Assessment of mac2 binding protein in patients with non-alcoholic fatty liver disease as a non-invasive biomarker of non-alcoholic steatohepatitis / Shaimaa Mohammed Ali ; Supervised Rokaya Abdelaziz Mohammed , Hany Mahmoud Khattab , Sahar Abdelaty

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Internal Medicine

Introduction: Non-alcoholic fatty liver disease (NAFLD) is among the most common causes of chronic liver disease in the world and is a growing medical problem in industrialized countries.Liver biopsy remains the gold standard for diagnosing NASH and grading the severity of liver damage.However, invasive liver biopsy is poorly suited as a diagnostic test for such a prevalent condition, and this in turn restricts therapeutic intervention. Moreover, biopsy itself carries significant limitations such as pain, risk of severe complications, sampling error, cost and patient unwillingness to undergo invasive testing. Therefore, the need for development and validation of a reproducible and non-invasive test that can accurately distinguish NASH from simple steatosis is urgent. Recently, serum mac 2 binding protein (mac 2bp) has been found to be significantly elevated in NASH patients compared with non-NASH patients, and has been suggested as a diagnostic tool for NASH. In this study, we hypothesized that serum mac2 binding protein levels would be elevated in NASH patients. Subjects and methods:forty patients diagnosed as fatty liver by abdominal ultrasound were subjected to full history taking and physical examination, full anthropometric measurements, laboratory studies including (complete blood count, fasting blood sugar, total lipid profile, liver function tests, HBsAg and Anti HCV Abs, CRP and mac 2bp) and abdominal ultrasound. Sonar-guided liver biopsies with pathological examination were done for 20 NAFLD patients. 15 age and sex matched healthy subjects were included as a control group. According to NAS scores, biopsied NAFLD patients were divided into 2 groups: Group 1: Patients without NASH whose NAS scores less than 5. Group 2: Patients with NASH whose NAS scores {u2265} 5. According to the grade of fibrosis in liver biopsy, patients were classified into 2 groups: Group 1: patients with fibrosis grades less than 2 (G0 and1). Group 2: patients with significant fibrosis (G2, 3and 4)

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