Our study aims at testing the accuracy of cytokeratin-18 (CK-18) fragment, fibroblast hypoxia-inducible factor cancer growth factor 21 (FGF21), interleukin 1 receptor antagonist (IL-1 Ra), Pigment epithelium-derived factor (PEDF) and osteoprotegerin (OPG) for the diagnosis of NAFLD and NASH. Methods: 98 patients with biopsy-proven

NAFLD and 43 age- and gender-matched healthy controls without evidence of liver disease were included. Serum CK-18, FGF21, IL-1 Ra, PEDF and OPG levels were measured by enzyme-linked immunosorbent assay. Results: The levels of Serum CK-18, FGF21, and IL-1 Ra increased in a stepwise fashion control subjects (median 7.52 ng/L, 12.65 ng/L, 39.68 ng/L), non-NASH NAFLD patients (13.12 ng/L, 32.03 ng/L, 99.36 ng/L) and NASH patients (29.11 ng/L, 62.92 ng/L, 239.36 ng/L) (p<0.01). The concentration of PEDF and OPG decreased successively from NASH patients (median 16.78 ug/L, 139.57 ng/L), to non-NASH NAFLD patients (38.42 ug/L, 373.90 ng/L) and to controls (49.50 ug/L, 516.98 ng/L, respectively) (P < 0.01). In the diagnosis of NASH, the 5 serum biomarkers all displayed statistical significance(p<0.01). Among them, only OPG could differentiate

simple fatty liver from control group (P=0.011), and only PEDF can differentiate borderline NASH from other groups (p<0.05). Cobimetinib purchase The area under receiver-operating characteristics curve to diagnose NASH was 0.86 for CK-18, 0.81 for FGF21, 0.92 for IL-1 Ra, 0.90 for PEDF and 0.94 for OPG. At cut-off of 171.79ng/L, the negative predictive value (NPV) for NASH of IL-1 Ra was 82.16% and positive

predictive value (PPV) was 83.22%. The use of a cut-off level was defined as 28.15ug/L for serum PEDF levels yielded sensitivity and specificity values of 87.9% and 94.9%, respectively. When the cut-off was defined as 242.96 ng/L for OPG, the sensitivity, specificity, PPV and NPV were 93.26%, 97.4%, 92.35% and 97.96%, respectively. We also obtained a predictive model of NASH using regression analysis: logitP=22.1 178-0.0413OPG+0.0159CK-18+0.0212FGF21-0.053PEDF (P < 0.05). Conclusion: CK-18, FGF21, IL-1 Ra, PEDF and OPG may serve as noninvasive biomarkers combination to identify NASH patients. PEDF and OPG may be the indicators of the development of NAFLD. The NASH prediction model can be an innovation selleck chemicals in the prediction and diagnosis of NASH. Disclosures: The following people have nothing to disclose: Jingmin Zhao, Mei Yang, Fangli Zhang, Wenshu Li, Jin Li, Jiyun Lv Background and Aim: Previous studies have reported that hypothyroidism may play a role in the development of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). However, data have frequently been inconsistent due to small sample size and/or lack of liver histopathology. The aim of this study was to assess the role of hypothyroidism in NAFLD. Methods: We measured in 253 patients (51±1 years, 66% male, 33.2±0.