Multimarker strategies for detecting NASH and NASH-related fibrosis: promises and caveats.

摘要

We read with great interest the recent article by Younossi et al. [1] who developed a new biomarker panel for the diagnosis of nonalcoholic steatohepatitis (NASH) and to stage NASH-related fibrosis. The authors identified a model for predicting NASH and NASH-related fibrosis that included diabetes, sex, BMI, triglycerides, and two bio-markers of cell death (M30 and M65). The model for identifying NASH-related advanced fibrosis incuded diabetes, serum triglycerides, aspartate aminotransferase (AST), and tissue inhibitor of metalloproteinase-1 (TIMP1) [1], an important regulator of collagen degradation.The authors are to be congratulated for this timely, thought-provoking, and challenging study. Obviously, a single biomarker for detecting NASH and NASH-related fibrosis has an inherent specificity and sensitivity that cannot be improved, while multiple biomarkers can be combined to achieve improved clinical performances [2].