Gut Liver.
2019 Jan;13(1):77-82. 10.5009/gnl18037.
Plasma Levels of K18 Fragments Do Not Correlate with Alcoholic Liver Fibrosis
- Affiliations
-
- 1Hepatology Unit, Clinic Beau-Site Hirslanden, Bern, Switzerland. Felix.stickel@uzh.ch
- 2Department of Visceral Surgery and Medicine, Inselspital, University Clinic of Bern, Bern, Switzerland.
- 3Department of Gastroenterology, Spital Interlaken, Unterseen, Switzerland.
- 4Department of Pathology, University of Bern, Bern, Switzerland.
- 5Department of Internal Medicine, Hospital Oberndorf, Teaching Hospital of the Paracelsus Private University of Salzburg, Oberndorf, Austria.
- 6Medical Department 1, University Hospital Dresden, Technische Universität Dresden, Dresden, Germany.
- 7Department of Gastroenterology and Hepatology, University Hospital of Zürich, Zurich, Switzerland.
- KMID: 2434394
- DOI: http://doi.org/10.5009/gnl18037
Abstract
- BACKGROUND/AIMS
Noninvasive markers of liver fibrosis in alcoholic liver disease (ALD) are crucial to establish early intervention. Previous studies have suggested that plasma levels of cleaved keratin-18 (K18; M30) fragments can predict the severity of liver disease. The aim of this study was to correlate plasma M30 levels with stages of liver fibrosis in ALD.
METHODS
Patients with ALD (n=139, 79.1% males) and liver histology were included, and plasma samples were collected to quantify plasma M30 levels. Patients were stratified into five groups by fibrosis stage (F0=14; F1=15; F2=35; F3=17; and F4=58) according to the Kleiner score. Differences between groups were evaluated using the chi-square test or analysis of variance. Trends by fibrosis stage were calculated by logistic regression analysis, and sensitivity, specificity and positive and negative predictive values were determined.
RESULTS
There were no significant differences in M30 levels among fibrosis stages. The correlation between plasma M30 levels and fibrosis was poor (Pearson's correlation coefficient=0.13, Spearman rho=0.20 [p=0.02]), and M30 levels did not correlate with alcohol-specific histological features. However, significant correlations of M30 levels with aspartate aminotransferase (Spearman rho=0.653, p < 0.001) and alanine aminotransferase (Spearman rho=0.432, p < 0.001) were found. M30 levels of >200 U/L reveal a sensitivity for predicting cirrhosis of 84.5% with a negative predictive value of 73.5%.
CONCLUSIONS
Plasma M30 levels are often elevated in ALD and correlate with serum transaminases but do not reflect fibrosis. The usefulness as a prognostic marker awaits evaluation in prospective studies.
MeSH Terms
-
Alanine Transaminase
Alcoholics*
Apoptosis
Aspartate Aminotransferases
Caspases
Early Intervention (Education)
Fibrosis
Humans
Keratin-18
Liver Cirrhosis*
Liver Diseases
Liver Diseases, Alcoholic
Liver*
Logistic Models
Plasma*
Prospective Studies
Sensitivity and Specificity
Transaminases
Alanine Transaminase
Aspartate Aminotransferases
Caspases
Keratin-18
Transaminases
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