title: Serum cystatin C: a non-invasive marker of liver fibrosis or of current liver fibrogenesis in chronic hepatitis C? .
abstract: BACKGROUND
  Serum levels of cystatin C, an endogenous inhibitor of cysteine proteases, provide an alternative method to creatinine-based criteria for measuring glomerular filtration rate. Preliminary data suggested that serum cystatin C levels parallel with the stage of liver fibrosis in chronic liver disorders. Our aim has been to evaluate the possible role of serum cystatin C as a marker of liver fibrosis in hepatitis C virus (HCV)-induced chronic liver disease.
  
  
  METHODS
  100 consecutive patients (56 men, mean age 51.2 ± 9.5 yrs) with HCV-induced chronic liver disease, scheduled for their first liver biopsy and naïve for antiviral therapy were included. Liver fibrosis was evaluated with the METAVIR score. Serum cystatin C and standard laboratory tests were measured simultaneously. Patients with ethanol abuse (> 50 g/day), HBV or HIV coinfection or plasma creatinine ≥ 1.20 mg/dL were excluded. In addition, a second group of 16 patients fulfilling the same requisites and diagnosed with HCV-induced compensated cirrhosis by clinical evidence of portal hypertension was included.
  
  
  RESULTS
  Serum cystatin C levels significantly increase from F0 to F2 fibrosis stages, remained stable in F3 and F4 stages and increased again in the group of non-biopsied compensated cirrhosis. Serum cystatin C levels were higher in patients with moderate-advanced necroinflammation in the liver biopsy.
  
  
  CONCLUSIONS
  Serum cystatin C level may reflect current fibrogenic and necroinflammatory activities in chronic HCV-induced liver disease with normal renal function but can not be considered as a non-invasive marker of liver fibrosis.
authors.affiliation: Service of Gastroenterology, Hospital Clínico San Carlos, Department of Medicne, Medical School Unibersidad Complutense, Instituto de Invstigación Sanitaria del Hospital Clnico San Carlos, Madrid, Spain. jladero.hcsc@salud.madrid.org
authors.forename: José M
authors.initials: JM
authors.lastname: Ladero
authors.forename: María C
authors.initials: MC
authors.lastname: Cárdenas
authors.forename: Luis
authors.initials: L
authors.lastname: Ortega
authors.forename: Andrea
authors.initials: A
authors.lastname: González-Pino
authors.forename: Francisca
authors.initials: F
authors.lastname: Cuenca
authors.forename: César
authors.initials: C
authors.lastname: Morales
authors.forename: Anna
authors.initials: A
authors.lastname: Lee-Brunner
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D016009:Chi-Square Distribution; D055316:Cystatin C / Q000097:blood*; D018450:Disease Progression; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000150:complications / Q000473:pathology / Q000821:virology; D006801:Humans; D008099:Liver / Q000473:pathology / Q000821:virology; D008103:Liver Cirrhosis / Q000097:blood* / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C