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2022 | OriginalPaper | Buchkapitel

14. Diagnostik: Blutbasierte Marker

verfasst von : Heike Bantel, Matthias J. Bahr

Erschienen in: Nicht-alkoholische Fettlebererkrankung

Verlag: Springer Berlin Heidelberg

Zusammenfassung

In der Diagnostik der nicht-alkoholischen Fettlebererkrankung (NAFLD) kommt es neben der Klärung der Ätiologie und Bestimmung des Fibrosestadiums auf die frühzeitige Identifikation der Patienten an, bei denen ein signifikanter Progress zu erwarten ist. Insbesondere die Differenzierung zwischen der unkomplizierten Fettleber (NAFL) und der nicht-alkoholischen Steatohepatitis (NASH) ist prognostisch bedeutsam, gelingt aber mit Standardlaborparametern nicht, sondern ist allein histologisch zu erreichen. Der Nachweis von K-18-Fragmenten, die bei der Apoptose von Hepatozyten entstehen, durch den M30-Biomarker stellt einen durch verschiedene Studien gut belegten Weg dar, progressionsgefährdete NAFLD-Patienten frühzeitig im Krankheitsgeschehen zu identifizieren. Dieser Abschnitt entspricht der Zusammenfassung und macht somit keinen Sinn (redundant)
Literatur
Zurück zum Zitat Alexander M, Loomis AK, Fairburn-Beech J et al (2018) Real-world data reveal a diagnostic gap in non-alcoholic fatty liver disease. BMC Med 16(1):130PubMedPubMedCentralCrossRef Alexander M, Loomis AK, Fairburn-Beech J et al (2018) Real-world data reveal a diagnostic gap in non-alcoholic fatty liver disease. BMC Med 16(1):130PubMedPubMedCentralCrossRef
Zurück zum Zitat Angulo P, Hui JM, Marchesini G et al (2007) The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology 45:846–854PubMedCrossRef Angulo P, Hui JM, Marchesini G et al (2007) The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology 45:846–854PubMedCrossRef
Zurück zum Zitat Angulo P, Kleiner DE, Dam-Larsen S et al (2015) Liver fibrosis, but no other histologic features, is associated with long-term outcomes of patients with nonalcoholic fatty liver disease. Gastroenterology 149:389–397PubMed Angulo P, Kleiner DE, Dam-Larsen S et al (2015) Liver fibrosis, but no other histologic features, is associated with long-term outcomes of patients with nonalcoholic fatty liver disease. Gastroenterology 149:389–397PubMed
Zurück zum Zitat Anty R, Iannelli A, Patouraux S et al (2010) A new composite model including metabolic syndrome, alanine aminotransferase and cytokeratin-18 for the diagnosis of non-alcoholic steatohepatitis in morbidly obese patients. Aliment Pharmacol Ther 32:1315–1322PubMedCrossRef Anty R, Iannelli A, Patouraux S et al (2010) A new composite model including metabolic syndrome, alanine aminotransferase and cytokeratin-18 for the diagnosis of non-alcoholic steatohepatitis in morbidly obese patients. Aliment Pharmacol Ther 32:1315–1322PubMedCrossRef
Zurück zum Zitat Armstrong MJ, Gaunt P, Aithal GP et al (2016) Liraglutide safety and efficacy in patients with non-alcoholic steatohepatitis (LEAN): a multicentre, double-blind, randomised, placebo-controlled phase 2 study. Lancet 387:679–690PubMedCrossRef Armstrong MJ, Gaunt P, Aithal GP et al (2016) Liraglutide safety and efficacy in patients with non-alcoholic steatohepatitis (LEAN): a multicentre, double-blind, randomised, placebo-controlled phase 2 study. Lancet 387:679–690PubMedCrossRef
Zurück zum Zitat Bantel H, Ruck P, Schulze-Osthoff K (2000) In situ monitoring of caspase activation in hepatobiliary diseases. Cell Death Differ 7:504–505PubMedCrossRef Bantel H, Ruck P, Schulze-Osthoff K (2000) In situ monitoring of caspase activation in hepatobiliary diseases. Cell Death Differ 7:504–505PubMedCrossRef
