**3.1 Serum OCT levels and ratios of OCT/AST and OCT/ALT**

Table 1 shows the mean serum AST, ALT, OCT levels, platelet counts, and the ratios of AST/ALT, OCT/AST and OCT/ALT in 153 NASH patients without HCC and LC, 24 NASH-LC patients, 12 NASH-HCC patients, 27 ALD patients, 40 chronic hepatitis with HCV<CH(C)> patients, 16 LC with HCV<LC(C)> patients without HCC, and 14 LC(C)- HCC patients. Significant associations between serum OCT levels and serum AST levels or ALT levels were noted (ALT, R=0.784 p<0.01; AST, r=0.853 p<0.01).

The AST and ALT levels of NASH-HCC were increased compared to those of NASH-LC. The ALT level of NASH-LC was slightly decreased compared to those of NASH. However, regarding AST and ALT, the differences between NASH and NASH-LC were not significant. In contrast, the serum OCT levels in NASH were higher than those of controls, and gradually increased with the development of liver disease from NASH to LC and HCC. In addition, the ratios of OCT/ALT and OCT/AST were significantly increased in parallel with the progression of NASH, LC and HCC. Especially, serum OCT levels and the ratios of OCT/ALT and OCT/AST were markedly increased in HCC.

Concerning CH(C), serum OCT levels were increased, but the ratios of OCT/ALT and OCT/AST were not significantly different from those of NASH patients. The ratio of OCT/ALT was slightly increased in LC(C) patients, compared with CH(C). Furthermore, in HCC with LC(C), both the ratios of OCT/ALT and OCT/AST were significantly increased.

As for comparison with several liver diseases without LC and HCC, serum OCT levels, OCT/ALT and OCT/AST ratios in ALD were significantly higher than those of other liver diseases (Figure 1).

#### **3.2 Association with fibrosis grade in NASH patients**

Figure 2 shows the association between liver fibrosis grade and serum OCT levels and the ratios of OCT/AST and OCT/ALT in NASH patients on the basis of liver biopsies. Serum OCT levels and OCT/ALT ratios were significantly increased in parallel with fibrosis grade (mean OCT levels: 50.8 ng/mL in F0-1, 68.7 ng/mL in F2, 108.3 ng/mL in F3, 156.4 ng/mL in F4)(mean OCT/ALT ratio: 1.43 in F0-1, 1.05 in F2, 1.69 in F3, 2.58 in F4). Regarding the relationship between OCT or ratios and platelet counts, there was a significant association between the ratio of OCT/ALT and platelet counts (r=-0.285 p<0.01)(Figure 3).
