Charles University, Czech Republic
Radan Bruha has completed his Ph.D at the age of 31 years from Charles University in Prague. He has conducted his postdoctoral studies at 1st Medical School of Charles University. At present he is the head of hepatogastroenterology department at 4th internal clinic, General Teaching Hospital, Charles University in Prague. He has published more than 20 papers in reputed journals on the topic of liver and biliary diseases and he has presented his work at international congresses. He has serving as a reviewer and an editorial board member for repute international journals.
Background: Non-alcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease worldwide and its prevalence continues to increase with the growing outbreak of obesity. NAFLD includes wide spectrum of diseases from fully benign simple steatosis to steatohepatitis, which could progress to liver cirrhosis and hepatocellular carcinoma. Liver biopsy is considering as the gold standard for assessing of disease severity. Recently non-invasive parameters are considered to substitute liver biopsy in evaluation of inflammation and fibrosis. The aim of our study was to assess the diagnostic value of serum markers of fibrosis and inflammation in patients with NASH. Patients and methods: Serum concentrations of hyalurinic acid (HA), cytokeratine-18 fragments, TIMP1 and P3NP were measured and index Hepascore was calculated in 88 patients with NASH indicated for liver biopsy; in 10 patients measurement of hepatic venous pressure gradient was performed. Results: The values of examined parameters were significantly elevated in patients with NASH compare to controls. Significant difference in HA, Hepascore and other parameters was found between cirrhosis and all other fibrosis stages (p<0,05). HA discriminated cirrhosis with AUC 0,966 (sensitivity 94% and specificity 95%) and correlated with the degree of portal hypertension (p=0.002). Conclusion: Significant differences of serum parameters of fibrosis and inflammation were found between patients with NASH with different degrees of fibrosis and controls. Examination of serum HA could discriminate patients with cirrhosis without liver biopsy and could evaluate the degree of portal hypertension. Supported by IGA MZCR: NT 11247/4 and NT 12290/4.