack of easy to use well-performing and well-validated tools. Different scores are available for the non-invasive assessment of fibrosis; some of them are very easy to use and implement in clinical practice even if affected by limitations like false-positive results and high uncertainty areas. Their use in combination with liver stiffness measurement can improve the diagnostic accuracy. Finally, different studies are ongoing to find more accurate markers of liver disease severity, as well as for predicting outcomes and response to treatment.

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  1. Section of Gastroenterology and Hepatology, DIBIMIS, University of Palermo, Palermo, Italy

    Salvatore Petta & Aurora Giannetti

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  1. Department of Medical Sciences, Division of Gastroentrology and Hepatology, University of Turin, Turin, Italy

    Elisabetta Bugianesi

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Petta, S., Giannetti, A. (2020). Non-invasive Diagnostic Approach to NASH: Biological Markers. In: Bugianesi, E. (eds) Non-Alcoholic Fatty Liver Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-95828-6_13

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