The possibilities of soluble selectins in the prediction of severe fi brosis in nonalcoholic fatty liver disease

Abstract

The aim of the work was to study the relationship of selectins with hepatic fi brosis in nonalcoholic fatty liver disease (NAFLD).Material and methods. In 40 patients with histologically confi rmed NAFLD (42.5% of women, 57.5% of men) aged 19 to 65 years (mean age — 40.93±1.95 years), the levels of E-, P- and L-selectins in the blood was studied. Severe liver steatosis was present in 47.5% of patients, nonalcoholic steatohepatitis was observed in 57.5% of cases, and severe liver fi brosis was detected in 22.5% of patients. The control group consisted of 60 practically healthy people.Results. The increase of plasma levels of all selectins was observed in NAFLD. The blood levels of E-selectin elevated with increasing of histological signs of hepatic steatosis. The concentration of E- and P-selectins in the blood was higher in patients with nonalcoholic steatohepatitis than in cases of its absence. The maximum values of E- and P-selectins in the blood were present in severe liver fi brosis. Correlation of soluble E- and P-selectins with fi brosis index was determined. The risk of severe fi brosis in NAFLD increased 27-fold with E-selectin values above 89 ng/ml and 33-fold in cases of P-selectin values greater than 166 ng/ml. The accuracy of the above levels of E- and P-selectins in predicting severe fi brosis in NAFLD was 80.0 and 82.5%, respectively. The probability of severe liver fi brosis in NAFLD was related with the presence of insulin resistance and increased levels of P-selectin in the blood.Conclusion. Determination of the profi le of soluble selectins in NAFLD allows us to state the severity of liver fi brosis and stratify patients into groups with its diff erent severity.