Serum TGF-beta, serum mmp-1, and HOMA-IR as non-invasive predictors of fibrosis in Egyptian patients with NAFLD

ABSTRACT

Non-alcoholic fatty liver disease [NAFLD] is an increasingly prevalent cause of chronic liver disease worldwide. A number of these patients progress to nonalcoholic steatohepatitis [NASH] which carries significant morbidity and mortality. The aim of this study is to evaluate the diagnostic value of serum levels of transforming growth factor beta-1 [TGF- beta 1] matrix metalloproteinase-1 [MMP-1], and insulin resistance as predictors of fibrosis in Egyptian NAFLD patients. Fifty patients with NAFLD and different stages of fibrosis were studied. Serum levels of TGF- beta 1, MMP-1, and fasting serum insulin were measured; calculation of the homeostasis model assessment for insulin resistance [HOMA-IR] was done. TGF- beta 1 gives a sensitivity of 100% and specificity of 94.4% for stage 1 fibrosis, 100% and 93.9%, respectively, for stage 2 fibrosis, and 97.7% and 100%, respectively, for stage 3 fibrosis. MMP-1 showed sensitivity and specificity of 88% and 81.8%, respectively, for stage 2 fibrosis, 90.9% and 55.56%, respectively, for stage 3 fibrosis, but it is of no diagnostic value in stage 1 fibrosis. Serum TGF- beta 1, MMP-1, and insulin resistance [HOMA-IR] proved to be potentially useful noninvasive markers in predicting fibrosis in NASH patients.