this answer can be found in the article of
Biochemical Biomarkers of NAFLD/NASH 2020
Liver biopsy is the gold standard for differentiating between NAFLD and NASH
Non alcoholic Fatty liver disease (NAFLD) means fat builds up in the liver, but with little to no inflammation or liver damage, while non alcoholic steatohepatitis (NASH) is a more serious form of fatty liver disease, where there is more severe liver damage or scarring known as cirrhosis.
Liver biopsy remains the standard in differentiating between them, however, it's invasive. Recently, some serum biomarkers including CK-18, FGF-21, and combined biomarker panel (CBP) are "hot" in liver research in the diagnosis of NAFLD, especially NASH, as they aren't invasive. They aren't recommended in guideline yet.
Tests may include blood tests, imaging tests, and sometimes liver biopsy.
The best test for separate both entities is to find the presence of inflammation and fibrosis in several degrees by the liver biopsy
Liver biopsy is the gold standard to differentiate between nafl and nash, but with some caveats. Transaminitis may help but not specific. CK 18 may help with good specificity
There is no one specific test. But the most objective is the liver biopsy
Liver biopsy is very necessary, but the use of non-invasive measures it is also convenient
Hello,
CK18, It is no better than ALT,
so no specific test
Sincerely,
The specificity of a test refers to how well a test identifies patients who do not have a disease. In the context of the question posed: it is necessary to identify patients with steatosis (NAFLD), excluding steatohepatitis (NASH) and the key difference is hepatitis. Thus, specific tests are tests indicating the presence of hepatitis.
Non-invasive tests include shear wave elastography, MRI elastography, ELF panel, APRI score, FIB4 and the NFS score etc.
Invasive test is the liver biopsy and is rarely required