A Noninvasive Score Model for Prediction of NASH in Patients with Chronic Hepatitis B and Nonalcoholic Fatty Liver Disease

Liang, Juhua; Liu, Fang; Wang, Fengmei; Han, Tao; Li, Jing; Ma, Zhe; Gao, Yingtang

doi:10.1155/2017/8793278

Cited by 17 publications

(15 citation statements)

References 36 publications

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“…Yang et al found that the serum CK-18 levels might be a risk factor for non-alcoholic steatohepatitis (NASH), chronic hepatitis C (CHC), and chronic hepatitis B (CHB) (all P < 0.05) through conducting a meta-analysis of eight case-control studies (20). Some reports also showed that the plasma levels of CK-18 M30 were associated with the progression of non-alcoholic steatohepatitis (NASH) in non-alcoholic fatty liver disease (NAFLD) patients (21,22). Recently, the associations between serum levels of CK-18 M30 and the progression of the chronic HBV infections were investigated.…”

Section: Introductionmentioning

confidence: 99%

Association between Serum Cytokeratin-18 Neoepitope M30 (CK-18 M30) Levels and Chronic Hepatitis B: A Meta-Analysis

Liu

et al. 2018

Hepat Mon

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Background: Cytokeratin-18 Neoepitope M30 (CK-18 M30) has been reported to be associated with chronic HBV infection and severity of liver injury; however, the results of these studies are inconsistent. Objectives: We sought to investigate the association between serum CK-18 M30 levels and the severity of liver injury in chronic hepatitis B (CHB) patients. Methods: A systematic literature search was performed in PubMed, Embase, and Cochrane Library databases for relevant studies published in English up to August 2017. Heterogeneity among individual studies was investigated for summarizing all the studies. The standard mean difference (SMD) and 95% confidence interval (CI) were calculated using a random-effects model or fixed-effects model. Finally, the sensitivity analysis and publication bias were performed to evaluate the accuracy of this meta-analysis. Statistical analysis was conducted using Review Manager 5.3 and Stata 12.0. Results: Five case-control studies were included in the ultimate analysis, recruiting 488 CHB patients, 276 inactive carriers, and 193 healthy controls. The major results of the meta-analysis revealed significantly elevated serum CK-18 M30 levels in chronic HBV infected patients including CHB patients with severe liver injury and inactive HBV carriers when compared to healthy controls (SMD = 1.13, 95% CI: 0.75-1.50, P < 0.001; SMD = 0.63, 95% CI: 0.38-0.89, P < 0.001, respectively). Furthermore, the serum CK-18 M30 levels were significantly higher in CHB patients with severe liver injury than in inactive carriers (SMD =1.29, 95% CI: 0.60-1.98, P < 0.001). The sensitivity and publication bias analysis verified the stability and reliability of our analysis. Conclusions: The elevated serum CK-18 M30 levels could be regarded as a useful non-invasive biomarker for the diagnosis of chronic HBV infection, and were associated with the severity of liver injury in chronic Hepatitis B patients. The serum CK-18 M30 levels could reflect the liver inflammation in inactive carriers, representing the early stage of chronic HBV infection.

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Section: Introductionmentioning

confidence: 99%

Association between Serum Cytokeratin-18 Neoepitope M30 (CK-18 M30) Levels and Chronic Hepatitis B: A Meta-Analysis

Liu

et al. 2018

Hepat Mon

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“…The pattern entered into our calculator consisted of abnormal levels of AST, ALT, AP, GGT associated with hyperlipidemia, obesity, and abnormal glucose metabolism (diabetes mellitus). Existing noninvasive models and scores combine clinical data (age, degree of obesity and diabetes, family history, AST:ALT ratio > 1), measures of elasticity and blood test variables (pointers of collagen metabolism, cell death (M30 CK-18), insulin resistance (adiponectin and resistin), or oxidative stress markers (thioredoxin, lipid peroxides), but have still not reached a wide clinical acceptance [28,29].…”

