Reference Values of Certain Serum Indicators of Liver Fibrosis

Abstract

Background: Liver fibrosis shows a continuously increasing trend worldwide, due to alcohol abuse, obesity, and, to a lesser extent, chronic hepatitis B and C. Biopsy is still considered the "gold standard" for diagnosis of liver fibrosis. However, it has a number of limitations, such as invasiveness, high cost, need for specialists to conduct and interpret biopsy results, risk of complications, inability to dynamically monitor the pathological process, low patient compliance, and uneven fibrosis distribution. Therefore, there is an increasing demand for non-invasive serum markers that are characterized by easy implementation, low cost, possible repeatability, and high patient compliance.

Methods: For a period of two years, 82 clinically healthy, middle aged subjects, mean age 40.5 ± 12.37 years, range 21 - 67 years, were studied. The group was tested for platelet count, prothrombin time, and the following biochemical parameters: Cholesterol - total, HDL, LDL; AST; ALT; GGT; total bilirubin, alfa-2-macroglobulin; haptoglobin and ELF (Enhanced Liver Fibrosis).

Results: Reference values of a large number of serum indicators of liver fibrosis are disputable and unspecified. A direct proportional and moderate correlation was found between the BMI and AST, ALT, INR, APRI, GPRI, and Forns Index.

Conclusions: We present our original reference values for ELF, AST/ALT, ARPI, GRPI, Fib 4, and Forns Index in 82 clinically healthy subjects.