Zurück zum Zitat Bantel H, Lügering A, Heidemann J et al (2004) Detection of apoptotic caspase activation in sera from patients with chronic HCV infection is associated with fibrotic liver injury. Hepatology 40:1078–1087PubMedCrossRef Bantel H, Lügering A, Heidemann J et al (2004) Detection of apoptotic caspase activation in sera from patients with chronic HCV infection is associated with fibrotic liver injury. Hepatology 40:1078–1087PubMedCrossRef
Zurück zum Zitat Bantel H, John K, Schulze-Osthoff K (2014) Robust detection of liver steatosis and staging of NAFLD by an improved ELISA for serum cytokeratin-18 fragments. Am J Gastroenterol 109:140–141PubMedCrossRef Bantel H, John K, Schulze-Osthoff K (2014) Robust detection of liver steatosis and staging of NAFLD by an improved ELISA for serum cytokeratin-18 fragments. Am J Gastroenterol 109:140–141PubMedCrossRef
Zurück zum Zitat Bechmann LP, Kocabayoglu P, Sowa JP et al (2013) Free fatty acids repress small heterodimer partner (SHP) activation and adiponectin counteracts bile acid-induced liver injury in superobese patients with nonalcoholic steatohepatitis. Hepatology 57:1394–1406PubMedCrossRef Bechmann LP, Kocabayoglu P, Sowa JP et al (2013) Free fatty acids repress small heterodimer partner (SHP) activation and adiponectin counteracts bile acid-induced liver injury in superobese patients with nonalcoholic steatohepatitis. Hepatology 57:1394–1406PubMedCrossRef
Zurück zum Zitat Boursier J, Vergniol J, Guillet A et al (2016) Diagnostic accuracy and prognostic significance of blood fibrosis tests and liver stiffness measurement by FibroScan in non-alcoholic fatty liver disease. J Hepatol 65:570–578PubMedCrossRef Boursier J, Vergniol J, Guillet A et al (2016) Diagnostic accuracy and prognostic significance of blood fibrosis tests and liver stiffness measurement by FibroScan in non-alcoholic fatty liver disease. J Hepatol 65:570–578PubMedCrossRef
Zurück zum Zitat Boursier J, Anty R, Vonghia L et al (2018) Screening for therapeutic trials and treatment indication in clinical practice: MACK-3, a new blood test for the diagnosis of fibrotic NASH. Aliment Pharmacol Ther 47:1387–1396PubMedCrossRef Boursier J, Anty R, Vonghia L et al (2018) Screening for therapeutic trials and treatment indication in clinical practice: MACK-3, a new blood test for the diagnosis of fibrotic NASH. Aliment Pharmacol Ther 47:1387–1396PubMedCrossRef
Zurück zum Zitat Canbay A, Feldstein A, Kronenberger B et al (2014) Cytokeratin 18 as marker for non-invasive diagnosis and prognosis of acute and chronic liver diseases. Z Gastroenterol 52:290–295PubMedCrossRef Canbay A, Feldstein A, Kronenberger B et al (2014) Cytokeratin 18 as marker for non-invasive diagnosis and prognosis of acute and chronic liver diseases. Z Gastroenterol 52:290–295PubMedCrossRef
Zurück zum Zitat Canbay A, Kälsch J, Neumann U et al (2019) Non-invasive assessment of NAFLD as systemic disease-A machine learning perspective. PLoS ONE 14:e0214436PubMedPubMedCentralCrossRef Canbay A, Kälsch J, Neumann U et al (2019) Non-invasive assessment of NAFLD as systemic disease-A machine learning perspective. PLoS ONE 14:e0214436PubMedPubMedCentralCrossRef
Zurück zum Zitat Castéra L, Vilgrain V, Angulo P (2013) Noninvasive evaluation of NAFLD. Nat Rev Gastroenterol Hepatol 10:666–675PubMedCrossRef Castéra L, Vilgrain V, Angulo P (2013) Noninvasive evaluation of NAFLD. Nat Rev Gastroenterol Hepatol 10:666–675PubMedCrossRef
