Hepatic
fibrosis in patients with
non-alcoholic fatty liver disease is associated with progression of the disease. In the present study, we analyzed the discriminative ability of serum
laminin,
type IV collagen and
hyaluronan levels to predict the presence of
fibrosis in these patients. In this preliminary report, we studied 30
overweight patients divided into two groups according to the absence (group I, N = 19) or presence (group II, N = 11) of
fibrosis in a liver biopsy.
Triglycerides,
aspartate aminotransferase,
alanine aminotransferase, gamma-glutamyltranspeptidade,
hyaluronan (noncompetitive fluoroassay),
type IV collagen, and
laminin (ELISA) were determined. Group II presented significantly higher mean
laminin,
hyaluronan,
type IV collagen, and
aspartate aminotransferase values, which were due to the correlation between these parameters and the stage of
fibrosis in the biopsy (Spearman's correlation coefficient, rS = 0.65, 0.62, 0.53, and 0.49, respectively). Analysis of the ROC curve showed that
laminin values >282 ng/ml were those with the best diagnostic performance, with 87% accuracy. Association of
laminin with
type IV collagen showed improvement in the positive predictive value (100%), but with reduction in diagnostic sensitivity (64%). When compared with the criteria of Ratziu et al. for the diagnosis of septal
fibrosis,
laminin values presented a better diagnostic accuracy (83 vs 70%). Determination of extracellular matrix components in serum, especially of
laminin, may identify patients with
non-alcoholic fatty liver disease and
fibrosis and these components may be used as indicators for liver biopsy in these patients.