title: Usefulness of non-invasive markers for predicting significant fibrosis in patients with chronic liver disease.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Korea University, Seoul, Korea.
authors.forename: Han Hyo
authors.initials: HH
authors.lastname: Lee
authors.forename: Yeon Seok
authors.initials: YS
authors.lastname: Seo
authors.forename: Soon Ho
authors.initials: SH
authors.lastname: Um
authors.forename: Nam Hee
authors.initials: NH
authors.lastname: Won
authors.forename: Hanna
authors.initials: H
authors.lastname: Yoo
authors.forename: Eun Suk
authors.initials: ES
authors.lastname: Jung
authors.forename: Yong Dae
authors.initials: YD
authors.lastname: Kwon
authors.forename: Sanghoon
authors.initials: S
authors.lastname: Park
authors.forename: Bora
authors.initials: B
authors.lastname: Keum
authors.forename: Yong Sik
authors.initials: YS
authors.lastname: Kim
authors.forename: Hyung Joon
authors.initials: HJ
authors.lastname: Yim
authors.forename: Yoon Tae
authors.initials: YT
authors.lastname: Jeen
authors.forename: Hoon Jai
authors.initials: HJ
authors.lastname: Chun
authors.forename: Chang Duck
authors.initials: CD
authors.lastname: Kim
authors.forename: Ho Sang
authors.initials: HS
authors.lastname: Ryu
mesh_terms: 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
chemical_list: D015415:Biomarkers; D006242:Haptoglobins; D000511:alpha-Macroglobulins; D006820:Hyaluronic Acid