Wisteria floribunda Agglutinin-Positive Mac-2 Binding Protein as a Screening Tool for Significant Liver Fibrosis in Health Checkup

Abstract

Chronic liver disease is generally widespread, and a test for screening fibrotic subjects in a large population is needed. The ability of Wisteria floribunda agglutinin-positive mac-2 binding protein (WFA+-M2BP) to detect significant fibrosis was investigated in health checkup subjects in this research. Of 2021 health checkup subjects enrolled in this prospective cross-sectional study, those with WFA+-M2BP ≥ 1.0 were defined as high risk. Liver fibrosis was evaluated using magnetic resonance elastography (MRE) in subjects with high risk. The primary outcome was the positive predictive value (PPV) of WFA+-M2BP for significant fibrosis (liver stiffness ≥ 2.97 kPa by MRE). This trial was registered with the UMIN clinical trial registry, UMIN000036175. WFA+-M2BP ≥ 1.0 was observed in 5.3% of the 2021 subjects. The PPV for significant fibrosis with the threshold of WFA+-M2BP at ≥1.0, ≥1.1, ≥1.2, ≥1.3, ≥1.4, and ≥1.5 was 29.2%, 36.4%, 43.5%, 42.9%, 62.5%, and 71.4%, respectively. A WFA+-M2BP of 1.2 was selected as the optimal threshold for significant fibrosis among high-risk subjects, and the PPV, negative predictive value, sensitivity, and specificity for significant fibrosis were 43.5%, 84.0%, 71.4%, and 61.8%, respectively. WFA+-M2BP ≥ 1.2 was significantly associated with significant fibrosis, with an odds ratio (OR) of 4.04 (95% confidence interval (CI): 1.1–16, p = 0.04), but not FIB-4 ≥ 2.67 (OR: 2.40, 95%CI: 0.7–8.6, p-value = 0.2). In conclusion, WFA+-M2BP is associated with significant fibrosis and could narrow down potential subjects with liver fibrosis. The strategy of narrowing down fibrosis subjects using WFA+-M2BP may be used to screen for fibrotic subjects in a large population.

Liver fibrosis and fatty liver as independent risk factors for cardiovascular disease

“…Advanced fibrosis was defined as FIB-4 ≥ 2.67, NFS ≥ 0.675, and WFA + -M2BP ≥ 1.0 cut-off index (COI), based on previous studies. [19][20][21][22][23][24][25] Cardiovascular disease risk assessment. Cardiovascular disease risk was assessed using Framingham risk score (FRS).…”

Noninvasive assessment of liver fibrosis and its clinical significance in nonalcoholic fatty liver disease

“…29 Therefore, although thresholds of FIB-4 vary by age, M2BPGi can measure liver fibrosis independent of age and may be useful for assessing liver fibrosis in the general population. 30 However, further validation studies are needed, especially in other regions outside Asia.…”

“…Another study that compared M2BPGi and FIB‐4 demonstrated that optimal cutoff values of M2BPGi for advanced fibrosis were similar in age‐differ groups, while those of FIB‐4 increased in parallel with age 29 . Therefore, although thresholds of FIB‐4 vary by age, M2BPGi can measure liver fibrosis independent of age and may be useful for assessing liver fibrosis in the general population 30 . However, further validation studies are needed, especially in other regions outside Asia.…”

SWOT analysis of noninvasive tests for diagnosing NAFLD with severe fibrosis: an expert review by the JANIT Forum

“…This marker is a useful predictor of NAFLD at fibrosis stages ≥ 2 and ≥ 3 [ 58 ], is not affected by age, and can be judged by a single cutoff point [ 59 ]. In addition, M2BPGi can differentiate patients at high risk for severe fibrosis from a healthy control group [ 60 ], and it may be a predictor of hepatocarcinogenesis, though further studies are required [ 61 ]. The M2BPGi clinical test is reimbursable in Japan, but limited data are available in other Asian-Pacific countries as highlighted in the 2016 Asian Pacific Association for the Study of the Liver consensus guidelines.…”