SERUM CYTOKERATIN-18 AS A NON-INVASIVE BIOMARKER IN NON-ALCOHOLIC FATTY LIVER DISEASE DIAGNOSIS

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is a growing global health concern, encompassing a spectrum from simple steatosis to non-alcoholic steatohepatitis (NASH), which may progress to fibrosis, cirrhosis, and hepatocellular carcinoma. Accurate, non-invasive tools are essential for distinguishing NASH from simple steatosis, as early identification significantly impacts clinical outcomes.

Methods: The study included 60 diagnosed cases of NAFLD, including 31 patients with Fatty liver and 29 patients with NASH.  Blood samples were collected at admission, and Serum liver function tests were measured. Serum cytokeratin-18 levels were measured using a sandwich enzyme-linked immunosorbent assay (ELISA).

Result: Serum CK-18 levels were significantly higher in the NASH group (mean = 204.85 ± 32.98 U/L) compared to the fatty liver group (mean = 173.97 ± 23.75 U/L), with a statistically significant difference (P < 0.001). Receiver operating characteristic (ROC) curve analysis demonstrated that serum CK-18 is a fair discriminatory marker for distinguishing NASH from simple fatty liver, with an area under the curve (AUC) of 0.775 (P < 0.0001). The optimal cutoff value identified was 198 U/L, yielding a sensitivity of 65.52% and a specificity of 83.87%.

Conclusion: Serum CK-18 levels can discriminate NASH from fatty liver in  NAFLD, its role as a supporting biomarker for disease severity. These findings support the diagnostic utility of CK-18 in clinical assessment of NAFLD, particularly in distinguishing NASH from simple steatosis.