Accurate non-invasive diagnosis and staging of non-alcoholic fatty liver disease using the urinary steroid metabolome

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Accurate non-invasive diagnosis and staging of non-alcoholic fatty liver disease using the urinary steroid metabolome. / Moolla, Ahmad; Boer, Jasper de; Pavlov, David; Amin, Amin; Taylor, Angela; Gilligan, Lorna; Hughes, Beverly; Ryan, John; Barnes, Eleanor; Hassan-Smith, Zaki; Grove, Jane; Aithal, Guruprasad Padur; Verrijken, An; Francque, Sven; Gaal, Luc Van; Armstrong, Matthew J; Newsome, Phillip; Cobbold, Jeremy F.; Arlt, Wiebke; Biehl, Michael ; Tomlinson, Jeremy.

In: Alimentary Pharmacology & Therapeutics, 16.04.2020.

Research output: Contribution to journalArticle

Harvard

Moolla, A, Boer, JD, Pavlov, D, Amin, A, Taylor, A, Gilligan, L, Hughes, B, Ryan, J, Barnes, E, Hassan-Smith, Z, Grove, J, Aithal, GP, Verrijken, A, Francque, S, Gaal, LV, Armstrong, MJ, Newsome, P, Cobbold, JF, Arlt, W, Biehl, M & Tomlinson, J 2020, 'Accurate non-invasive diagnosis and staging of non-alcoholic fatty liver disease using the urinary steroid metabolome', Alimentary Pharmacology & Therapeutics. https://doi.org/10.1111/apt.15710

APA

Moolla, A., Boer, J. D., Pavlov, D., Amin, A., Taylor, A., Gilligan, L., Hughes, B., Ryan, J., Barnes, E., Hassan-Smith, Z., Grove, J., Aithal, G. P., Verrijken, A., Francque, S., Gaal, L. V., Armstrong, M. J., Newsome, P., Cobbold, J. F., Arlt, W., ... Tomlinson, J. (2020). Accurate non-invasive diagnosis and staging of non-alcoholic fatty liver disease using the urinary steroid metabolome. Alimentary Pharmacology & Therapeutics. https://doi.org/10.1111/apt.15710

Vancouver

Author

Moolla, Ahmad ; Boer, Jasper de ; Pavlov, David ; Amin, Amin ; Taylor, Angela ; Gilligan, Lorna ; Hughes, Beverly ; Ryan, John ; Barnes, Eleanor ; Hassan-Smith, Zaki ; Grove, Jane ; Aithal, Guruprasad Padur ; Verrijken, An ; Francque, Sven ; Gaal, Luc Van ; Armstrong, Matthew J ; Newsome, Phillip ; Cobbold, Jeremy F. ; Arlt, Wiebke ; Biehl, Michael ; Tomlinson, Jeremy. / Accurate non-invasive diagnosis and staging of non-alcoholic fatty liver disease using the urinary steroid metabolome. In: Alimentary Pharmacology & Therapeutics. 2020.

Bibtex

@article{926dcbb73abb42c79b2e9e23a07b6a8f,
title = "Accurate non-invasive diagnosis and staging of non-alcoholic fatty liver disease using the urinary steroid metabolome",
abstract = "BackgroundThe development of accurate, non‐invasive markers to diagnose and stage non‐alcoholic fatty liver disease (NAFLD) is critical to reduce the need for an invasive liver biopsy and to identify patients who are at the highest risk of hepatic and cardio‐metabolic complications. Disruption of steroid hormone metabolic pathways has been described in patients with NAFLD.Aim(s)To assess the hypothesis that assessment of the urinary steroid metabolome may provide a novel, non‐invasive biomarker strategy to stage NAFLD.MethodsWe analysed the urinary steroid metabolome in 275 subjects (121 with biopsy‐proven NAFLD, 48 with alcohol‐related cirrhosis and 106 controls), using gas chromatography‐mass spectrometry (GC‐MS) coupled with machine learning‐based Generalised Matrix Learning Vector Quantisation (GMLVQ) analysis.ResultsGeneralised Matrix Learning Vector Quantisation analysis achieved excellent separation of early (F0‐F2) from advanced (F3‐F4) fibrosis (AUC receiver operating characteristics [ROC]: 0.92 [0.91‐0.94]). Furthermore, there was near perfect separation of controls from patients with advanced fibrotic NAFLD (AUC ROC = 0.99 [0.98‐0.99]) and from those with NAFLD cirrhosis (AUC ROC = 1.0 [1.0‐1.0]). This approach was also able to distinguish patients with NAFLD cirrhosis from those with alcohol‐related cirrhosis (AUC ROC = 0.83 [0.81‐0.85]).ConclusionsUnbiased GMLVQ analysis of the urinary steroid metabolome offers excellent potential as a non‐invasive biomarker approach to stage NAFLD fibrosis as well as to screen for NAFLD. A highly sensitive and specific urinary biomarker is likely to have clinical utility both in secondary care and in the broader general population within primary care and could significantly decrease the need for liver biopsy.",
author = "Ahmad Moolla and Boer, {Jasper de} and David Pavlov and Amin Amin and Angela Taylor and Lorna Gilligan and Beverly Hughes and John Ryan and Eleanor Barnes and Zaki Hassan-Smith and Jane Grove and Aithal, {Guruprasad Padur} and An Verrijken and Sven Francque and Gaal, {Luc Van} and Armstrong, {Matthew J} and Phillip Newsome and Cobbold, {Jeremy F.} and Wiebke Arlt and Michael Biehl and Jeremy Tomlinson",
year = "2020",
month = apr,
day = "16",
doi = "10.1111/apt.15710",
language = "English",
journal = "Alimentary Pharmacology & Therapeutics",
issn = "0269-2813",
publisher = "Wiley",

