Ann Lab Med.  2021 May;41(3):302-309. 10.3343/alm.2021.41.3.302.

Diagnostic Efficacy of Serum Mac-2 Binding Protein Glycosylation Isomer and Other Markers for Liver Fibrosis in Non-Alcoholic Fatty Liver Diseases

• Jang SY
• Tak WY
• Park SY
• Kweon YO
• Lee YR
• Kim G
• Hur K
• Han MH
• Lee WK

• KMID: 2512688
• DOI: http://doi.org/10.3343/alm.2021.41.3.302

Abstract

Background
Mac-2 binding protein glycosylation isomer (M2BPGi) has been established as a non-invasive biomarker for liver fibrosis. We evaluated the diagnostic efficacy of M2BPGi compared with those of other liver fibrosis markers in liver fibrosis in non-alcoholic fatty liver disease (NAFLD).
Methods
We analyzed serum M2BPGi levels in 113 NAFLD patients. A pathologist graded liver fibrosis histopathologically. The diagnostic efficacies of serum M2BPGi and other liver fibrosis markers (aspartate aminotransferase to platelet ratio index, fibrosis index based on four factors, and NAFLD fibrosis score [NFS]) were evaluated using correlation, area under the ROC curve (AUC), logistic regression, and C-statistics.
Results
Serum M2BPGi level and other liver fibrosis markers showed a moderate correlation with fibrosis grade. The AUC values of M2BPGi were 0.761, 0.819, 0.866, and 0.900 for diagnosing fibrosis (F) > 0, F > 1, F > 2, and F > 3, respectively. Logistic regression analysis showed M2BPGi as the only independent factor associated with F > 2 and F > 3. Although C-statistics showed that NFS was the best diagnostic factor for F > 2 and F > 3, M2BPGi with NFS had an increased C-statistics value, indicating that it is a better diagnostic model.
Conclusions
The serum M2BPGi level increased with liver fibrosis severity and could be a good biomarker for diagnosing advanced fibrosis and cirrhosis in NAFLD patients. A well-controlled, prospective study with a larger sample size is needed to validate the diagnostic power of M2BPGi and other fibrosis markers in NAFLD.

Keyword

Mac-2 binding protein glycosylation isomer; Non-alcoholic fatty liver disease; Liver fibrosis; Diagnosis; Biomarker

Figure

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  Fig. 1 Liver fibrosis marker values at each liver fibrosis stage in NAFLD patients. Spearman’s rank correlation analysis showed that the serum M2BPGi level (ρ=0.653, P<0.001) and FIB-4 (ρ=0.689, P<0.001) increased with the liver fibrosis stage. There were moderate correlations between APRI (ρ=0.515, P<0.001) and NFS (ρ=0.628, P<0.001) and fibrosis stage, respectively. However, the median APRI score decreased in F4 than in F3, and median NFS decreased in F1 than in F0. (A) Serum M2BPGi level, (B) APRI, (C) FIB-4, and (D) NFS. The box height represents the interquartile range, and the line across each box represents the median. *P<0.05, †P<0.01, ‡P<0.001. Abbreviations: APRI, aspartate transaminase to platelet ratio index; FIB-4, fibrosis index based on four factors; M2BPGi, Mac-2 binding protein glycosylation isomer; NAFLD, non-alcoholic fatty liver disease; NFS, NAFLD fibrosis score; ns, not significant.

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