Zurück zum Zitat Castéra L, Friedrich-Rust M, Loomba R (2019) Noninvasive assessment of liver disease in patients with nonalcoholic fatty liver disease. Gastroenterology 156:1264–1281PubMedCrossRef Castéra L, Friedrich-Rust M, Loomba R (2019) Noninvasive assessment of liver disease in patients with nonalcoholic fatty liver disease. Gastroenterology 156:1264–1281PubMedCrossRef
Zurück zum Zitat Chalasani N, Younossi Z, Lavine JE et al (2018) The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology 67:328–357PubMedCrossRef Chalasani N, Younossi Z, Lavine JE et al (2018) The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology 67:328–357PubMedCrossRef
Zurück zum Zitat Daniels SJ, Leeming DJ, Eslam M et al (2019) ADAPT: an algorithm incorporating PRO-C3 XE „PRO-C3“ accurately identifies patients with NAFLD and advanced fibrosis. Hepatology 69:1075–1086PubMedCrossRef Daniels SJ, Leeming DJ, Eslam M et al (2019) ADAPT: an algorithm incorporating PRO-C3 XE „PRO-C3“ accurately identifies patients with NAFLD and advanced fibrosis. Hepatology 69:1075–1086PubMedCrossRef
Zurück zum Zitat Demir M, Lang S, Nierhoff D et al (2013) Stepwise combination of simple noninvasive fibrosis scoring systems increases diagnostic accuracy in nonalcoholic fatty liver disease. J Clin Gastroenterol 47:719–726PubMedCrossRef Demir M, Lang S, Nierhoff D et al (2013) Stepwise combination of simple noninvasive fibrosis scoring systems increases diagnostic accuracy in nonalcoholic fatty liver disease. J Clin Gastroenterol 47:719–726PubMedCrossRef
Zurück zum Zitat Diab DL, Yerian L, Schauer P et al (2008) Cytokeratin 18 fragment levels as a noninvasive biomarker for nonalcoholic steatohepatitis in bariatric surgery patients. Clin Gastroenterol Hepatol 6:1249–1254PubMedPubMedCentralCrossRef Diab DL, Yerian L, Schauer P et al (2008) Cytokeratin 18 fragment levels as a noninvasive biomarker for nonalcoholic steatohepatitis in bariatric surgery patients. Clin Gastroenterol Hepatol 6:1249–1254PubMedPubMedCentralCrossRef
Zurück zum Zitat Dixon JB, Bhathal PS, O’Brien PE (2001) Nonalcoholic fatty liver disease: predictors of nonalcoholic steatohepatitis and liver fibrosis in the severely obese. Gastroenterology 121:91–100PubMedCrossRef Dixon JB, Bhathal PS, O’Brien PE (2001) Nonalcoholic fatty liver disease: predictors of nonalcoholic steatohepatitis and liver fibrosis in the severely obese. Gastroenterology 121:91–100PubMedCrossRef
Zurück zum Zitat Dulai PS, Singh S, Patel J et al (2017) Increased risk of mortality by fibrosis stage in nonalcoholic fatty liver disease: systematic review and meta-analysis. Hepatology 65:1557–1565PubMedCrossRef Dulai PS, Singh S, Patel J et al (2017) Increased risk of mortality by fibrosis stage in nonalcoholic fatty liver disease: systematic review and meta-analysis. Hepatology 65:1557–1565PubMedCrossRef
Zurück zum Zitat European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD) and European Association for the Study of Obesity (EASO) (2016) EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol 64:1388–1402 European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD) and European Association for the Study of Obesity (EASO) (2016) EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol 64:1388–1402
