Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronically elevated liver enzymes. Diagnosis and risk stratification of NAFLD remains clinically challenge as patients with NAFLD are either asymptomatic or have nonspecific presenting complaints and may have normal liver enzymes. Nonalcoholic steatohepatitis (NASH), the clinically aggressive variant of NAFLD, is also difficult to differentiate noninvasively, and a liver biopsy is required to definitively diagnose NASH. Thus, the definitive diagnosis and risk stratification of NAFLD is embedded in histological assessment of the liver. Several clinical aides been investigated in an attempt to risk stratify and identify patients noninvasively as doing a liver biopsy in all patients with NAFLD are not feasible. Since these biomarkers are unable to differentiate NASH from non-NASH, they have leveraged biochemical changes within the liver as patients progress to varying degree of hepatic fibrosis to identify patients with moderate fibrosis (fibrosis stage 2 or greater) and advanced fibrosis (fibrosis stage 3 or greater) to help guide the need for additional and more definitive workup. These clinical aides span from by-products of apoptosis to statistical modelling of clinically available data to identify 'at-risk' patients with NAFLD. The current review will focus the diagnostic performance of these noninvasive serum-based biomarkers in NAFLD.? 2020 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.
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机译：非酒精脂肪肝病（NAFLD）是慢性肝酶最常见的原因。 NAFLD的诊断和风险分层仍然是临床挑战，因为NAFLD患者无症状或具有非特异性呈递投诉，并且可能具有正常的肝酶。非酒精性脱皮肝炎（NASH），NAFLD的临床侵袭性变体也难以非侵略性地分化，并且需要肝脏活组织检查才能明确地诊断肿瘤。因此，NAFLD的明确诊断和风险分层嵌入了肝脏的组织学评估中。研究了几种临床助理试图冒险，以危险的危险，因为在所有NAFLD患者中进行肝脏活组织检查是不可行的。由于这些生物标志物无法从非纳什区分纳什，因此在患者进展到不同程度的肝纤维化时，它们可以利用肝脏内的生化变化，以确定中度纤维化（纤维化2或更高）和先进纤维化（纤维化阶段3或者更大）帮助指导需要额外的和更明确的工作。这些临床助手从副产物跨越凋亡到临床上可用数据的统计建模，以鉴定NAFLD患者的“风险”患者。目前的审查将重点关注NAFLD这些非血清基础生物标志物的诊断性能。 2020作者。 John Wiley＆Sons Ltd.出版的内分泌，糖尿病和新陈代谢
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