Hepatocyte apoptosis fragment product cytokeratin-18 M30 level and non-alcoholic steatohepatitis risk diagnosis: an international registry study.

Autor:	Zhang H; Department of Biostatistics and Medical Record, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China.; Department of Hepatology, MAFLD Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China., Rios RS; Department of Hepatology, MAFLD Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China., Boursier J; Service d'Hépato-Gastroentérologie et Oncologie Digestive, Centre Hospitalier Universitaire d'Angers, Angers, France.; Laboratoire HIFIH, UPRES EA3859, SFR ICAT 4208, Université d'Angers, Angers, France., Anty R; Université Côte d'Azur, CHU, INSERM, U1065, C3M, 06204 Nice, France., Chan WK; Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia., George J; Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Sydney, NSW, Australia., Yilmaz Y; Department of Gastroenterology, School of Medicine, Marmara University, Istanbul, Turkey.; Department of Gastroenterology, School of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey., Wong VW; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong 999077, China., Fan J; Department of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200000, China., Dufour JF; University Clinic for Visceral Surgery and Medicine, Inselspital, University Hospital Bern, Bern, Switzerland.; Graduate School for Health Sciences, University of Bern, Bern, Switzerland., Papatheodoridis G; Academic Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, General Hospital, of Athens 'Laiko', Athens, Greece., Chen L; Department of Gastroenterology, Ruijin Hospital, Shanghai 200000, China., Schattenberg JM; Metabolic Liver Research Program I, Department of Medicine, University Medical Center Mainz, Mainz, Germany., Shi J; The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang 310000, China., Xu L; Tianjin Second People's Hospital, Tianjin 300000, China., Wong GL; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong 999077, China., Lange NF; University Clinic for Visceral Surgery and Medicine, Inselspital, University Hospital Bern, Bern, Switzerland.; Graduate School for Health Sciences, University of Bern, Bern, Switzerland., Papatheodoridi M; Academic Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, General Hospital, of Athens 'Laiko', Athens, Greece., Mi Y; Tianjin Second People's Hospital, Tianjin 300000, China., Zhou Y; Department of Hepatology, MAFLD Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China.; Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai 200000, China., Byrne CD; Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton, Southampton General Hospital, Southampton, UK., Targher G; Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy., Feng G; Xi'an Medical University, Xi'an, Shaanxi 710000, China., Zheng M; Department of Hepatology, MAFLD Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China.; Institute of Hepatology, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China.; Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, Zhejiang 325000, China.
Jazyk:	angličtina
Zdroj:	Chinese medical journal [Chin Med J (Engl)] 2023 Feb 05; Vol. 136 (3), pp. 341-350. Date of Electronic Publication: 2023 Feb 05.
DOI:	10.1097/CM9.0000000000002603
Abstrakt:	Background: Liver biopsy for the diagnosis of non-alcoholic steatohepatitis (NASH) is limited by its inherent invasiveness and possible sampling errors. Some studies have shown that cytokeratin-18 (CK-18) concentrations may be useful in diagnosing NASH, but results across studies have been inconsistent. We aimed to identify the utility of CK-18 M30 concentrations as an alternative to liver biopsy for non-invasive identification of NASH. Methods: Individual data were collected from 14 registry centers on patients with biopsy-proven non-alcoholic fatty liver disease (NAFLD), and in all patients, circulating CK-18 M30 levels were measured. Individuals with a NAFLD activity score (NAS) ≥5 with a score of ≥1 for each of steatosis, ballooning, and lobular inflammation were diagnosed as having definite NASH; individuals with a NAS ≤2 and no fibrosis were diagnosed as having non-alcoholic fatty liver (NAFL). Results: A total of 2571 participants were screened, and 1008 (153 with NAFL and 855 with NASH) were finally enrolled. Median CK-18 M30 levels were higher in patients with NASH than in those with NAFL (mean difference 177 U/L; standardized mean difference [SMD]: 0.87 [0.69-1.04]). There was an interaction between CK-18 M30 levels and serum alanine aminotransferase, body mass index (BMI), and hypertension ( P  < 0.001, P  = 0.026 and P  = 0.049, respectively). CK-18 M30 levels were positively associated with histological NAS in most centers. The area under the receiver operating characteristics (AUROC) for NASH was 0.750 (95% confidence intervals: 0.714-0.787), and CK-18 M30 at Youden's index maximum was 275.7 U/L. Both sensitivity (55% [52%-59%]) and positive predictive value (59%) were not ideal. Conclusion: This large multicenter registry study shows that CK-18 M30 measurement in isolation is of limited value for non-invasively diagnosing NASH. (Copyright © 2023 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.)
Databáze:	MEDLINE
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