Purpose: Non-alcoholic fatty liver disease (NAFLD) is at present the most common cause of chronic liver disease, ranging from steatosis, steatohepatitis, fibrosis, and cirrhosis. Apart from end-stage NAFLD, the gold standard for assessment of liver damage is a liver biopsy. The current study aims to evaluate the clinical utility of a safe, simple, highly-sensitive quantitative liver function method, the galactose single point (GSP) test in patients with NAFLD.
Methods: 168 non-diabetic subjects with a various degree of NAFLD were studied. The liver function was determined by the galactose single point (GSP) test, an assay recommended by the US FDA to quantitatively measure the residual liver function. Subjects’ fatty liver score as determined by ultrasonogram, CT scan or liver biopsy with Ishak Fibrosis score, were available in 158, 149 and 67 subjects, and serum biomarkers from all 168 subjects were available for analysis to determine the clinical utility of the GSP test.
Results: The test was safe with no complications. The functional capacity of the liver, as determined by GSP, showed good correlation with the Fatty Score as determined by ultrasonogram (r = 0.742, p < 0.005, n=158) and by computerized tomography (r = -0.819, p < 0.005, n=149). Importantly, GSP showed very tight correlation with minimal overlap when correlated with the Ishak Fibrosis score based on the biopsy result (r = 0.922, p < 0.0001, n=67). There was also correlation demonstrated with serum biomarkers including the serum biochemistry, blood glucose, and lipid profile but they were weaker correlation and also with significant overlap in results between subjects with a different range of liver diseases.
Conclusion: The GSP test is a safe, simple, and highly sensitive quantitative liver function test that correlated very well with the extent of liver damage in subjects with NAFLD. The test has the potential to replace liver biopsy in the clinical management of NAFLD and a potential new clinical management algorithm is proposed.
Ton Ho Young– Cardinal Tien Hospital, Taipei, Taiwan, ROC
Tien Yu Huang– Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
Hong Shun Tang– Cardinal Tien Hospital, Taipei, Taiwan, ROC
Hsin Tien Ho– National Defense Medical Center, Taipei, Taiwan, ROC
Ping Yang– National Defense Medical Center, Taipei, Taiwan, ROC
Johnson Yiu-Nam Lau– The Hong Kong Polytechnic University, Hong Kong
Oliver Yoa-Pu Hu– Chair Professor, Taipei Medical University, National Defense Medical Center, Taipei, Taiwan, ROC, Taipei