Serum levels of endotrophin are associated with nonalcoholic steatohepatitis

Background and aims There are no currently available biomarkers that can accurately indicate the presence of non-alcoholic steatohepatitis (NASH). We investigated the association between endotrophin, a cleavage product of collagen type 6 alpha 3, and disease severity in patients with non-alcoholic fatty liver disease (NAFLD). Methods We measured serum endotrophin levels in 211 patients with NAFLD and nine healthy controls. Liver biopsy data was available for 141 (67%) of the patients. Associations between endotrophin and the presence of NASH and advanced fibrosis were investigated alone and in combination with standard clinical parameters using logistic regression. Results A total of 211 patients were enrolled in this study, consisting of 108 (51%) men and 103 (49%) women with a mean age of 55.6 years. 58 (27%) of the patients had advanced fibrosis. Of those with biopsy data, 87 (62%) had NASH. Serum levels of endotrophin were significantly higher in patients with NAFLD than those in healthy controls (37[+/- 12] vs. 17[+/- 7] ng/mL, p<.001). Serum levels of endotrophin were also significantly higher in patients with NASH than in those without NASH (40[+/- 12] vs. 32[+/- 13] ng/mL, p<.001). A model using age, sex, body mass index and levels of alanine aminotransferase (ALT), glucose and endotrophin effectively predicted the presence of NASH in a derivation (AUROC 0.83, 95%CI = 0.74-0.92) and validation cohort (AUROC 0.71, 95%CI = 0.54-0.88). There was no significant association between serum levels of endotrophin and advanced fibrosis. Conclusions These data suggest that serum endotrophin could be a valuable biomarker for diagnosing NASH, but not for detecting advanced fibrosis in NAFLD.

Automated summary

The study suggests that serum endotrophin could be a valuable biomarker for diagnosing NASH in patients with NAFLD, but it is not significantly associated with detecting advanced fibrosis.