Zurück zum Zitat Ekstedt M, Hagström H, Nasr P et al (2015) Fibrosis stage is the strongest predictor for disease-specific mortality in NAFLD after up to 33 years of follow-up. Hepatology 61:1547–1554PubMedCrossRef Ekstedt M, Hagström H, Nasr P et al (2015) Fibrosis stage is the strongest predictor for disease-specific mortality in NAFLD after up to 33 years of follow-up. Hepatology 61:1547–1554PubMedCrossRef
Zurück zum Zitat Feldstein AE, Wieckowska A, Lopez AR et al (2009) Cytokeratin-18 fragment levels as noninvasive biomarkers for nonalcoholic steatohepatitis: a multicenter validation study. Hepatology 50:1072–1078PubMedCrossRef Feldstein AE, Wieckowska A, Lopez AR et al (2009) Cytokeratin-18 fragment levels as noninvasive biomarkers for nonalcoholic steatohepatitis: a multicenter validation study. Hepatology 50:1072–1078PubMedCrossRef
Zurück zum Zitat Feldstein AE, Alkhouri N, De Vito R et al (2013) Serum cytokeratin-18 fragment levels are useful biomarkers for nonalcoholic steatohepatitis in children. Am J Gastroenterol 108:1526–1531PubMedCrossRef Feldstein AE, Alkhouri N, De Vito R et al (2013) Serum cytokeratin-18 fragment levels are useful biomarkers for nonalcoholic steatohepatitis in children. Am J Gastroenterol 108:1526–1531PubMedCrossRef
Zurück zum Zitat Festi D, Schiumerini R, Marzi L et al (2013) The diagnosis of non-alcoholic fatty liver disease – availability and accuracy of non-invasive methods. Aliment Pharmacol Ther 37:392–400PubMedCrossRef Festi D, Schiumerini R, Marzi L et al (2013) The diagnosis of non-alcoholic fatty liver disease – availability and accuracy of non-invasive methods. Aliment Pharmacol Ther 37:392–400PubMedCrossRef
Zurück zum Zitat Fitzpatrick E, Mitry RR, Quaglia A et al (2010) Serum levels of CK18 M30 and leptin are useful predictors of steatohepatitis and fibrosis in paediatric NAFLD. JPGN 15:500–506 Fitzpatrick E, Mitry RR, Quaglia A et al (2010) Serum levels of CK18 M30 and leptin are useful predictors of steatohepatitis and fibrosis in paediatric NAFLD. JPGN 15:500–506
Zurück zum Zitat Fracanzani AL, Valenti L, Bugianesi E et al (2008) Risk of severe liver disease in nonalcoholic fatty liver disease with normal aminotransferase levels: a role for insulin resistance and diabetes. Hepatology 48:792–798PubMedCrossRef Fracanzani AL, Valenti L, Bugianesi E et al (2008) Risk of severe liver disease in nonalcoholic fatty liver disease with normal aminotransferase levels: a role for insulin resistance and diabetes. Hepatology 48:792–798PubMedCrossRef
Zurück zum Zitat Friedman SL, Ratziu V, Harrison SA et al (2018) A randomized, placebo-controlled trial of cenicriviroc for treatment of nonalcoholic steatohepatitis with fibrosis. Hepatology 67:1754–1767PubMedCrossRef Friedman SL, Ratziu V, Harrison SA et al (2018) A randomized, placebo-controlled trial of cenicriviroc for treatment of nonalcoholic steatohepatitis with fibrosis. Hepatology 67:1754–1767PubMedCrossRef
Zurück zum Zitat Gholam PM, Flancbaum L, Machan JT et al (2007) Nonalcoholic fatty liver disease in severely obese subjects. Am J Gastroenterol 102:399–408PubMedCrossRef Gholam PM, Flancbaum L, Machan JT et al (2007) Nonalcoholic fatty liver disease in severely obese subjects. Am J Gastroenterol 102:399–408PubMedCrossRef
Zurück zum Zitat Hsu C, Caussy C, Imajo K et al (2019) Magnetic resonance vs transient elastography analysis of patients with nonalcoholic fatty liver disease: a systematic review and pooled analysis of individual participants. Clin Gastroenterol Hepatol 17:630–637PubMedCrossRef Hsu C, Caussy C, Imajo K et al (2019) Magnetic resonance vs transient elastography analysis of patients with nonalcoholic fatty liver disease: a systematic review and pooled analysis of individual participants. Clin Gastroenterol Hepatol 17:630–637PubMedCrossRef
