Serum PRO-C3 is useful for risk prediction and fibrosis assessment in MAFLD with chronic kidney disease in an Asian cohort.

Autor: Tang LJ; MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.; Cancer Center, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China., Sun DQ; Department of Nephrology, Jiangnan University Medical Center, Wuxi, China.; Affiliated Wuxi Clinical College of Nantong University, Wuxi, China., Song SJ; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.; State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China., Yip TC; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.; State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China., Wong GL; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.; State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China., Zhu PW; Department of Laboratory Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China., Chen SD; Department of Pathology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China., Karsdal M; Nordic Bioscience Biomarkers and Research A/S, Herlev, Denmark., Leeming DJ; Nordic Bioscience Biomarkers and Research A/S, Herlev, Denmark., Jiang P; Fosun Diagnostics (Shanghai) Co., Ltd, Shanghai, China., Wang C; Fosun Diagnostics (Shanghai) Co., Ltd, Shanghai, China., Chen Q; Cancer Center, Faculty of Health Sciences, University of Macau, Taipa, Macau SAR, China.; MOE Frontier Science Centre for Precision Oncology, University of Macau, Taipa, Macau SAR, China., Byrne CD; Southampton National Institute for Health and Care Research, Biomedical Research Centre, University of Southampton and University Hospital Southampton, Southampton, UK., Targher G; Department of Medicine, University of Verona, Verona, Italy.; IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Italy., Eslam M; Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital, Westmead, New South Wales, Australia.; University of Sydney, Sydney, New South Wales, Australia., George J; Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital, Westmead, New South Wales, Australia.; University of Sydney, Sydney, New South Wales, Australia., Wong VW; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.; State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China., Zheng MH; MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.; Institute of Hepatology, Wenzhou Medical University, Wenzhou, China.; Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China.
Jazyk: angličtina
Zdroj: Liver international : official journal of the International Association for the Study of the Liver [Liver Int] 2024 May; Vol. 44 (5), pp. 1129-1141. Date of Electronic Publication: 2024 Mar 01.
DOI: 10.1111/liv.15878
Abstrakt: Background: Metabolic dysfunction-associated fatty liver disease (MAFLD) is an emerging risk factor for chronic kidney disease (CKD). N-terminal propeptide of collagen type 3 (PRO-C3) is a biomarker of advanced fibrosis in MAFLD and PRO-C3 may be involved in renal fibrosis. We aimed to use PRO-C3 measurements to generate a new algorithmic score to test the prediction of MAFLD with chronic kidney disease (MAFLD-CKD).
Methods: A derivation and independent validation cohort of 750 and 129 Asian patients with biopsy-confirmed MAFLD were included. Serum PRO-C3 concentration was measured and regression analyses were performed to examine associations with MAFLD-CKD. A derivative algorithm for MAFLD-CKD risk prediction was evaluated with receiver operator characteristic (ROC) curve analysis.
Results: The study included two Asian cohorts (n = 180 with MAFLD-CKD; mean-eGFR: 94.93 mL/min/1.73 m 2 ; median-urinary albumin-to-creatinine ratio: 6.58 mg/mmol). PRO-C3 was associated with the severity of MAFLD-CKD and independently associated with MAFLD-CKD (adjusted odds ratio = 1.16, 95% confidence interval [CI]: 1.08-1.23, p < .001). A new non-invasive score (termed PERIOD) including PRO-C3 efficiently predicted MAFLD-CKD (AUROC = .842, 95% CI: .805-.875). Accuracy, specificity and negative predictive values were 80.2%, 85.1% and 88.4%, respectively. In the validation cohort, the PERIOD score had good diagnostic performance (AUROC = .807, 95% CI: .691-.893) with similar results in all patient subgroups. In the MAFLD-CKD subgroup, the accuracy for identifying advanced fibrosis was further improved by combining the PRO-C3-based ADAPT with the Agile 3+ scores (AUROC = .90, 95% CI: .836-.964).
Conclusions: The PERIOD score is helpful for accurately predicting the risk of MAFLD-CKD. PRO-C3 can also be used to assess liver fibrosis in people with MAFLD-CKD.
(© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
Externí odkaz: