HepaRank

HepaRank is a non-invasive hepatic bioprognostic test based on an algorithmic analysis of serological and biochemical markers, designed to assess the risk of liver damage.

The test integrates laboratory biomarkers and patient clinical parameters (age, sex, weight, height, and body mass index), providing a comprehensive evaluation of liver status.

HepaRank is used to assess the main processes associated with chronic liver diseases:

• liver fibrosis
• hepatic steatosis
• necroinflammatory activity / cytolysis
• metabolic liver damage
• possible alcohol-related liver injury

Indications

• suspected MAFLD / MASLD
• imaging-confirmed hepatic steatosis
• overweight or obesity
• type 2 diabetes or prediabetes
• dyslipidemia
• metabolic syndrome
• persistent elevation of ALT, AST, or GGT
• suspected MASH/NASH
• suspected alcohol-related liver disease
• non-invasive fibrosis risk assessment before gastroenterology consultation or elastography

Test components

HepaRank includes 10 biomarkers:

• glucose
• ALT
• AST
• GGT
• total bilirubin
• apolipoprotein A-I
• total cholesterol
• triglycerides
• alpha-2-macroglobulin
• haptoglobin

Result interpretation

HepaRank results are expressed as numerical scores and risk categories. Each score must be interpreted together with the patient’s medical history, clinical findings, and additional investigations.

The test provides an algorithmic assessment of major domains:

• fibrosis (F0–F4)
• steatosis (S0–S3)
• inflammatory activity (V0–V3)
• metabolic liver damage (M0–M2)
• alcohol-related liver damage (E0–E3)

Limitations and contraindications

HepaRank is not a definitive etiological diagnostic test and must be interpreted in a full clinical context alongside imaging and additional laboratory investigations.

Results may be influenced by:

• acute inflammatory conditions
• acute hepatitis (viral, toxic, or drug-induced)
• cholestasis or biliary obstruction
• hemolysis
• Gilbert syndrome
• severe hyperlipidemia
• recent or excessive alcohol intake
• systemic inflammation or infection

Procedure

Blood collection is performed via venipuncture, usually from the antecubital vein. The procedure takes a few minutes and is performed by qualified medical staff.

After collection, mild local bleeding or a small bruise may occur, usually resolving spontaneously.

Sources:

https://pmc.ncbi.nlm.nih.gov/articles/PMC2725370/
https://emedicine.medscape.com/article/175472-overview
https://pubmed.ncbi.nlm.nih.gov/23651331/
https://pmc.ncbi.nlm.nih.gov/articles/PMC8481240/