The validity of serum autotaxin as a predictor of hepatic fibrosis in patients with nonalcoholic fatty liver disease

Background and aim Nonalcoholic fatty liver disease (NAFLD) involves a spectrum of liver disorders, ranging from benign steatosis to nonalcoholic steato-hepatitis to fibrosis and cirrhosis. This study aims to evaluate the diagnostic validity of using s.autotaxin (ATX) as a noninvasive bio-marker of fibrosis in NAFLD cases as compared with Controlled Attenuation Parameter and scoring systems of hepatic steatosis. Patients and methods This cross-sectional study was performed at Al-Azhar University Hospitals and Assiut Liver Center, conducted on 100 adult men and women patients who showed evidence of fatty liver disease between September 2020 and March 2021. Results There were 66 patients without fibrosis (group I) and 34 patients with fibrosis [group II] with significant change between the two groups regarding NAFLD fibrosis score [P=0.002] and grade of fibrosis by fibroscan (P< 0.001) but nonsignificant as regard FIB4 score, BARD score, and Steatosis. The mean ATX level in NAFLD cases was 81.37±14.56 ng/ml. It was noticed that patients with fibrosis showed higher ATX levelsl in comparison with cases with no fibrosis (P= 0.027). Regarding lab data, higher cholesterol, low-density lipoproteins, lower high-density lipoproteins level, and triglycerides levels were in males (P< 0.05) with nonsignificant change regarding fasting glucose, hemoglobin A1C, AST, ALT, AST/ALT ratio, Albumin, HB, white blood cell, and Platelet (P0.05). Conclusion ATX showed poor validity in the prediction of hepatic fibrosis in cases with NAFLD disease, there was a statistically significant increase prevalence of hypertension among females compared with males, an important change was found among males and females regarding NAFLD fibrosis-score, and grade of fibrosis by fibro-scan. Keywords: autotaxin, fatty liver disease, fibrosis score, hepatic steatosis, nonalcoholic steato-hepatitis, validity