Liver Fatty Acid-Binding Protein as a Diagnostic Marker for Non-Alcoholic Fatty Liver Disease

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as NAFLD,  is the most common cause of chronic liver disease in the developed world. It represents a spectrum of diseases starting from metabolic dysfunction to cirrhosis and hepatocellular carcinoma. Liver biopsy remains the gold standard for diagnosis of MASLD. However, liver biopsy has significant limitations, including pain, risk of severe complications, sampling error, cost and patient unwillingness to undergo invasive testing. Therefore, it is preferable to use effective noninvasive methods in clinical practice for identifying the disease, tracking its processes, and monitoring treatment effects. Aim of the Work: The aim of the current study was to investigate the diagnostic value of Liver Fatty Acid-Binding Protein (L-FABP) as a noninvasive marker for  metabolic-dysfunction associated steatotic liver disease (MASLD). Patients and Methods: We enrolled in this study 80 consecutive MASLD patients presented to the GIT clinic and internal medicine clinic at Ain Shams University Hospitals between November 2021 and November 2022. Patients were diagnosed with ultrasonography and elastography. The control group consisted of 20 healthy control subjects matched for age and gender. Serum levels of L-FABP were determined by enzyme-linked immunosorbent assay. L-FABP was measured in patients and controls as well as laboratory and imaging modalities for diagnosis. Results: L-FABP levels in MASLD patients were higher than in the control group. According to ROC curve analysis, we have found that LFABP was diagnostic of  MASLD at a Cutoff value >145 ng/L with sensitivity of 88.7%, specificity of 85%, PPV of 95.9, NPV of 65.4 and Accuracy of 90.7%. Conclusion: Serum L-FABP could be considered as a reliable non-invasive marker for detection of MASLD with a significant positive correlation between its serum level and degree of steatosis and fibrosis.