ArticlePloS one2015
Combined Serum Biomarkers in Non-Invasive Diagnosis of Non-Alcoholic Steatohepatitis.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 3 of them syntheses that pooled it.
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Who cites it
38 citing papers in PubMed, 3 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- Circulating Fibroblast Growth Factor-21 in Patients with Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis.Current obesity reports · 2025Pooled it
- Pooled it
- Diagnostic Value of CK-18, FGF-21, and Related Biomarker Panel in Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis.BioMed research international · 2017Pooled it
- Ultrasound/Elastography techniques, lipidomic and blood markers compared to Magnetic Resonance Imaging in non-alcoholic fatty liver disease adults.International journal of medical sciences · 2019Trial
- Fibroblast growth factor 21 decreases after liver fat reduction via growth hormone augmentation.Growth hormone & IGF research : official journal of the Growth Hormone Research Society and the International IGF Research Society · 2017Trial
- Exploratory analysis of serum FGF-21 and CK-18 as biomarkers for ultrasound-detected MASLD in type 2 diabetes mellitus: a UAE multicenter study.Translational gastroenterology and hepatology · 2026Article
- Review
- The hepatocellular model of fatty liver disease: from current imaging diagnostics to innovative proteomics technologies.Frontiers in medicine · 2025Review
- Osteokines in Nonalcoholic Fatty Liver Disease.Current obesity reports · 2024Review
- Positron emission tomography combined with serum biomarkers detects fibrotic MASH.Scientific reports · 2024Article
- The gut-liver axis calibrates PEDF production for ISC homeostasis.Biophysics reports · 2024Article
- Article
- Article
- Osteoprotegerin/Receptor Activator of Nuclear Factor-Kappa B Ligand/Receptor Activator of Nuclear Factor-Kappa B Axis in Obesity, Type 2 Diabetes Mellitus, and Nonalcoholic Fatty Liver Disease.Current obesity reports · 2023Review
- Osteoprotegerin deficiency aggravates methionine-choline-deficient diet-induced nonalcoholic steatohepatitis in mice.Scientific reports · 2023Article
- Exploring the Validity of Available Markers and Indices in the Diagnosis of Nonalcoholic Fatty Liver Disease (NAFLD) in People with Type 2 Diabetes in Saudi Arabia.Diseases (Basel, Switzerland) · 2023Article
- Dysregulated peripheral proteome reveals NASH-specific signatures identifying patient subgroups with distinct liver biology.Frontiers in immunology · 2023Article
- Fibroblast Growth Factor-21 as a Potential Therapeutic Target of Nonalcoholic Fatty Liver Disease.Therapeutics and clinical risk management · 2023Review
- Fibroblast growth factor 21 levels and liver inflammatory biomarkers in obese subjects after weight loss.Archives of medical science : AMS · 2022Article
- Leukocyte cell-derived chemotaxin-2 and fibroblast growth factor 21 in alcohol-induced liver cirrhosis.World journal of hepatology · 2021Article
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNon-alcoholic steatoheaptitis (NASH), the critical stage of non-alcoholic fatty liver disease (NAFLD), is of chronic progression and can develop cirrhosis even hepatocellular carcinoma (HCC). However, non-invasive biomarkers for NASH diagnosis remain poorly applied in clinical practice. Our study aims at testing the accuracy of the combination of cytokeratin-18 M30 fragment (CK-18-M30), fibroblast growth factor 21 (FGF-21), interleukin 1 receptor antagonist (IL-1Ra), pigment epithelium-derived factor (PEDF) and osteoprotegerin (OPG) in diagnosing NAFLD and NASH.
methods179 patients with biopsy-proven NAFLD were enrolled as training group, 91 age- and gender-matched healthy subjects were recruited at the same time as controls. 63 other NAFLD patients were separately collected as validation group. 45 alcoholic fatty liver disease (AFLD) patients, 50 hepatitis B virus (HBV) patients, 52 hepatitis C virus (HCV) patients were also included. Serum biomarker levels were measured by enzyme-linked immunosorbent assay.
resultsSerum levels of CK-18-M30, FGF-21, IL-1Ra and PEDF increased, while OPG decreased in a stepwise fashion in controls, non-NASH NAFLD patients and NASH patients (P < 0.01). The area under receiver-operating characteristics curve to diagnose NASH was 0.86 for CK-18-M30, 0.89 for FGF-21, 0.89 for IL-1Ra, 0.89 for PEDF and 0.89 for OPG. CK-18-M30 had 70% negative predictive value (NPV) and 79% positive predictive value (PPV) to diagnose NASH. A 5-step approach measuring CK-18-M30 followed by FGF21, IL-1Ra, PEDF and OPG gradually improved the NPV to 76% and PPV to 85%, which reached 80% and 76% respectively in the validation cohort.
conclusionCompared to single biomarker, stepwise combination of CK-18-M30, FGF-21, IL-1Ra, PEDF and OPG can further improve the accuracy in diagnosing NASH.
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