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Abstract

Non-alcoholic fatty liver disease (NAFLD) has emerged as a leading cause of chronic liver disease in children. Liver biopsy remains the gold standard for diagnosis of NASH. A scoring system predictive of NASH based on these biomarkers would prove indispensable for avoiding the invasive liver biopsy. The estimated prevalence of pediatric NAFLD is 2.6%-9.6%. Studies estimate that the prevalence of NAFLD among overweight or obese children and adolescents is 24%-77%. Serum biomarkers to diagnose NASH may be divided into four categories: Markers of Inflammation, oxidative stress, apoptosis and fibrosis. TNF-�± mRNA cutoff value of 100 ng/mL predicted NASH with a sensitivity of 66.7%, specificity 74.1%, Serum adiponectin, levels are lower in patients with NASH but no definite level for accurate prediction has been determined. Serum CK-18 is an independent predictor of NASH. A cut off value of 380 U/l provided a specificity of 94% and sensitivity of 91%. Ox-LDL and TBARS in serum were higher in biopsy-proven NASH patients. Apart from these a panel comprising of hyaluronic acid (HA), amino-terminal propeptide of type III collagen (PIIINP), and tissue inhibitor of metalloproteinase 1 (TIMP-1) is under evaluation as a predictor of fibrosis. Liver biopsy, considered as the gold standard to diagnose NASH is invasive and costly. Some of the Noninvasive Biomarkers have an established role in the diagnosis of NASH whereas the role of some needs further evaluation. Better noninvasive biomarkers or panels of biomarkers are urgently needed for diagnosis of NASH, providing risk information, and monitoring disease progression and treatment response.

Biography

Email: drrakeshigmc@gmail.com