Background: Nonalcoholic fatty liver disease (NAFLD) is a common disorder and becoming a leading cause of cirrhosis in the western world. The monitoring of the disease is challenging and the prognostic importance of α-fetoprotein (AFP) level elevation in NAFLD remains uncertain.
Methods: Eighty-four patients were evaluated in the study. Patients with evidence of fatty liver in an abdominal ultrasonography performed for any reason were enrolled in the study. Degree of liver steatosis was graded into three groups. As a control group, patients without fatty liver or other liver diseases were included. All patients and controls were asked about prior hepatic diseases, consumption of alcohol, smoking, drug use, and a physical examination, biochemical analyses including liver function tests, different components of the metabolic syndrome, and the homeostasis model assessment-estimated insulin resistance (HOMA-IR) score were also performed.
Results: Body mass index, aspartate aminotransferase, alanine aminotransferase, glucose, insulin, and HOMA-IR in patients with NAFLD were higher than in control group. Triglyceride, total cholesterol, low-density lipoprotein, and high-density lipoprotein cholesterol levels were higher in NAFLD group than in control group. A statistically significant increase in AFP levels was noted in patients with NAFLD (4.09 ± 1.68) when compared with healthy controls (2.95 ± 0.41) (P < 0.05). A statistically significant increase in AFP levels was noted in patients with grade 3 NAFLD (5.43 ± 1.51) when compared with grade 1 (2.92 ± 1.06) and grade 2 NAFLD groups (3.97 ± 1.45). Also, AFP was significantly higher in grade 2 NAFLD group than in grade 1 NAFLD group. AFP was correlated with NAFLD grade, but neither ALT nor AST showed correlation. According to multivariate analysis, correlation between NAFLD grade and serum AFP levels was independent from the other factors.
Conclusion: Patients with NAFLD have higher AFP levels than those without fatty liver changes. AFP levels rise as grade of liver steatosis increases. NAFLD should be among the differential diagnosis of elevated serum AFP levels.