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  • Author: Pisit Tangkijvanich x
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Open access

Puth Muangpaisarn, Kanisa Jampoka, Sunchai Payungporn, Naruemon Wisedopas, Chalermrat Bunchorntavakul, Pisit Tangkijvanich and Sombat Treeprasertsuk



MicroRNA-34a (miR-34a) contributes to liver injury through an apoptosis pathway.


To determine the correlation between serum miR-34a and liver inflammation as assessed by nonalcoholic fatty liver disease (NAFLD) activity score (NAS).


We included a cross-selectional study of 50 patients with NAFLD in this observational study and confirmed diagnosis by liver biopsy, with NAS grading. A control group comprised 23 healthy individuals without chronic liver disease. Serum miR-34a was assayed using a real-time quantitative PCR (Applied Biosystems).


The mean age of NAFLD patients was 46.0 ± 13.7 years, and 52% were female. Metabolic syndrome was found in 76%. Liver histopathology showed that 54% of patients had NAS ≥4 and significant fibrosis (≥2) was found in 22%. Serum levels of miR-34a were significantly correlated with NAS (r = 0.39, P = 0.005), and the degree of steatosis (r = 0.28, P = 0.049), ballooning (r = 0.30, P = 0.034), and fibrosis (r = 0.39, P = 0.005). Serum miR-34a in patients with NAS ≥4 was significantly higher than in those with NAS <4 (P = 0.011) and controls (P < 0.001). There was no significant correlation between serum miR-34a and other variables. The area under receiver operating characteristic curve for serum miR-34a comparing patients with NAS ≥4 and with NAS <4 was 0.67 (95% CI 0.52, 0.82).


Serum level of miR-34a has a significant fair to good correlation with NAS and may serve as a biomarker of liver inflammation and fibrosis in patients with NAFLD.

Open access

Pakkapon Rattanachaisit, Paweena Susantitaphong, Kessarin Thanapirom, Roongruedee Chaiteerakij, Piyawat Komolmit, Pisit Tangkijvanich and Sombat Treeprasertsuk



Non-alcoholic fatty liver disease (NAFLD) is one of the major causes of chronic liver disease. The primary treatment of NAFLD by statins has not been clearly elucidated.


To evaluate the effectiveness of statin use in patients with biopsy-proven NAFLD or non-alcoholic steatohepatitis on the change in liver histology.


We searched MEDLINE, Scopus, Google Scholar, and the Cochrane Central Register of Controlled Trials for clinical trials and observational studies investigating the effects of statins on histological change regardless of type or dosage from inception to December 2015. Random-effect model meta-analyses were used to compute changes in outcomes of interest. The study protocol was registered in advance with the International Prospective Register of Systematic Reviews (PROSPERO 2016 CRD42016033132).


We identified 6 studies (111 patients), representing 5 cohort studies and 1 randomized controlled clinical trial. There was significant decrease in steatosis grading with a standardized mean difference of –2.580 (95% confidence interval [CI] –4.623 to –0.536; P = 0.013) and NAFLD activity score standardized mean difference of –1.488 (95% CI –2.506 to –0.471; P = 0.004). However, there was no significant change in fibrosis stage (0.156; 95% CI –0.553 to 0.865; P = 0.667).


Statin use can possibly reduce the extent of steatohepatitis but not the stage of fibrosis. Further randomized controlled studies to assess histological evidence with adequate sample size and duration are required in order to establish the role of statin as a primary treatment of NAFLD.

Open access

Prachya Kongtawelert, Theerawut Chanmee, Peraphan Pothacharoen, Naruemon Wisedopa, Pavanrat Kranokpiruk, Kittiyod Poovorawan, Yong Poovorawan and Pisit Tangkijvanich


Background: The assessment of liver fibrosis in chronic hepatitis B is crucial in clinical practice.

Objective: We compared the diagnostic accuracy of liver stiffness measurement (LSM) using transient elastography and serum hyaluronic acid (HA) in detecting liver fibrosis (METAVIR) in chronic hepatitis B, with respect to ALT levels.

Method: One hundred fifty-six Thai patients with chronic hepatitis B who had undergone a liver biopsy were enrolled, and included 112 (71.8%) men and 44 (28.2%) women. The mean age of the patients was 40.1±12.2 years. The predictive accuracy was analyzed by comparing the areas under the receiver-operating characteristic curves (AUROCs).

Result: LSM was superior to HA in predicting fibrosis stages of ≥F2 (AUROCs were 0.820 vs 0.727, p=0.009), ≥ F3 (0.910 vs 0.848, p=0.015) and F4 (0.938 vs 0.876, p=0.031). There was significant correlation between ALT level and LSM value, while such correlation between ALT and HA was not detected. Regarding the subgroup of patients with ALT levels >80 IU/L (2 × ULN), AUROCs of LSM and HA for predicting fibrosis stages of ≥F2 (0.733 vs 0.696), ≥F3 (0.892 vs 0.844) and F4 (0.934 vs 0.893) were not significantly different.

Conclusion: LSM was superior to HA in predicting liver fibrosis and cirrhosis in patients with chronic hepatitis B. However, in patients with ALT elevation, the diagnostic performance of LSM was reduced and its accuracy was comparable to that of HA. Thus, HA could be an alternative method in assessing liver fibrosis in patients with high ALT levels.