Usefulness of non-invasive markers for predicting significant fibrosis in patients with chronic liver disease.
The purpose of this prospective study was to verify and compare the strengths of various blood markers and fibrosis models in predicting significant liver fibrosis. One hundred fifty-eight patients with chronic liver disease who underwent liver biopsy were enrolled. The mean age was 41 yr and male patients accounted for 70.2%. The common causes of liver disease were hepatitis B (67.7%) and C (16.5%) and fatty liver (9.5%). Stages of liver fibrosis (F0-4) were assessed according to the Batts and Ludwig scoring system. Significant fibrosis was defined as > or =F2. Sixteen blood markers were measured along with liver biopsy, and estimates of hepatic fibrosis were calculated using various predictive models. Predictive accuracy was evaluated with a receiver-operating characteristics (ROC) curve. Liver biopsy revealed significant fibrosis in 106 cases (67.1%). On multivariate analysis, alpha2-macroglobulin, hyaluronic acid, and haptoglobin were found to be independently related to significant hepatic fibrosis. A new predictive model was constructed based on these variables, and its area under the ROC curve was 0.91 (95% confidence interval, 0.85-0.96). In conclusion, alpha2-macroglobulin, hyaluronic acid, and haptoglobin levels are independent predictors for significant hepatic fibrosis in chronic liver disease.
Lee
Han Hyo
HH
Department of Internal Medicine, Korea University, Seoul, Korea.
Seo
Yeon Seok
YS
Um
Soon Ho
SH
Won
Nam Hee
NH
Yoo
Hanna
H
Jung
Eun Suk
ES
Kwon
Yong Dae
YD
Park
Sanghoon
S
Keum
Bora
B
Kim
Yong Sik
YS
Yim
Hyung Joon
HJ
Jeen
Yoon Tae
YT
Chun
Hoon Jai
HJ
Kim
Chang Duck
CD
Ryu
Ho Sang
HS
D000328:Adult; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D005234:Fatty Liver / Q000150:complications; D005260:Female; D005355:Fibrosis; D006242:Haptoglobins / Q000032:analysis; D006509:Hepatitis B / Q000150:complications; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis*; D008107:Liver Diseases / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D000511:alpha-Macroglobulins / Q000032:analysis
D015415:Biomarkers; D006242:Haptoglobins; D000511:alpha-Macroglobulins; D006820:Hyaluronic Acid