Serum levels of YKL-40 and PIIINP as prognostic markers in patients with alcoholic liver disease.
OBJECTIVE
YKL-40 (growth factor) and PIIINP (N-terminal propeptide of Type III procollagen) are potential markers of liver fibrosis. The aim was to evaluate the prognostic value of serum YKL-40 and PIIINP levels in patients with alcoholic liver disease.


METHODS
Three hundred and seventy patients with alcoholic liver disease were studied in a trial of malotilate with a median follow-up period of 470 days; 75 patients died; 336 patients had a liver biopsy on entry. Serum levels of YKL-40 and PIIINP were determined by radioimmunoassay (RIA).


RESULTS
Serum YKL-40 and PIIINP were elevated in the patients compared to controls. Patients with steatosis or no fibrosis had the lowest serum levels of YKL-40 and PIIINP, whereas patients with alcoholic hepatitis and/or cirrhosis had the highest levels. Serum YKL-40 was associated with the presence of fibrosis, and serum PIIINP was also associated with the different grades of fibrosis. Patients with elevated serum YKL-40 or PIIINP had shorter survival than patients with normal serum levels of YKL-40 (P<0.0001) or PIIINP (P=0.044). High degree of fibrosis predicted shorter survival (P=0.004).


CONCLUSIONS
Serum levels of YKL-40 and PIIINP are elevated in alcoholic patients, related to the presence of liver fibrosis and may provide prognostic information.
Nøjgaard
Camilla
C
Department of Gastroenterology and Alcohol Unit, Hvidovre Hospital, Hvidovre, Denmark. mille@dadlnet.dk
Johansen
Julia S
JS
Christensen
Erik
E
Skovgaard
Lene Theil
LT
Price
Paul A
PA
Becker
Ulrik
U
D054392:Adipokines; D000328:Adult; D000368:Aged; D015415:Biomarkers; D000071451:Chitinase-3-Like Protein 1; D005260:Female; D005500:Follow-Up Studies; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D037102:Lectins; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis / Q000401:mortality; D008108:Liver Diseases, Alcoholic / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011347:Procollagen / Q000097:blood*; D011379:Prognosis; D016019:Survival Analysis
D054392:Adipokines; D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D006023:Glycoproteins; D037102:Lectins; D010446:Peptide Fragments; D011347:Procollagen; C041876:procollagen Type III-N-terminal peptide