Serum ceruloplasmin can predict liver fibrosis in hepatitis B virus-infected patients

Kang, Na-Ling; Zhang, Jiemin; Lin, Min; Chen, Xudong; Huang, Zuxiong; Zhu, Yueyong; Liu, Yurui; Zeng, Da‐Wu

doi:10.3748/wjg.v26.i27.3952

Cited by 7 publications

(4 citation statements)

References 41 publications

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“…Tan et al [ 22 ] have shown that in patients with CHB, CER levels correlated with the liver fibrosis degree, which was of great value in diagnosing CHB cirrhosis. Kang et al [ 23 ] showed that patients with HBV infection have a negative correlation between CER and liver fibrosis. Significant fibrosis, advanced fibrosis, and liver cirrhosis were all predicted by CER with AUCs of 0.774, 0.812, and 0.853, respectively, which were similar to the results of this study.…”

Section: Discussionmentioning

confidence: 99%

Correlation of Serum M-CSF, CER, and TIMP-1 Levels with Liver Fibrosis in Viral Hepatitis

Yao

Yang

Yan

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. This research is aimed at investigating the relationship between liver fibrosis in viral hepatitis and macrophage colony-stimulating factor (M-CSF), tissue inhibitor of matrix metalloproteinase (TIMP-1), and ceruloplasmin (CER) in serum level. Methods. Patients were randomly selected among those admitted to our hospital, and 60 healthy volunteers were chosen to serve as control participants. The levels of serum M-CSF, CER, and TIMP-1 were compared. According to the severity of their liver fibrosis, patients with CHB were separated into four groups: S1, S2, S3, and S4. Serum levels of M-CSF, CER, and TIMP-1 were correlated with liver fibrosis and hepatitis markers, and the diagnostic usefulness of the three indices was assessed with liver cirrhosis patients. Results. Increases in M-CSF and TIMP-1 in the CHB group but decreases in CER were statistically significant ( P < 0.05 ). Serum levels of M-CSF, CER, TIMP-1, HA, PC-III, C-IV, and LN differed significantly across the four study groups ( P < 0.05 ). Over time, as liver fibrosis worsened, we observed a progressive uptick in M-CSF, TIMP-1, LN, HA, C-IV, and PC-III levels and a progressive downtick in CER levels, with significant ( P < 0.05 ) differences between the groups. There was a significant positive correlation between liver fibrosis and serum M-CSF, PC-III, TIMP-1, HA, LN, and C-IV levels in the CHB group ( P < 0.05 ) and a significant negative correlation between serum CER and these same factors ( P < 0.05 ). The AUC of 0.956 for diagnosing the S4 stage was greater than that of 0.857, 0.851, and 0.817 for M-CSF, CER, and TIMP-1, respectively. Conclusions. In CHB patients, the liver fibrosis degree is associated with the M-CSF, CER, and TIMP-1 levels, and the combined clinical detection of these three markers has better diagnostic significance.

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Section: Discussionmentioning

confidence: 99%

Correlation of Serum M-CSF, CER, and TIMP-1 Levels with Liver Fibrosis in Viral Hepatitis

Yao

Yang

Yan

et al. 2022

Computational and Mathematical Methods in Medicine

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“…CP also serves as a ferroxidase that oxidizes ferrous iron to ferric iron for further incorporation into transferrin ( 15 ). Despite the important diagnostic value in Wilson's disease, some studies suggested serum CP was inversely correlated to fibrosis or positively associated with steatosis in hepatitis B patients ( 16 , 17 ). And another study enrolled 100 children with biopsy-proven NAFLD demonstrated that CP had an accuracy of 82% in distinguishing pediatric patients with NAS score ≥ 5 from those with NAS score < 5 ( 18 ).…”

Section: Introductionmentioning

confidence: 99%

A Novel Non-Invasive Approach Based on Serum Ceruloplasmin for Identifying Non-Alcoholic Steatohepatitis Patients in the Non-Diabetic Population

Wang

Zhou²,

Wang³

et al. 2022

Front. Med.