Zurück zum Zitat Hyysalo J, Männistö VT, Zhou Y et al (2014) A population-based study on the prevalence of NASH using scores validated against liver histology. J Hepatol 60:839–846PubMedCrossRef Hyysalo J, Männistö VT, Zhou Y et al (2014) A population-based study on the prevalence of NASH using scores validated against liver histology. J Hepatol 60:839–846PubMedCrossRef
Zurück zum Zitat Joka D, Wahl K, Moeller S et al (2012) Prospective biopsy-controlled evaluation of cell death biomarkers for prediction of liver fibrosis and nonalcoholic steatohepatitis. Hepatology 55:455–464PubMedCrossRef Joka D, Wahl K, Moeller S et al (2012) Prospective biopsy-controlled evaluation of cell death biomarkers for prediction of liver fibrosis and nonalcoholic steatohepatitis. Hepatology 55:455–464PubMedCrossRef
Zurück zum Zitat Karsdal MA, Henriksen K, Nielsen MJ et al (2016) Fibrogenesis assessed by serological type III collagen formation identifies patients with progressive liver fibrosis and responders to a potential antifibrotic therapy. Am J Physiol Gastrointest Liver Physiol 311:G1009–G1017PubMedCrossRef Karsdal MA, Henriksen K, Nielsen MJ et al (2016) Fibrogenesis assessed by serological type III collagen formation identifies patients with progressive liver fibrosis and responders to a potential antifibrotic therapy. Am J Physiol Gastrointest Liver Physiol 311:G1009–G1017PubMedCrossRef
Zurück zum Zitat Kleiner DE, Brunt EM, Van Natta M et al (2005) Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology 41:1313–1321 PubMedCrossRef Kleiner DE, Brunt EM, Van Natta M et al (2005) Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology 41:1313–1321 PubMedCrossRef
Zurück zum Zitat Ku NO, Strnad P, Bantel H et al (2016) Keratins: biomarkers and modulators of apoptotic and necrotic cell death in the liver. Hepatology 64:966–976PubMedCrossRef Ku NO, Strnad P, Bantel H et al (2016) Keratins: biomarkers and modulators of apoptotic and necrotic cell death in the liver. Hepatology 64:966–976PubMedCrossRef
Zurück zum Zitat Labenz C, Huber Y, Kalliga E et al (2018) Predictors of advanced fibrosis in non-cirrhotic non-alcoholic fatty liver disease in Germany. Aliment Pharmacol Ther 48:1109–1116PubMedCrossRef Labenz C, Huber Y, Kalliga E et al (2018) Predictors of advanced fibrosis in non-cirrhotic non-alcoholic fatty liver disease in Germany. Aliment Pharmacol Ther 48:1109–1116PubMedCrossRef
Zurück zum Zitat Leers MP, Kölgen W, Björklund V et al (1999) Immunocytochemical detection and mapping of a cytokeratin 18 neo-epitope exposed during early apoptosis. J Pathol 187:567–572PubMedCrossRef Leers MP, Kölgen W, Björklund V et al (1999) Immunocytochemical detection and mapping of a cytokeratin 18 neo-epitope exposed during early apoptosis. J Pathol 187:567–572PubMedCrossRef
Zurück zum Zitat Liebig S, Stoeckmann N, Geier A et al (2019) Multicenter validation study of a diagnostic algorithm to detect NASH and fibrosis in NAFLD patients with low NAFLD fibrosis score or liver stiffness. Clin Transl Gastroenterol 10(8):e00066PubMedPubMedCentralCrossRef Liebig S, Stoeckmann N, Geier A et al (2019) Multicenter validation study of a diagnostic algorithm to detect NASH and fibrosis in NAFLD patients with low NAFLD fibrosis score or liver stiffness. Clin Transl Gastroenterol 10(8):e00066PubMedPubMedCentralCrossRef
