| Theme |
NASH -- Pathogenesis and Treatment |
| Title |
Scoring Systems for Diagnosis of NASH |
| Author |
Yoshio Sumida |
Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine |
| Author |
Masato Yoneda |
Division of Gastroenterology, Yokohama City University |
| Author |
Hideyuki Hyogo |
Department of Gastroenterology and Metabolism, Hiroshima University |
| Author |
Yuichiro Eguchi |
Liver Disease Control and Assistance Task Force, Saga Medical School |
| Author |
Masafumi Ono |
Department of Gastroenterology and Hepatology, Kochi Medical School |
| Author |
Takeshi Okanoue |
Saiseikai Suita Hospital |
| [ Summary ] |
Although liver biopsy is the gold standard for diagnosis of nonalcoholic steatohepatitis (NASH), it is impractical to perform liver biopsies on all nonalcoholic fatty liver disease (NAFLD) patients. Because the levels of ALT are sometimes normal, even in patients with advanced stage NASH, useful parameters should be established to detect NASH. A variety of scoring systems have been developed with the purpose of differentiating NASH from NAFL. To discriminate between various fibrosis stages in Western countries. According to a multi-institutional study by the Japan Study Group of NAFLD, NAFIC scores which are calculated on the basis of serum ferritin, fasting insulin, and type 4 collagen 7S can be useful to detect NASH in NAFLD patients. On the other hand, the FIB-4 index consisting of age, platelet count, AST, and ALT is of use to exclude advanced stage NASH in patients with not only abnormal ALT levels but also normal levels. The FIB-4 index is expected to provide parameters for large populations such as those observed in health checkups. |