The mid-infrared spectroscopy: A novel non-invasive diagnostic tool for NASH diagnosis in severe obesity

Rodolphe Anty; Marie Morvan; Maëna Le Corvec; Clémence M Canivet; Stéphanie Patouraux; Jean Gugenheim; Stéphanie Bonnafous; Béatrice Bailly-Maitre; Olivier Sire; Hugues Tariel; Jérôme Bernard; Thierry Piche; Olivier Loréal; Judith Aron-Wisnewsky; Karine Clément; Albert Tran; Antonio Iannelli; Philippe Gual

doi:10.1016/j.jhepr.2019.09.005

The mid-infrared spectroscopy: A novel non-invasive diagnostic tool for NASH diagnosis in severe obesity

JHEP Rep. 2019 Oct 23;1(5):361-368. doi: 10.1016/j.jhepr.2019.09.005. eCollection 2019 Nov.

Authors

Rodolphe Anty¹, Marie Morvan², Maëna Le Corvec³, Clémence M Canivet¹, Stéphanie Patouraux¹, Jean Gugenheim¹, Stéphanie Bonnafous¹, Béatrice Bailly-Maitre⁴, Olivier Sire⁵, Hugues Tariel³, Jérôme Bernard³, Thierry Piche¹, Olivier Loréal⁶, Judith Aron-Wisnewsky⁷, Karine Clément⁷, Albert Tran¹, Antonio Iannelli¹, Philippe Gual¹

Affiliations

¹ Université Côte d'Azur, CHU, INSERM, U1065, C3M, France.
² University of Rennes, CNRS, IRMAR - UMR, 6625, Rennes, France.
³ DIAFIR, Avenue Chardonnet, Parc Lorans 26 J, Rennes.
⁴ Université Côte d'Azur, INSERM, U1065, C3M, France.
⁵ IRDL UMR CNRS 6027, Vannes.
⁶ INSERM, Univ Rennes, INRA, Nutrition Metabolisms and Cancer (NuMeCan), UMR-1241, Rennes, France.
⁷ Sorbonne Université/Inserm Unité UMRS NutriOmics, Assistance publique hôpitaux de Paris, service de Nutrition, Paris, France.

Abstract

There is an urgent medical need to develop non-invasive tests for non-alcoholic steatohepatitis (NASH). This study evaluates the diagnostic performance of an innovative model based on mid-infrared (MIR) spectroscopy for the diagnosis of NASH.

Methods: Severely obese patients who underwent a bariatric procedure at the University Hospital of Nice, France (n = 395) were prospectively recruited. The clinico-biological characteristics were measured prior to surgery. Liver biopsies were collected during the surgical procedure and assessed by a pathologist. A training group (316 patients, NASH: 16.8%) and a validation group (79 patients, NASH: 16.5%) were randomly defined. MIR spectra were acquired by fiber evanescent wave spectroscopy, using chalcogenide glass fiber optic sensors and a spectrometer. This absorption spectroscopic technique delivers a spectrum that identifies the molecular composition of a sample, defining a patient's metabolic fingerprint.

Results: The areas under the receiver operating curve (AUROC) for the diagnosis of NASH were 0.82 and 0.77 in the training and validation groups, respectively. The best threshold was 0.15, which was associated with a sensitivity of 0.75 and 0.69, and a specificity of 0.72 and 0.76. Negative predictive values of 0.94 and 0.93 and positive predictive values of 0.35 and 0.36, as well as correctly classified patient rates of 72% and 75% were obtained in the training and validation groups, respectively. A composite model using aspartate aminotransferase level, triglyceride level and waist circumference alongside the MIR spectra led to an increase in AUROC (0.88 and 0.84 for the training and validations groups, respectively).

Conclusions: MIR spectroscopy provides good sensitivity and negative predictive values for NASH screening in patients with severe obesity.

Lay summary: There is an urgent need for tools to non-invasively diagnose and monitor non-alcoholic steatohepatitis (NASH). This study evaluates the performance of a new tool for fast NASH diagnosis based on mid-infrared (MIR) spectroscopy. Using serum samples from severely obese patients who underwent a bariatric procedure, which enabled a concomitant liver biopsy to be performed, the MIR spectroscopy model performed well in screening patients for NASH compared to a traditional, histological diagnosis.

Keywords: Fiber evanescent wave spectroscopy; NASH; chalcogenide glass; metabolic fingerprint; mid-infrared (MIR) spectroscopy; non-alcoholic steatohepatitis; non-invasive test; severely obese patients.