title: Kallistatin, a new and reliable biomarker for the diagnosis of liver cirrhosis.
abstract: Kallistatin, which protects organs and cells against inflammation, fibrosis and oxidative stress, is mainly synthesized and secreted in liver. However, its relationship to human liver disease remains unclear. The purpose of this study was to explore the relationship between serum kallistatin and clinical evidence of both cirrhosis and hepatocellular carcinoma (HCC), and to determine if serum kallistatin levels could be used as a diagnostic indicator of hepatic health status, especially human liver cirrhosis (LC). Our cohort consisted of 115 patients with clinically proven liver fibrosis (LF), LC, or HCC by liver biopsies, and 31 healthy controls (CON). Serum kallistatin levels were quantified by ELISA. Results of the present study demonstrated that irrespective of the underlying etiology, serum kallistatin levels were significantly lower in the LF/LC group when compared with the CON group. A decrease in serum kallistatin levels appeared to reflect the extent of cirrhosis, with the lowest levels associated with higher grades of cirrhosis. Patients with LC had a noticeable correlation between serum kallistatin levels and other serum biochemical indicators. The area under the curve (AUC) for LC, viral liver cirrhosis (VLC) and alcoholic liver cirrhosis (ALC) was 0.845, 0.757 and 0.931, respectively. In conclusion, our findings demonstrated that kallistatin, a plasma protein produced by the liver, can be a useful and reliable diagnostic indicator of hepatic health status, especially for LC.
authors.affiliation: School of Medicine and Institute of Molecular Medicine, Huaqiao University, Quanzhou 362021, China ; Engineering Research Center of Molecular Medicine, Ministry of Education, Xiamen 362021, China.
authors.forename: Zhiyun
authors.initials: Z
authors.lastname: Cheng
authors.affiliation: School of Medicine and Institute of Molecular Medicine, Huaqiao University, Quanzhou 362021, China ; Engineering Research Center of Molecular Medicine, Ministry of Education, Xiamen 362021, China.
authors.forename: Yinghui
authors.initials: Y
authors.lastname: Lv
authors.affiliation: School of Medicine and Institute of Molecular Medicine, Huaqiao University, Quanzhou 362021, China ; Engineering Research Center of Molecular Medicine, Ministry of Education, Xiamen 362021, China.
authors.forename: Suqiu
authors.initials: S
authors.lastname: Pang
authors.affiliation: School of Medicine and Institute of Molecular Medicine, Huaqiao University, Quanzhou 362021, China ; Engineering Research Center of Molecular Medicine, Ministry of Education, Xiamen 362021, China.
authors.forename: Ruyu
authors.initials: R
authors.lastname: Bai
authors.affiliation: School of Medicine and Institute of Molecular Medicine, Huaqiao University, Quanzhou 362021, China ; Engineering Research Center of Molecular Medicine, Ministry of Education, Xiamen 362021, China.
authors.forename: Mingxi
authors.initials: M
authors.lastname: Wang
authors.affiliation: School of Medicine and Institute of Molecular Medicine, Huaqiao University, Quanzhou 362021, China ; Engineering Research Center of Molecular Medicine, Ministry of Education, Xiamen 362021, China.
authors.forename: Shuyu
authors.initials: S
authors.lastname: Lin
authors.affiliation: Department of Medical Oncology, the 2nd Affiliated Hospital of Fujian Medical University, Quanzhou 362021, China.
authors.forename: Tianwen
authors.initials: T
authors.lastname: Xu
authors.affiliation: Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
authors.forename: Duncan
authors.initials: D
authors.lastname: Spalding
authors.affiliation: Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
authors.forename: Nagy
authors.initials: N
authors.lastname: Habib
authors.affiliation: School of Medicine and Institute of Molecular Medicine, Huaqiao University, Quanzhou 362021, China ; Engineering Research Center of Molecular Medicine, Ministry of Education, Xiamen 362021, China.
authors.forename: Ruian
authors.initials: R
authors.lastname: Xu
keywords: ALB, albumin; ALC, alcoholic liver cirrhosis; ALP, alkaline phosphatase; ALT, alanine transaminase; AST, aspartate aminotransferase; AUC, area under the curve; Biomarker; CAP, community-acquired pneumonia; CE, choline esterase; CON, controls; DBIL, direct bilirubin; GGT, gamma-glutamyl transpeptidase; GLB, globulin; HCC, hepatocellular carcinoma; Hepatocellular carcinoma; IBIL, indirect bilirubin; KBP, kallikrein-binding protein; Kallistatin; LC, liver cirrhosis; LF, liver fibrosis; Liver cirrhosis; Liver fibrosis; NASH, non-alcoholic steatohepatitis; PA, prealbumin; STP, serum total protein; TBA, total bile acid; TBIL, total bilirubin; VLC, viral liver cirrhosis