Serum hyaluronate correlates with histological progression in alcoholic liver disease.
OBJECTIVE
Chronic alcohol consumption may lead to the development of liver cirrhosis. Serum concentrations of hyaluronate were suggested as a predictor in chronic liver disease, but its power to distinguish between severity of fibrosis and inflammation had not been assessed. In order to evaluate hyaluronate as a marker to detect early stages of alcoholic liver disease and to establish a possible correlation with hepatic histology, serum concentrations were measured by radioimmunoassay in 87 patients with biopsy-proven fatty liver, fatty liver and mild fibrosis, fatty liver and inflammation, severe fibrosis and inflammation, and cirrhosis, and in 12 non-alcoholic control subjects. In addition, serum hyaluronate was determined in 40 non-cirrhotic alcoholic patients with either a normal serum aspartate aminotransferase (AST) or an AST elevated at least two-fold.


RESULTS
Serum hyaluronate increased significantly with advanced stages of alcoholic liver disease, while levels in patients with fatty liver were elevated only slightly without reaching significance. Hyaluronate correlated well with histological stage and was highly sensitive for detecting fibrosis in general and perivenular fibrosis as an indicator of progression to cirrhosis. Hyaluronate levels were not influenced by AST levels.


CONCLUSIONS
Serum hyaluronate is a good predictor of the presence of even moderate hepatic fibrosis in alcoholic liver disease, justifying its clinical use to assess morphological alterations of the liver in alcoholics.
Stickel
Felix
F
Department of Medicine I, University of Erlangen-Nuremberg, Erlangen, Germany. felix.stickel@med1.uni-erlangen.de
Poeschl
Gudrun
G
Schuppan
Detlef
D
Conradt
Christian
C
Strenge-Hesse
Anke
A
Fuchs
Florian S
FS
Hofmann
Walter J
WJ
Seitz
Helmut K
HK
D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D018450:Disease Progression; D005234:Fatty Liver / Q000097:blood; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood*; D008099:Liver / Q000473:pathology*; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood / Q000473:pathology; D008108:Liver Diseases, Alcoholic / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D011379:Prognosis; D012372:ROC Curve; D012680:Sensitivity and Specificity
D015415:Biomarkers; D006820:Hyaluronic Acid