Novel serum biomarkers modified by the body mass index z-score for the detection of liver fibrosis and steatosis in children with chronic hepatitis C

Abstract

BackgroundThere is a need for validation of noninvasive alternatives to liver biopsy for the evaluation of fibrosis in children with chronic hepatitis C (CHC). The aim of this study was to evaluate the diagnostic performance of serum biomarkers modified by the body mass index z-score (BMI z-score) for the detection of fibrosis and steatosis in children with CHC.MethodsThirty children aged 9.4 ± 3.7 years (14 males, 16 females) with CHC underwent liver biopsy. Fibrosis was scored using a 5-point METAVIR scale (≥2 = significant fibrosis). For all the children, the following noninvasive markers were calculated: The aspartate transaminase (AST)-to-platelets ratio index (APRI), the modified APRI (M-APRI: BMI z-score × APRI), the Fibrosis-4 index (FIB-4), the modified FIB-4 (M-FIB-4: BMI z-score × FIB-4), and a novel marker, B-AST (BMI z-score × AST). The area under the receiver operator characteristic curve (AUROC) was calculated to detect significant fibrosis and steatosis.ResultsIn the histopathological evaluation, 22/30 (73%) patients presented with fibrosis, and 8/30 (27%) presented with steatosis. For the detection of significant fibrosis, the AUROCs for M-APRI, M-FIB-4 and B-AST were 0.842, 0.823, and 0.848, respectively. For significant steatosis, the AUROCs were more than 0.9 for all markers that included the BMI z-score. B-AST, with a cut-off of 92.8, showed 71% sensitivity and 95% specificity for detecting significant fibrosis. For predicting severe steatosis, B-AST had 100% sensitivity and 92% specificity. Negative values of all three markers that included BMI z-scores excluded all patients with both significant fibrosis and significant steatosis.ConclusionsIncluding the BMI z-score in serum biomarker formulas enhances their diagnostic ability to detect significant fibrosis and steatosis. B-AST may thus act as an effective alternative to liver biopsy.

Protective Effect of α-Linolenic Acid on Non-Alcoholic Hepatic Steatosis and Interleukin-6 and -10 in Wistar Rats

“…The morphological analyses of the liver were based on the presence of the following histopathological parameters: steatosis (fatty degeneration), necrosis, vasodilation, leukocyte infiltration, hyaline degeneration, and hydropic degeneration [39]. We used a scoring system: 2, absence of lesion; 4, focal microvesicular steatosis in some liver lobes; 6, diffuse micro and macrovesicular steatosis by the hepatic lobes; and 8, diffuse macrovesicular stenosis by the hepatic lobes.…”

Campomanesia sp. flour attenuates non‐alcoholic fatty liver disease on rats fed with a hypercaloric diet

“…For hepatic morphology, the presence or absence of the following histopathology parameters was considered: steatosis, necrosis, vasodilatation, leucocyte infiltration, hyaline degeneration, hydropic degeneration and fibrosis. All analyses were classified by score system, being: 2—the absence of lesion; 4—minimal lesion; 6—moderate lesion; and 8—severe lesion (Pokorska‐Śpiewak, Kowalik‐Mikołajewska, Aniszewska, Pluta, & Marczyńska, 2017).…”

Clinical usefulness of new noninvasive serum biomarkers for the assessment of liver fibrosis and steatosis in children with chronic hepatitis C

“…The biomarker determinations were performed using commercially available laboratory kits (XT-1800i, Sysmex for platelets; Vitros 5600, Ortho-Clinical Diagnostics, Johnson & Johnson for biochemical parameters). The diagnostic performance for all three biomarkers was calculated using area under the ROC curve (AUROC) analysis, and these data were presented in our previous study [ 6 ].…”

“…In our recent study, we demonstrated that novel serum biomarkers modified by including the body mass index z -score (BMI z -score) in their formulas show a better diagnostic performance in detecting significant fibrosis and significant steatosis compared to standard tests (aspartate transaminase-to-platelet ratio index, APRI, and the Fibrosis-4 index, FIB-4) [ 6 ]. We also proposed and evaluated a novel simple biomarker, B-AST, based on the BMI z -score and aspartate aminotransferase (AST) only (B-AST = AST × BMI z -score).…”

“…We also proposed and evaluated a novel simple biomarker, B-AST, based on the BMI z -score and aspartate aminotransferase (AST) only (B-AST = AST × BMI z -score). Its diagnostic performance was excellent in predicting significant fibrosis and significant steatosis in pediatric patients with CHC [ 6 ].…”