Assessment of Pro Collagen III as Non Invasive Biomarker for Diagnosis of Non Alcoholic Steatohepatitis

Abstract Background Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease worldwide. NAFLD is considered to represent the hepatic manifestation of metabolic syndrome. NAFLD was traditionally considered as a relatively benign liver disease. However, some patients with NAFLD progress to liver fibrosis, cirrhosis and hepatocellular carcinoma. Therefore, the precise diagnosis and staging of NAFLD patients is clinically important. Liver biopsy is the current gold standard in diagnosis and prognosis. Because of poor patient acceptance of this invasive standard technique and Significant sampling variability of routine liver biopsy in patients with NAFLD, there is an urgent need for reliable, accurate, and non- or minimally invasive biomarker. Aim of the Work Assess the performance of Pro Collagen III As a NASH-Fibrosis biomarker within the best diagnostic context of use in comparison with FIB-4 Patients and Methods this study is a Case control study. Gastroenterology and Hepatology outpatient clinic at Damas centre for liver and GIT. 6 months from August 2022 to January 2023. This study will be performed on 56 Egyptian patients who are ≥18years of age and are overweight with Body Mass Index ≥ 25 and diagnosed with NAFLD by US. Results As regard age; there is no significant difference between NAFL and NASH groups. As regard sex; there is no significant difference between NAFL and NASH groups. The mean BMI was significant higher in NASH group than NAFLD group. Patients with NASH have relatively low platelet count in comparison with NAFLD patients. Patients with NASH has Higher AST & ALT levels than NAFLD patients. FIB-4 was higher in NASH group than NAFLD group. Pro Collagen III level was higher in patients with NASH than Patients with NAFLD. Pro Collagen III was a significant discriminator of NAFLD & NASH. Pro Collagen III correlates with the grades of histological steatohepatitis, and stage of fibrosis. Pro Collagen III can diagnose steatohepatitis at cut-off 9.57 with sensitivity & specificity was 92.9 & 92.9 respectively. Conclusion Pro Collagen III is a sensitive biomarker to discriminate between NAFLD & NASH. Pro Collagen III level correlate positively with BMI, AST & ALT. Pro Collagen III level correlate with grades of histological steatohepatitis, and grades of fibrosis.