title: Role of hyaluronic acid, its degrading enzymes, degradation products, and ferritin in the assessment of fibrosis stage in Egyptian patients with chronic hepatitis C.
abstract: OBJECTIVE
  Liver biopsy is considered a gold standard for fibrosis staging, but it has a high risk of morbidity. Therefore, there is an interest in developing noninvasive markers for the prediction of liver fibrosis stages.
  
  
  METHODS
  Hyaluronic acid, ferritin, N-acetyl-β-D-glucosaminidase, β-glucuronidase, glucosamine, aspartate transaminase, and alanine transaminase were assayed in 210 individuals with chronic hepatitis C infection. Statistical analysis was carried out by logistic regression and receiver-operating characteristic curves.
  
  
  RESULTS
  The best linear combination of only significant blood markers was used for the determination of the fibrosis discriminant score; score=[1.64 (numerical constant)-0.002×hyaluronic acid (pg/l)-2.68×β-glucuronidase (µmol/ml/min)-0.026×glucosamine (µg/dl)-0.001×ferritin-0.033 (ng/ml)×aspartate transaminase/alanine transaminase]. The selected fibrosis discriminant score function correctly classified 81% of patients with severe liver fibrosis at a discriminant cut-off score=0.55 (i.e. less than 0.55 indicated mild liver fibrosis and greater than 0.55 indicated severe liver fibrosis), with a sensitivity of 100% and a specificity of 73%.
  
  
  CONCLUSIONS
  A simple fibrosis index can be useful to select hepatitis C virus-infected patients with a very low risk of significant fibrosis in whom the protocol of liver biopsies may be avoided.
authors.affiliation: Department of Chemistry, Helwan University, Cairo, Egypt. hatem_mezayen@yahoo.com
authors.forename: Hatem A
authors.initials: HA
authors.lastname: El-mezayen
authors.forename: El-Shahat A
authors.initials: el-SA
authors.lastname: Toson
authors.forename: Gamal E
authors.initials: GE
authors.lastname: Shiha
mesh_terms: D000118:Acetylglucosaminidase / Q000097:blood; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D003661:Decision Support Techniques; D016002:Discriminant Analysis; D004534:Egypt / Q000453:epidemiology; D005260:Female; D005293:Ferritins / Q000097:blood*; D005944:Glucosamine / Q000097:blood*; D005966:Glucuronidase / Q000097:blood*; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood*; D006821:Hyaluronoglucosaminidase / Q000097:blood; D016014:Linear Models; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000821:virology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D019564:Unnecessary Procedures
chemical_list: D015415:Biomarkers; D006820:Hyaluronic Acid; D005293:Ferritins; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D005966:Glucuronidase; D006821:Hyaluronoglucosaminidase; D000118:Acetylglucosaminidase; D005944:Glucosamine