title: [Value of serum osteoprotegerin in noninvasive diagnosis of nonalcoholic steatohepatitis].
abstract: OBJECTIVE
  To investigate the correlation of serum osteoprotegerin (OPG) with the progression of nonalcoholic fatty liver disease (NAFLD) and the noninvasive prediction and diagnosis of nonalcoholic steatohepatitis (NASH).
  
  
  METHODS
  A total of 136 patients with NAFLD were enrolled, and their tissue samples for liver biopsy and serum samples obtained at 1 week after liver biopsy were collected; 83 healthy subjects without the symptoms of fatty liver disease proved by ultrasound examination were enrolled as controls. The physiological indicators including height, body weight, and waist circumference were measured, and body mass index was calculated. The biochemical parameters including alanine aminotransferase (ALT), aspartate aminotransferase (AST), AST/ALT, alkaline phosphatase, gamma-glutamyl transferase, total cholesterol, triglyceride (TG), high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were measured. Double-antibody sandwich enzyme-linked immunosorbent assay was used to determine the serum level of OPG. The rank sum test, chi-square test, t-test, one-way analysis of variance, Spearman correlation analysis, least significant difference test, and receiver operating characteristic (ROC) curve were applied for statistical analysis of various data.
  
  
  RESULTS
  Serum OPG level was correlated with AST and TG (P < 0.05), and was highly correlated with hepatocyte fatty degeneration, ballooning degeneration, intralobular inflammation, portal inflammation, and fibrosis degree (P < 0.01). With the increasing NAFLD activity score (NAS), serum OPG level decreased, and there was a highly negative correlation between them (r = -0.928, P < 0.01). Serum OPG level was significantly lower in NASH patients than non-NASH patients. The area under the ROC curve of serum OPG level was 0.963, and according to the Youden index, its optimal sensitivity and specificity were 96.1% and 97.4%, respectively, at an optimal cut-off value of 242.96 ng/L, which suggested a high diagnostic power.
  
  
  CONCLUSIONS
  In NASH patients, serum OPG level decreases significantly. Serum OPG level can be used as an independent predictive factor to evaluate NASH and its severity, as well as a noninvasive diagnostic index for NASH.
authors.affiliation: Department of Pathology and Hepatology, 302 Military Hospital of China, Beijing 100039, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Yang
authors.forename: Yisi
authors.initials: Y
authors.lastname: Liu
authors.forename: Guangde
authors.initials: G
authors.lastname: Zhou
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Guo
authors.forename: Saiying
authors.initials: S
authors.lastname: Zou
authors.forename: Shuhong
authors.initials: S
authors.lastname: Liu
authors.forename: Lina
authors.initials: L
authors.lastname: Jiang
authors.forename: Yuan
authors.initials: Y
authors.lastname: Liu
authors.forename: Li
authors.initials: L
authors.lastname: Zhu
authors.forename: Chaonan
authors.initials: C
authors.lastname: Guo
authors.forename: Jingmin
authors.initials: J
authors.lastname: Zhao
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001706:Biopsy; D015992:Body Mass Index; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005355:Fibrosis; D006801:Humans; D007249:Inflammation / Q000473:pathology; D008099:Liver / Q000473:pathology; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000175:diagnosis*; D053244:Osteoprotegerin / Q000097:blood*; D012372:ROC Curve; D014280:Triglycerides / Q000097:blood; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D053244:Osteoprotegerin; C506030:TNFRSF11B protein, human; D014280:Triglycerides; D002784:Cholesterol; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase