title: Elevation of Nepsilon-(carboxymethyl)lysine-modified advanced glycation end products in chronic liver disease is an indicator of liver cirrhosis.
abstract: OBJECTIVE
  Progression of liver fibrosis to cirrhosis is a dire consequence of chronic liver diseases (CLD). Nepsilon-(carboxymethyl)lysine (CML)-modified advanced glycation end products (AGEs) in patients with CLD could reflect the degree of severity of the disease.
  
  
  METHODS
  In 110 patients with CLD and 124 healthy controls, CML serum levels and their diagnostic sensitivity and specificity were determined and compared to hyaluronan (HA).
  
  
  RESULTS
  Serum levels of CML were significantly affected by the stage of liver cirrhosis and were closely associated with liver function capacity. CML correlated positively with HA (r = 0.639, P < 0.0001). In ROC analysis, the diagnostic sensitivity and specificity in distinguishing healthy controls from liver disease patients for CML (AUC 0.908; 95%-CI 0.863-0.942, cut-off 640 ng/mL, sensitivity 74.5% and specificity 97.6%) resembled HA (AUC 0.948; 95%-CI 0.907-0.974; cut-off 50 ng/mL, sensitivity 80.7% and specificity 97.9%). The combination of CML and HA shows an AUC of 0.932; 95%-CI 0.888-0.962; sensitivity 82.6%; and specificity 95.8%.
  
  
  CONCLUSIONS
  Our data suggest that serum levels of CML could provide a supplementary diagnostic marker for advanced stages of liver cirrhosis. However, the quality of interaction needs further investigation.
authors.affiliation: Institute of Clinical Chemistry and Pathobiochemistry, University Hospital Aachen (UKA), Aachen University (RWTH), Pauwelsstrasse 30, 52074 Aachen, Germany. eyagmur@ukaachen.de
authors.forename: Eray
authors.initials: E
authors.lastname: Yagmur
authors.forename: Frank
authors.initials: F
authors.lastname: Tacke
authors.forename: Claudia
authors.initials: C
authors.lastname: Weiss
authors.forename: Birgit
authors.initials: B
authors.lastname: Lahme
authors.forename: Michael P
authors.initials: MP
authors.lastname: Manns
authors.forename: Paul
authors.initials: P
authors.lastname: Kiefer
authors.forename: Christian
authors.initials: C
authors.lastname: Trautwein
authors.forename: Axel M
authors.initials: AM
authors.lastname: Gressner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D017127:Glycation End Products, Advanced / Q000378:metabolism*; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000378:metabolism; D008239:Lysine / Q000031:analogs & derivatives* / Q000097:blood / Q000378:metabolism; D008297:Male; D008875:Middle Aged
chemical_list: D017127:Glycation End Products, Advanced; C048496:N(6)-carboxymethyllysine; D006820:Hyaluronic Acid; D008239:Lysine