Correlation Between Some Biochemical Markers of Fibrosis in Nonalcoholic Fatty Liver Disease Iraqi Patients Diagnosis by Fibroscan

Abstract

Introduction: nonalcoholic fatty liver disease starts with liver fat accumulation which is a dangerous factor for disease progression. This study aimed to determine serum of galectin 3 binding protein(G3BP), serum retinol 4 binding protein(R4BP), Haptoglobin(Hp), ِalpha-2-macroglobin(A2M), apolipoprotein A1(ApoA1), gamma-glutamyl transferase(GGT), hemoglobin A1c(HbA1c), Total bilirubin, Triglyceride(TG), cholesterol, low-density lipoprotein(LDL), high-density lipoprotein (HDL), very low-density lipoprotein(VLDL), Albumin, urea, and creatinine among patients with NAFLD and healthy individuals. Method: Sixty Iraqi patients with NAFLD and thirty Iraqi healthy control were attending Gastroenterology and Hepatology Teaching Hospital/Baghdad during the period from August /2019 to March /2020. Then taken an age, gender, body mass index, and abdominal ultrasound result with other medical information. All the biochemical tests are done by Autoanalyzer, while serum G3BP, R4BP, Hp, A2M, and Apo A1 are measured by the ELISA technique. Results: The present study observed a highly significant increased (P = 0.000) in the HbA1c, Total bilirubin, G3BP, and A2M. A highly significant elevated (P = 0.001) in triglyceride, LDL, and VLDL. Besides, a highly significant decrease ( P = 0.000 ) in the HDL, Apo A1, and Haptoglobin. But, the recent study found a decrease significantly in serum albumin with the progression of fibrosis (p= 0.013 ). Also, retinol 4 binding protein in NAFLD patients raised significantly (P=0.027) with stages of fibrosis when compared with healthy control. In addition, the present study observed that positive correlations were observed with significance at P<0.01 between stages of fibrosis with cholesterol (mg/dl) and GGT (IU/L) ( r = 0.428 with P = 0.001 and r =0.790 with P = 0.000 , respectively).While highly significant and negative correlations were found between HDL ( mg/dl) ( r=0.376 with P=0.003); Haptoglobin (ng/ml) (r=0.840 with P=0.000); Apo A1 (ng/ml) (r=0. 865 with P=0.000). But, the positive significant correlation between Alpha 2 macroglobin and stages of fibrosis in NAFLD patients. Finally, no significant correlation at P>0.05 notably between Triglyceride, R4BP, and G3BP with stages of fibrosis.Conclusion: We conclude that total cholesterol, A2M, and GGT were positively correlated with the fibrosis stage. Also, showed HDL, Hpt. , and Apo A1were negatively correlated with fibrosis in NAFLD patients. Finally, we observed that older age, obesity, dyslipidemia, hypertension, and type 2 diabetes are risk factors for nonalcoholic fatty liver disease.