Value of Zonulin as a Diagnostic and Prognostic Marker in Patients with Nonalcoholic Fatty Liver Disease

Abstract

Abstract Background Nonalcoholic fatty liver disease (NAFLD) is a spectrum of liver disorders ranging from simple fat accumulation in the hepatocytes (hepatic steatosis), to liver inflammation and hepatocytes injury (nonalcoholic steatohepatitis, NASH) with increasing levels of fibrosis to cirrhosis and hepatocellular carcinoma (HCC). The gut microbiota is involved in the occurrence and development of chronic liver diseases. Zonulin is considered a marker of intestinal permeability. Aim and Objectives to study the value of zonulin as a diagnostic and prognostic marker in different degrees of Non-alcoholic fatty liver disease (Steatosis, Steatohepatitis, Cirrhosis) in patients with and without Diabetes Mellitus. Subjects and Methods This was Case control study, was conducted in Ain-Shams University Hospitals Internal medicine& Gastroenterology department and bariatric surgery unit over 60 subjects divided into 3 groups:(Group A): 20 Patients have mild NASH, (Group B): 20 Patients have moderate to severe NASH, (Group C): 20 Healthy controls, during a period 1 year. Result There was high statistically significant difference between the studied groups as regard Zonulin concentration. Conclusion serum zonulin concentration is increased in patients with NAFLD and correlates with the severity of steatosis. However, the cross-sectional design of our study precludes the establishment of causal or temporal relationships between increased zonulin concentrations and severity of steatosis and the presence of NASH. Follow up studies may be helpful in elucidating the cause-and effect relations and the underlying mechanisms.