title: Serum immunoglobulin a concentration is an independent predictor of liver fibrosis in nonalcoholic steatohepatitis before the cirrhotic stage.
abstract: OBJECTIVE
  The similarity of alcoholic liver disease and nonalcoholic steatohepatitis (NASH) in terms of pathogenic mechanisms suggests that immunoglobulin A (IgA) may play an important role in the pathogenesis of NASH. We aimed to determine whether serum IgA concentrations allow a diagnosis of liver fibrosis in NASH.
  
  
  METHODS
  We compared serum IgA concentrations between 108 patients with stages 0-2 NASH and 19 patients with stage 3 NASH.
  
  
  RESULTS
  In a univariate analysis, age (P < 0.0001), gender (P = 0.0039), serum albumin level (P = 0.0192), AST (P < 0.0001), AST/ALT ratio (P < 0.0001), platelet count (P = 0.0027), hyaluronic acid level (P < 0.0001), fasting blood sugar (FBS) (P = 0.0013), IRI (P = 0.0001), prothrombin time (%) (P = 0.0287), IgA (P < 0.0001), total sum of IgG, IgA, and IgM (P = 0.0049), and IgA/(IgG + IgA + IgM) (P = 0.0105) were significantly elevated in severe-stage NASH patients compared with the early-stage NASH group. Multiple logistic regression analysis showed that in severe-stage NASH patients, only serum IgA concentrations were significantly elevated (P = 0.0225) relative to early-stage NASH patients. The area under the curve (AUC) of serum IgA concentrations was 0.758 for detecting severe-stage NASH compared with early-stage NASH.
  
  
  CONCLUSIONS
  Serum IgA concentration could be a useful independent predictor for assessing the pre-cirrhotic progression of NASH.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. kengo@boreas.dti.ne.jp
authors.forename: Kengo
authors.initials: K
authors.lastname: Tomita
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Teratani
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Yokoyama
authors.forename: Takahiro
authors.initials: T
authors.lastname: Suzuki
authors.forename: Rie
authors.initials: R
authors.lastname: Irie
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Ebinuma
authors.forename: Hidetsugu
authors.initials: H
authors.lastname: Saito
authors.forename: Ryota
authors.initials: R
authors.lastname: Hokari
authors.forename: Soichiro
authors.initials: S
authors.lastname: Miura
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Hibi
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D003937:Diagnosis, Differential; D018450:Disease Progression; D005234:Fatty Liver / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D008103:Liver Cirrhosis / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D007070:Immunoglobulin A