Serum MFAP4, a novel potential biomarker for liver cirrhosis screening, correlates with transient elastography in NAFLD patients

Abstract

Background and Aim: Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in different countries. Liver fibrosis is considered as the most appropriate predictor of NAFLD-associated outcome. Microfibrillar-associated protein 4 (MFAP4) is a glycoprotein located in the extracellular matrix. Circulatory MFAP4 has been suggested as a noninvasive biomarker for the assessment of hepatitis C virus and alcoholic liver disease associated liver fibrosis. In this study, we aimed to investigate the association between serum MFAP4 and liver fibrosis severity in NAFLD patients. Methods: A case-control study was conducted in which NAFLD patients (n = 25) and healthy participants (n = 12) were recruited. Liver fibrosis/cirrhosis was assessed by transient elastography (TE) and biochemical parameters were collected. Serum MFAP4 was measured by sandwich ELISA based on two monoclonal anti-MFAP4 antibodies and calibrated with a standard of recombinant MFAP4. Results: Serum MFAP4 levels increased with fibrosis severity and were highly upregulated in patients with cirrhosis (F4 fibrosis stage). In addition, serum MFAP4 levels positively correlated with TE measurement and showed significant association with the severely advanced fibrotic stage in NAFLD patients, in multiple linear regression analysis following adjustment for age, gender, and body mass index. Conclusion: This study suggests the use of MFAP4 as a potential diagnostic noninvasive biomarker for cirrhosis screening in NAFLD patients.

Serum MFAP4 as a Non Invasive Diagnostic Marker of Oesophageal Varices in Cirrhotic Hepatitis C Virus Patients

“…These findings are consistent with the study conducted by Bracht T et al, [24], which determined that MFAP4 can serve as a beneficial blood biomarker for identifying individuals at a greater risk of severe fibrosis stages in HCV patients and for assessing hepatic fibrosis. This was similar with Kanaan R et al [25] finding that patients with advanced stage cirrhosis and fibrosis (stage F4) had greater serum MFAP4 levels than those with F1-F2-F3. He found no significant difference between F3/F2/F1 and healthy controls, F3 against F2, or F2 versus F1.…”

“…As indicated in Table 6, we discovered that serum MFAP4 did not correlate with the FIB-4 or APRI in any of the cirrhotic patients, with the exception of a negative correlation with the APRI score in patients with large varcies. Similarly, Kanaan R et al [25] found no correlation between serum MFAP4 levels and liver function parameters, including ALT, AST, ALP, GGT, and bilirubin, in their study.…”