Correlation Between Serum Liver Enzymes and Fibrosis Severity in Non-Alcoholic Fatty Liver Disease (NAFLD) Patients. A Cross-Sectional Study

• AHMAD SHABBIR

  Department of medicine , Nishtar Medical University Multan Pakistan

  Author

• HAFIZ HAMMAD ABDULLAH

  Department of medicine, Allama Iqbal Teaching Hospital D.G Khan

  Author

• NOUMAN ANAYAT

  Department of medicine, Shaikh Zayed Medical Complex, Lahore

  Author

• ALI AHMAD KHAN

  Department of medicine, Nishtar Medical University Multan Pakistan

  Author

• H MUHAMMAD ISMAIL MUGHAL

  Department of medicine, Nishtar Hospital Multan Pakistan

  Author

• ALI USAMA

  Department of medicine, Nishtar Medical University Multan Pakistan

  Author

Background:

One of the major chronic liver diseases in the world is NAFLD which tends to start as mere steatosis but tends to evolve into fibrosis and cirrhosis. Serum liver enzymes are common measurement of hepatocellular damage which is however not predictable regarding its association with the severity of fibrosis. This was done to determine the connection between serum liver enzyme levels and the severity of fibrosis in NAFLD patients by non-invasive means of assessment.

Methods:

The present study is a cross-sectional one that was carried out at a tertiary care hospital located in Punjab, Pakistan, between January 2023 and March 2024, including 100 patients with a diagnosis of NAFLD according to ultrasound results. Patients who consume alcohol, those with viral hepatitis and other liver-related pathologies were excluded. The normal range of serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and gamma-glutamyl transferase (GGT) were also conducted by standard enzymatic methods. Transient elastography was used to quantify the level of fibrosis and the stages of fibrosis F0–F4 were measured. Pearson correlation and ANOVA tests were applied in order to analyze statistical correlations.

Results:

Out of 100 patients (58 men, 42 women; median age, 47.6 + 9.8 years) serum liver enzymes became elevated directly in proportion to fibrosis stage. AST and ALT mean levels were very different in the case of advanced fibrosis (F364) and mild fibrosis (F0-F1). Fibrosis stage and AST (r = 0.71), ALT (r = 0.68), GGT (r = 0.63), and ALP (r = 0.57) were statistically significantly positively correlated to a strong degree.

Conclusion:

Liver enzymes in serum especially AST and ALT exhibit significant correlation with severity of fibrosis in NAFLD patients. These are easily accessible biomarkers which can be considered useful non-invasive biomarkers of identifying those patients who are at risk of advanced fibrosis which would be crucial in early interventions and enhanced disease monitoring.

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Copyright (c) 2025 AHMAD SHABBIR, HAFIZ HAMMAD ABDULLAH, NOUMAN ANAYAT, ALI AHMAD KHAN, H MUHAMMAD ISMAIL MUGHAL, ALI USAMA (Author)

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