Background and Aims: Plasma aldo-keto reductase family 1 member B10 (AKR1B10) well reflects the progression of NAFLD. Thus, we aimed to evaluate whether composite blood biomarkers including AKR1B10 and cytokeratin 18 (CK-18) have acceptable for the diagnosis NASH, advanced liver fibrosis, and high-risk NASH (NASH + significant fibrosis), respectively.
Methods: A total of 116 subjects in our pooled cohort (24 healthy controls and 92 patients with biopsy-proven NAFLD (48 patients with NAFL and 44 patients with NASH) were analysed to assess composite blood-based and imaging-based biomarkers, which included the markers below either singly or in combination: AKR1B10, CK-18, AST, ALT, enhanced liver fibrosis (ELF) score, FIB-4, proton density fat fraction (MRI-PDFF), MR elastography-liver stiffness measurement (MRE-LSM), and the known MRI-AST (MAST) and FibroScan-AST (FAST) scores
Results: Composite blood biomarker comprised of AKR1B10, CK-18, AST, and ALT showed excellent performance for the diagnosis of, NASH, advanced fibrosis, and high-risk NASH, with AUROC curve values of 0.934 (95% CI: 0.888-0.981), 0.902 (95% CI 0.832-0.971) and 0.918 (95% CI 0.862-0.974), respectively. However, the performances of this blood composite biomarker were all inferior to various MR-based composite biomarkers (MRI-PDFF/MRE-LSM/ALT/AST for NASH, AUROC = 0.964; MRE-LSM + FIB-4 for advanced fibrosis, AUROC=0.982; and the MAST score for high-risk NASH, AUROC=0.947), with a better performance than the FAST score (AUROC=0.909) for the diagnosis of high-risk NASH.
Conclusion: Although slightly inferior to the MR imaging-based composite biomarkers, blood composite biomarker composed of AKR1B10, CK-18, AST, and ALT showed excellent performance in the diagnosis of progressive forms of NAFLD.
D.Lee: None.