Zurück zum Zitat Machado MV, Cortez-Pinto H (2013) Non-invasive diagnosis of non-alcoholic fatty liver disease. A Critical Appraisal. J Hepatol 58:1007–1019PubMed Machado MV, Cortez-Pinto H (2013) Non-invasive diagnosis of non-alcoholic fatty liver disease. A Critical Appraisal. J Hepatol 58:1007–1019PubMed
Zurück zum Zitat Mofrad P, Contos MJ, Haque M et al (2003) Clinical and histologic spectrum of nonalcoholic fatty liver disease associated with normal ALT values. Hepatology 37:1286–1292PubMedCrossRef Mofrad P, Contos MJ, Haque M et al (2003) Clinical and histologic spectrum of nonalcoholic fatty liver disease associated with normal ALT values. Hepatology 37:1286–1292PubMedCrossRef
Zurück zum Zitat Musso G, Gambino R, Cassader M et al (2011) Meta-analysis: natural history of non-alcoholic fatty liver disease (NAFLD) and diagnostic accuracy of non-invasive tests for liver disease severity. Ann Med 43:617–649PubMedCrossRef Musso G, Gambino R, Cassader M et al (2011) Meta-analysis: natural history of non-alcoholic fatty liver disease (NAFLD) and diagnostic accuracy of non-invasive tests for liver disease severity. Ann Med 43:617–649PubMedCrossRef
Zurück zum Zitat Ong JP, Pitts A, Younossi ZM (2008) Increased overall mortality and liver-related mortality in non-alcoholic fatty liver disease. J Hepatol 49:608–612PubMedCrossRef Ong JP, Pitts A, Younossi ZM (2008) Increased overall mortality and liver-related mortality in non-alcoholic fatty liver disease. J Hepatol 49:608–612PubMedCrossRef
Zurück zum Zitat Palekar NA, Naus R, Larson SP et al (2006) Clinical model for distinguishing nonalcoholic steatohepatitis from simple steatosis in patients with nonalcoholic fatty liver disease. Liver Int 26:151–156PubMedCrossRef Palekar NA, Naus R, Larson SP et al (2006) Clinical model for distinguishing nonalcoholic steatohepatitis from simple steatosis in patients with nonalcoholic fatty liver disease. Liver Int 26:151–156PubMedCrossRef
Zurück zum Zitat Petta S, Vanni E, Bugianesi E et al (2015) The combination of liver stiffness measurement and NAFLD fibrosis score improves the noninvasive diagnostic accuracy for severe liver fibrosis in patients with nonalcoholic fatty liver disease. Liver Int 35:1566–1573PubMedCrossRef Petta S, Vanni E, Bugianesi E et al (2015) The combination of liver stiffness measurement and NAFLD fibrosis score improves the noninvasive diagnostic accuracy for severe liver fibrosis in patients with nonalcoholic fatty liver disease. Liver Int 35:1566–1573PubMedCrossRef
Zurück zum Zitat Poynard T, Ratziu V, Charlotte F et al (2006) Diagnostic value of biochemical markers (NashTest) for the prediction of non alcoholo steato hepatitis in patients with non-alcoholic fatty liver disease. BMC Gastroenterol 6:34PubMedPubMedCentralCrossRef Poynard T, Ratziu V, Charlotte F et al (2006) Diagnostic value of biochemical markers (NashTest) for the prediction of non alcoholo steato hepatitis in patients with non-alcoholic fatty liver disease. BMC Gastroenterol 6:34PubMedPubMedCentralCrossRef
Zurück zum Zitat Roeb E, Steffen HM, Bantel H et al (2015) S2K guideline non-alcoholic fatty liver disease. Z Gastroenterol 53:668–723PubMedCrossRef Roeb E, Steffen HM, Bantel H et al (2015) S2K guideline non-alcoholic fatty liver disease. Z Gastroenterol 53:668–723PubMedCrossRef
