ELF is a New Test to Assess Liver Fibrosis Risk


The ELF Test stands for Enhanced Liver Fibrosis. This test was approved by the FDA in 2021 as a prognostic test for patients with a progressive form of fatty liver disease known as NASH with advanced fibrosis. At Atlanta Endocrine Associates, Dr. Scott Isaacs is a fatty liver expert and offers accurate diagnosis and state-of-the-art treatment of fatty liver disease and hepatic hypothyroidism. To learn more, contact the office in Atlanta, Georgia.

ELF measures three markers of liver fibrosis:

  1. Hyaluronic acid (HA) (extracellular matrix component)
  2. Tissue inhibitors of metalloproteinase 1 (TIMP-1) (extracellular matrix component)
  3. Procollagen III N-terminal peptide (PIIINP) (inhibitor of breakdown of collagen III)

The ELF test allows doctors to assess the risk of disease progression in patients with advanced fibrosis due to nonalcoholic steatohepatitis (NASH) with a simple blood test instead of a more invasive liver biopsy. The ELF Test has been extensively studied and validated. The test assesses active fibrosis rather than the damage it has caused. This allows the ELF Test to be used as a marker for prognosis. The ELF test has been a meaningful change for my approach to patients with NAFLD because it is a simple test that I can order from Quest or LabCorp. Although the test is FDA approved as a prognostic test for patients with NASH and advanced fibrosis, I also use test as a diagnostic test to identify high-risk patients who have indeterminate FIB-4 scores. This technique for risk assessment has been recommended in the recent AACE NAFLD Guidelines.