《Table 4 Dysbiosis in human non-alcoholic fatty liver disease/non-alcoholic steatohepatitis》

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《"Current status, problems, and perspectives of non-alcoholic fatty liver disease research"》

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NAFLD:Non-alcoholic fatty liver disease；NASH:Non-alcoholic steatohepatitis.

Evaluation of liver fibrosis:Considering recent trends，the need for less invasive，more accurate methods of assessing liver fibrosis has produced several potential fibrosis indicators.Platelet count and serum levels of hyaluronic acid，type 4 collagen7S，Mac2-binding protein，and autotaxin are promising biomarkers that predict advanced fibrosis（Table 1）[58-63].Although those single indicators are simple，convenient，and useful for busy clinicians，it should be emphasized that results may be influenced by underlying conditions，such as co-existing collagen disease，systemic inflammation，and renal dysfunction.NAFLD fibrosis score，AST-to-platelet ratio index（APRI），FIB-4 index，BARD，CA index，ELF，and FibroTest have also been proposed as indices to predict advanced fibrosis in NAFLD patients（Table 2）[64-71].ELF and FibroTest use direct markers of collagen synthesis and degradation，but such measurements are uncommon in clinical situations.In contrast，NAFLD fibrosis score，APRI，and FIB-4 exploit the biochemical test components of age，AST，ALT，glucose，BMI，platelets and albumin，all of which are routinely obtained in clinical practice.However，the scores of these indices tend to be increased in the elderly，and it is also unclear whether changes in AST，ALT，and BMI are correlated with the degree of actual fibrosis.For more global applicability，the cut-off values of single biomarkers and panels will require optimization according to country，race，sex，age，and other factors.