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Background and AimFew non-invasive models were established to identify patients with non-alcoholic steatohepatitis (NASH). Liver biopsy remains the gold standard in the clinic. Decreased serum ceruloplasmin (CP) is reported in patients with non-alcoholic fatty liver disease (NAFLD). We aimed to develop a non-invasive model incorporating CP for identifying NASH from NAFLD without type 2 diabetes mellitus (T2DM).MethodsA total of 138 biopsy-proven patients with NAFLD without T2DM were enrolled. The CP ratio was calculated for standardization as the CP value divided by the lower limit of normal. The clinical, anthropometric, biochemical, and histological parameters were compared between the low and high CP ratio groups divided by the median value. Multivariate logistic regression analysis was performed to develop a model for identifying NASH in patients with NAFLD.ResultsThe medians of the high (n = 69) and low (n = 69) CP ratio groups were 1.43 (1.28–1.61) and 1.03 (0.94–1.12), respectively. A comparison of the two groups showed that the severity of steatosis, hepatocellular ballooning, inflammation activity, fibrosis, and liver iron deposition decreased along with the CP ratio (p < 0.05). The median CP ratio of patients with NASH was significantly lower than those with NAFL [1.15 (1.01–1.41) vs. 1.33 (1.24–1.54), p = 0.001]. A novel model which consists of the CP ratio, BMI, and aspartate aminotransferase (AST) was developed. The AUCs of the model in discriminating NASH from NAFLD was 0.796 (0.694–0.899) and 0.849 (0.713–0.984) in the training and validation groups, and 0.836 (0.659–1.000), 0.833 (0.705–0.962), and 0.821 (0.612–1.000) in patients with normal serum alanine aminotransferase, AST, and both levels, respectively.ConclusionsDecreased CP ratio is associated with more severe histological activity, a diagnosis of NASH, and hepatic iron deposition among patients with NAFLD without T2DM. The CP ratio model could be served as a non-invasive approach to identifying patients with NASH, which might reduce the need for liver biopsy.

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“…A noninvasive model composed of PT, AST, GGT, and anti-hepatitis B core antibody levels is valuable in predicting significant liver inflammation in CHB patients [ 28 ], however, it ignores the fibrosis stage. Conversely, another noninvasive model called CPHBV could accurately predict liver fibrosis in CHB patients with normal ALT level, regardless of liver inflammation [ 29 ]. AGH model composed of AST, hepatitis B core antigen and GGT is a reliable index to predict moderate to severe inflammation or significant fibrosis, which helps to determine the initiation of antiviral therapy [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

A noninvasive model discriminating significant histological changes in treatment-naive chronic hepatitis B patients with normal ALT

Teng

Visalath

et al. 2023

Virol J

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Background Traditionally part of chronic hepatitis B (CHB) patients with normal alanine aminotransferase (ALT) are recommended to antiviral therapy referring to liver biopsy. However, liver biopsy is an invasive method with various potential complications. A noninvasive model was established in the study to evaluate liver histology and to identify the need of antiviral therapy. Methods A total of 614 liver biopsied CHB patients with ALT less than upper limit of normal from 2 centers were retrospectively analyzed. They were divided into a training cohort and a validation cohort. A noninvasive model to predict the significant liver histological changes was established and validated. Results The results of analysis showed that ALT, Age, platelet (PLT) and liver stiffness (LS) were independent risk factors for significant liver injury. The model was established based on the 4 indexes, with the area under the curve of 0.85 and 0.87 in training cohort and validation cohort. Meanwhile, 2 cut-off scores were selected. By applying the low cut-off score (− 0.207), patients without significant liver injury could be identified with high accuracy, with negative predictive value of 72.7% and 73.7% in training and validation cohorts. By applying the high cut-off score (0.537), the presence of significant liver injury could be diagnosed with high accuracy, with positive predictive value of 90.3% and 88.8% in the training and validation cohorts. By applying the model, liver biopsy would have been avoided in 87.6% (538/614) patients, with correct prediction in 87.9% (473/538). Conclusion The novel noninvasive model composed of ALT, Age, PLT, LS can correctly assess liver histology in CHB patient with normal ALT, which helps to determine the need of antiviral therapy without liver biopsy.

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Serum ceruloplasmin can predict liver fibrosis in hepatitis B virus-infected patients

Cited by 7 publications

References 41 publications

Correlation of Serum M-CSF, CER, and TIMP-1 Levels with Liver Fibrosis in Viral Hepatitis

Correlation of Serum M-CSF, CER, and TIMP-1 Levels with Liver Fibrosis in Viral Hepatitis

A Novel Non-Invasive Approach Based on Serum Ceruloplasmin for Identifying Non-Alcoholic Steatohepatitis Patients in the Non-Diabetic Population

A noninvasive model discriminating significant histological changes in treatment-naive chronic hepatitis B patients with normal ALT

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