Zurück zum Zitat Schuppan D, Surabattula R, Wang XY (2018) Determinants of fibrosis progression and regression in NASH. J Hepatol 68:238–250PubMedCrossRef Schuppan D, Surabattula R, Wang XY (2018) Determinants of fibrosis progression and regression in NASH. J Hepatol 68:238–250PubMedCrossRef
Zurück zum Zitat Shen J, Chan HL, Wong GL et al (2012) Assessment of non-alcoholic fatty liver disease using serum total cell death and apoptosis markers. Aliment Pharmacol Ther 36:1057–1066PubMedCrossRef Shen J, Chan HL, Wong GL et al (2012) Assessment of non-alcoholic fatty liver disease using serum total cell death and apoptosis markers. Aliment Pharmacol Ther 36:1057–1066PubMedCrossRef
Zurück zum Zitat Sumida Y, Yoneda M, Hyogo H et al (2011) A simple clinical scoring system using ferritin, fasting insulin, and type IV collagen 7S for predicting steatohepatitis in nonalcoholic fatty liver disease. J Gastroenterol 46:257–268PubMedCrossRef Sumida Y, Yoneda M, Hyogo H et al (2011) A simple clinical scoring system using ferritin, fasting insulin, and type IV collagen 7S for predicting steatohepatitis in nonalcoholic fatty liver disease. J Gastroenterol 46:257–268PubMedCrossRef
Zurück zum Zitat Tsutsui M, Tanaka N, Kawakubo M et al (2010) Serum fragmented cytokeratin 18 levels reflect the histologic activity score of nonalcoholic fatty liver disease more accurately than serum alanine aminotransferase levels. J Clin Gastroenterol 44:440–447PubMedCrossRef Tsutsui M, Tanaka N, Kawakubo M et al (2010) Serum fragmented cytokeratin 18 levels reflect the histologic activity score of nonalcoholic fatty liver disease more accurately than serum alanine aminotransferase levels. J Clin Gastroenterol 44:440–447PubMedCrossRef
Zurück zum Zitat Vuppalanchi R, Jain AK, Deppe R et al (2014) Relationship between changes in serum levels of keratin 18 and changes in liver histology in children and adults with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol 12:2121–2130PubMedPubMedCentralCrossRef Vuppalanchi R, Jain AK, Deppe R et al (2014) Relationship between changes in serum levels of keratin 18 and changes in liver histology in children and adults with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol 12:2121–2130PubMedPubMedCentralCrossRef
Zurück zum Zitat Wong VW, Vergniol J, Wong GL et al (2010) Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease. Hepatology 51:454–462PubMedCrossRef Wong VW, Vergniol J, Wong GL et al (2010) Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease. Hepatology 51:454–462PubMedCrossRef
Zurück zum Zitat Wong VW, Vergniol J, Wong GL et al (2012) Liver stiffness measurement using XL probe in patients with nonalcoholic fatty liver disease. Am J Gastroenterol 107:1862–1871PubMedCrossRef Wong VW, Vergniol J, Wong GL et al (2012) Liver stiffness measurement using XL probe in patients with nonalcoholic fatty liver disease. Am J Gastroenterol 107:1862–1871PubMedCrossRef
Zurück zum Zitat Younes R, Rosso C, Petta S et al (2018) Usefulness of the index of NASH – ION for the diagnosis of steatohepatitis in patients with non-alcoholic fatty liver: An external validation study. Liver Int 38:715–723PubMedCrossRef Younes R, Rosso C, Petta S et al (2018) Usefulness of the index of NASH – ION for the diagnosis of steatohepatitis in patients with non-alcoholic fatty liver: An external validation study. Liver Int 38:715–723PubMedCrossRef
Metadaten
Titel
Diagnostik: Blutbasierte Marker
verfasst von
Heike Bantel
Matthias J. Bahr
Copyright-Jahr
2022
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-62484-5_14

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