Applying Non-Invasive Fibrosis Measurements in NAFLD/NASH: Progress to Date

Pharmaceut Med. 2019 Dec;33(6):451-463. doi: 10.1007/s40290-019-00305-z.

Abstract

Nonalcoholic fatty liver disease (NAFLD) has now become a worldwide health issue due to the obesity epidemic, affecting approximately 90% of the obese population and 15-40% of the general population. It is the most common form of chronic liver disease in the United States. NAFLD constitutes a spectrum of diseases ranging in severity from mild, such as fatty liver, progressing into nonalcoholic steatohepatitis (NASH), then fibrosis, and ending with cirrhosis. NASH and increasing fibrosis stage are associated with increased morbidity and mortality; the fibrosis stage is therefore a critical element of risk stratification needed to determine therapeutic approach and also the response to treatment. Liver biopsy is considered the 'gold standard' in the diagnosis of NAFLD. However, it is not practical for widespread clinical use because it is invasive, costly, and associated with complications including occasional death. These limitations have driven the development of noninvasive tests that can accurately predict the fibrosis stage in those with NAFLD. In this review, we provide a concise overview of different non-invasive measurements used for NAFLD/NASH.

Publication types

  • Review

MeSH terms

  • Biomarkers / blood
  • Biopsy / adverse effects
  • Biopsy / economics
  • Circulating MicroRNA / blood
  • Disease Progression
  • Elasticity Imaging Techniques / methods
  • Gastrointestinal Microbiome
  • Humans
  • Liver / diagnostic imaging
  • Liver / metabolism
  • Liver / pathology
  • Liver Cirrhosis / blood
  • Liver Cirrhosis / diagnosis*
  • Liver Cirrhosis / epidemiology
  • Liver Cirrhosis / pathology
  • Metabolomics / methods
  • Non-alcoholic Fatty Liver Disease / blood
  • Non-alcoholic Fatty Liver Disease / diagnosis
  • Non-alcoholic Fatty Liver Disease / etiology
  • Non-alcoholic Fatty Liver Disease / pathology*
  • Obesity / blood
  • Obesity / complications*
  • Obesity / epidemiology
  • Obesity / metabolism
  • Observer Variation
  • Predictive Value of Tests
  • Prevalence
  • Proteomics / methods
  • Risk Assessment
  • Severity of Illness Index
  • United States

Substances

  • Biomarkers
  • Circulating MicroRNA