SERUM TYPE IV COLLAGEN: A MARKER TO DETECT NON - ALCOHOLIC STEATO HEPATITIS (NASH), AMONG TYPE II DIABETES MELLITUS PATIENTS HAVING NON - ALCOHOLIC FATTY LIVER DISEASE (NAFLD).

Surapaneni Krishna Mohan1, Subramaniam S2, Shyama Subramaniam2

1 Department of Biochemistry, Saveetha Medical College & Hospital, Saveetha University, Chennai - 600 077, T.N, INDIA, 2 Department of Biochemistry, Apollo Hospitals, Chennai, T.N, INDIA.

Introduction : Non-Alcoholic Fatty Liver Disease (NAFLD) covers a spectrum of liver diseases from simple fatty infiltration to progressive fibrosis. Non-Alcoholic Steato Hepatitis (NASH) can lead to cirrhosis and hepato cellular carcinoma,both events that ultimately lead to early death.It is becoming the leading cause for referral to liver clinics in most areas.The prevalence of NAFLD in Indian population is estimated around 7 – 13%. The prevalence of NAFLD will likely continue to rise. Obesity, hyperglycemia, Type-II diabetes mellitus and hypertriglyceridemia are most important risk factors. In India high prevalence of Type-II diabetes mellitus is common. The prevalence of NAFLD is higher in type II diabetes mellitus.

Aim : To evaluate the Type-IV collagen – NASH test, a new bio marker for Non- Alcoholic Steato Hepatitis in patients with NAFLD.

Materials & Methods : 40 patients with NAFLD with out Type-II diabetes mellitus, 40 patients of NAFLD with Type-II diabetes mellitus and age & sex matched 47 normal healthy individuals as controls were selected for this study. Levels of serum Type-IV collagen, Electrophoretic separation of collagen, lipid profile and liver function test parameters were estimated in patients and compared to controls.

Results : Type – IV collagen levels were significantly increased in patients with NASH among the NAFLD patients compared to controls. Significantly higher levels of type-IV collagen are observed in patients with type-II diabetes mellitus when compared to the NAFLD patients without type-II diabetes mellitus. When compared to liver function test parameters and lipid profile levels, type-IV collagen has got positive negative predictive value among the NAFLD patients.

Conclusion : In patients with NAFLD, Type – IV collagen test, a simple and non – invasive and reliable to predict the presence or absence of NASH.

Keywords : Type – IV Collagen, Non-Alcoholic Fatty Liver Disease (NAFLD), Non-Alcoholic Steato Hepatitis (NASH), Type-II Diabetes Mellitus.

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