}

RIS

TY - JOUR

T1 - Accurate non-invasive diagnosis and staging of non-alcoholic fatty liver disease using the urinary steroid metabolome

AU - Moolla, Ahmad

AU - Boer, Jasper de

AU - Pavlov, David

AU - Amin, Amin

AU - Taylor, Angela

AU - Gilligan, Lorna

AU - Hughes, Beverly

AU - Ryan, John

AU - Barnes, Eleanor

AU - Hassan-Smith, Zaki

AU - Grove, Jane

AU - Aithal, Guruprasad Padur

AU - Verrijken, An

AU - Francque, Sven

AU - Gaal, Luc Van

AU - Armstrong, Matthew J

AU - Newsome, Phillip

AU - Cobbold, Jeremy F.

AU - Arlt, Wiebke

AU - Biehl, Michael

AU - Tomlinson, Jeremy

PY - 2020/4/16

Y1 - 2020/4/16

N2 - BackgroundThe development of accurate, non‐invasive markers to diagnose and stage non‐alcoholic fatty liver disease (NAFLD) is critical to reduce the need for an invasive liver biopsy and to identify patients who are at the highest risk of hepatic and cardio‐metabolic complications. Disruption of steroid hormone metabolic pathways has been described in patients with NAFLD.Aim(s)To assess the hypothesis that assessment of the urinary steroid metabolome may provide a novel, non‐invasive biomarker strategy to stage NAFLD.MethodsWe analysed the urinary steroid metabolome in 275 subjects (121 with biopsy‐proven NAFLD, 48 with alcohol‐related cirrhosis and 106 controls), using gas chromatography‐mass spectrometry (GC‐MS) coupled with machine learning‐based Generalised Matrix Learning Vector Quantisation (GMLVQ) analysis.ResultsGeneralised Matrix Learning Vector Quantisation analysis achieved excellent separation of early (F0‐F2) from advanced (F3‐F4) fibrosis (AUC receiver operating characteristics [ROC]: 0.92 [0.91‐0.94]). Furthermore, there was near perfect separation of controls from patients with advanced fibrotic NAFLD (AUC ROC = 0.99 [0.98‐0.99]) and from those with NAFLD cirrhosis (AUC ROC = 1.0 [1.0‐1.0]). This approach was also able to distinguish patients with NAFLD cirrhosis from those with alcohol‐related cirrhosis (AUC ROC = 0.83 [0.81‐0.85]).ConclusionsUnbiased GMLVQ analysis of the urinary steroid metabolome offers excellent potential as a non‐invasive biomarker approach to stage NAFLD fibrosis as well as to screen for NAFLD. A highly sensitive and specific urinary biomarker is likely to have clinical utility both in secondary care and in the broader general population within primary care and could significantly decrease the need for liver biopsy.

AB - BackgroundThe development of accurate, non‐invasive markers to diagnose and stage non‐alcoholic fatty liver disease (NAFLD) is critical to reduce the need for an invasive liver biopsy and to identify patients who are at the highest risk of hepatic and cardio‐metabolic complications. Disruption of steroid hormone metabolic pathways has been described in patients with NAFLD.Aim(s)To assess the hypothesis that assessment of the urinary steroid metabolome may provide a novel, non‐invasive biomarker strategy to stage NAFLD.MethodsWe analysed the urinary steroid metabolome in 275 subjects (121 with biopsy‐proven NAFLD, 48 with alcohol‐related cirrhosis and 106 controls), using gas chromatography‐mass spectrometry (GC‐MS) coupled with machine learning‐based Generalised Matrix Learning Vector Quantisation (GMLVQ) analysis.ResultsGeneralised Matrix Learning Vector Quantisation analysis achieved excellent separation of early (F0‐F2) from advanced (F3‐F4) fibrosis (AUC receiver operating characteristics [ROC]: 0.92 [0.91‐0.94]). Furthermore, there was near perfect separation of controls from patients with advanced fibrotic NAFLD (AUC ROC = 0.99 [0.98‐0.99]) and from those with NAFLD cirrhosis (AUC ROC = 1.0 [1.0‐1.0]). This approach was also able to distinguish patients with NAFLD cirrhosis from those with alcohol‐related cirrhosis (AUC ROC = 0.83 [0.81‐0.85]).ConclusionsUnbiased GMLVQ analysis of the urinary steroid metabolome offers excellent potential as a non‐invasive biomarker approach to stage NAFLD fibrosis as well as to screen for NAFLD. A highly sensitive and specific urinary biomarker is likely to have clinical utility both in secondary care and in the broader general population within primary care and could significantly decrease the need for liver biopsy.

U2 - 10.1111/apt.15710

DO - 10.1111/apt.15710

M3 - Article

JO - Alimentary Pharmacology & Therapeutics

JF - Alimentary Pharmacology & Therapeutics

SN - 0269-2813

ER -