Section: Discussionmentioning

confidence: 99%

Performance of a calculator for diagnosing the cause of liver damage

et al. 2019

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Introduction/Objective Making a calculator that would recognize patterns of abnormal liver function tests and link them to the most probable etiology could help clinicians in their initial orientation towards a definitive diagnosis in patients with liver damage. The aim of our study was to design, construct, and validate a calculator that based on a pattern of abnormalities in liver function tests of a patient with liver damage would propose the most probable etiology. Methods Patterns of abnormal liver function tests for certain etiology of liver damage were extracted from distributions of actual values taken from reports in medical literature about patients whose etiology of liver damage was proven by reliable diagnostic tests. After setting up the calculator with the patterns extracted, its diagnostic value was checked under real-life conditions, on a sample of patients with liver damage whose etiology was established by the gold standard of diagnostics (biopsy or else). The calculator validation study was carried out at the Military Medical Academy in Belgrade during a two-year period (2015)(2016). Results For all tested diagnoses, the calculator demonstrated a highly significant difference between the area under the receiver-operator curves' values and the value of 0.5 (p < 0.001), and high level of sensitivity (more than 90%, except for the model for chronic hepatitis) as well as relatively high specificity (more than 75%) were noted, indicating good ability of the calculator to detect etiology of liver damage. Conclusion New calculators showed satisfactory sensitivity and specificity for revealing major liver damage etiologies.

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“…A number of noninvasive score models were applied to identify NASH among patients with CHB. In a relatively small study with 64 CHB patients, Liang et al found that elevated serum level of CK18M30, higher CAP scores, and elevated fasting plasma glucose level were all independent risk factors for NASH [ 81 ]. Subsequently, a logistic regression model combining CK-18 M30, CAP, fasting plasma glucose, and HBV DNA level was established for diagnosis of NASH in CHB patients.…”

Section: Current and Novel Serum Biomarkers For Nafldmentioning

confidence: 99%

A New Endemic of Concomitant Nonalcoholic Fatty Liver Disease and Chronic Hepatitis B

et al. 2020

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Hepatitis B virus (HBV) infection remains a global public problem despite the availability of an effective vaccine. In the past decades, nonalcoholic fatty liver disease (NAFLD) has surpassed HBV as the most common cause of chronic liver disease worldwide. The prevalence of concomitant chronic hepatitis B (CHB) and NAFLD thus reaches endemic proportions in geographic regions where both conditions are common. Patients with CHB and NAFLD are at increased risk of liver disease progression to cirrhosis and hepatocellular carcinoma. Due to the complexity of the pathogenesis, accurate diagnosis of NAFLD in CHB patients can be challenging. Liver biopsy is considered the gold standard for diagnosing and determining disease severity, but it is an invasive procedure with potential complications. There is a growing body of literature on the application of novel noninvasive serum biomarkers and advanced radiological modalities to diagnose and evaluate NAFLD, but most have not been adequately validated, especially for patients with CHB. Currently, there is no approved therapy for NAFLD, although many new agents are in different phases of development. This review provides a summary of the epidemiology, clinical features, diagnosis, and management of the NAFLD and highlights the unmet needs in the areas of CHB and NAFLD coexistence.

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A Noninvasive Score Model for Prediction of NASH in Patients with Chronic Hepatitis B and Nonalcoholic Fatty Liver Disease

Cited by 17 publications

References 36 publications

Association between Serum Cytokeratin-18 Neoepitope M30 (CK-18 M30) Levels and Chronic Hepatitis B: A Meta-Analysis

Association between Serum Cytokeratin-18 Neoepitope M30 (CK-18 M30) Levels and Chronic Hepatitis B: A Meta-Analysis

Performance of a calculator for diagnosing the cause of liver damage

A New Endemic of Concomitant Nonalcoholic Fatty Liver Disease and Chronic Hepatitis B

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