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Non-invasive tests for NAFLD are unreliable in South Asians

Non-invasive tests for NAFLD are unreliable in South Asians
Last Updated: 2017-12-27
By Lorraine L. Janeczko

NEW YORK (Reuters Health) - Blood-test-based non-invasive tests for non-alcoholic fatty liver disease (NAFLD) are unreliable alternatives to liver biopsy in South Asians, new research suggests.

Non-invasive liver tests (NILTs) include those based on biomarkers or on clinical and laboratory data such as NAFLD fibrosis score (NFS); Fibrosis-4 (Fib-4); BMI, AST/ALT ratio, diabetes (BARD); aspartate transaminase (AST)-to-platelet ratio index (APRI); and the AST/alanine transaminase (ALT) ratio, researchers note in Frontline Gastroenterology, online November 16.

Dr. Syn cautioned, "Because the sensitivity of these commonly used tests is lower in patients of South Asian ethnicity, it suggests that a significant number of South Asian patients may be inappropriately reassured that they do not have advanced disease. As with any clinical test, there is a danger that, if a test is applied or interpreted inappropriately, wrong decisions can be made and harm may ultimately come to a patient."

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Liver Research
Non-invasive markers of liver fibrosis in fatty liver disease are unreliable in people of South Asian descent

Sampath De Silva1, Wenhao Li1, Polychronis Kemos1, James H Brindley1, Jibran Mecci1, Salma Samsuddin1, Joanne Chin-Aleong2, Roger M Feakins2, Graham R Foster1, Wing-Kin Syn1,3,4, William Alazawi1

Abstract

Objective

Liver biopsy is the most accurate method for determining stage and grade of injury in non-alcoholic fatty liver disease (NAFLD). Given risks and limitations of biopsy, non-invasive tests such as NAFLD fibrosis score, aspartate transaminase (AST) to platelet ratio index, Fib-4, AST/alanine transaminase ratio and BARD are used. Prevalence and severity of NAFLD and metabolic syndrome vary by ethnicity, yet tests have been developed in largely white populations. We tested our hypothesis that non-invasive tests that include metabolic parameters are less accurate in South Asian compared with white patients.

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