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Systematic review of the diagnostic performance of serum markers of liver fibrosis in alcoholic liver disease

Systematic review of the diagnostic performance of serum markers of liver fibrosis in alcoholic liver disease
Systematic review of the diagnostic performance of serum markers of liver fibrosis in alcoholic liver disease
BACKGROUND: Alcoholic liver disease (ALD) is a significant cause of death and morbidity. Detection of liver fibrosis at an early stage could provide opportunities for more optimal management. Serum markers of liver fibrosis offer an alternative to biopsy. Evidence of the performance of biomarkers in ALD is needed and a systematic review to evaluate available studies was conducted.

METHODS: Electronic databases were searched. Studies were included if they evaluated paired samples of biopsy and serum, and presented data as sensitivity, specificity, or ROC curves.

RESULTS: 15 studies were included- median participant number?=?146 (range 44-1034). Studies differed with respect to patient populations. 6 single markers were evaluated (mostly Hyaluronic Acid), and ten combined panels. Biomarkers could discriminate between people with severe fibrosis/cirrhosis with high diagnostic accuracy- HA (median AUROC 0.79 range 0.69-0.93), panels (median AUROC 0.83 range 0.38-0.95). Significant heterogeneity precluded pooling. Performance was poorer for detecting less severe fibrosis.

CONCLUSIONS: There are limited numbers of small studies evaluating the accuracy of biomarkers in identifying fibrosis on biopsy in ALD. Some showed promise (both HA alone and some panels) in the identification of cirrhosis/severe fibrosis and could be used to rule it out in heavy drinkers. Biomarkers less accurate with less severe fibrosis.
alcoholic liver disease, systematic review, serum markers, liver fibrosis
1476-5926
5
Parkes, Julie
59dc6de3-4018-415e-bb99-13552f97e984
Guha, I.N.
15ece18d-5a89-4c6d-9c85-9df96dd022e1
Harris, S.
19ea097b-df15-4f0f-be19-8ac42c190028
Rosenberg, W.
1a551f54-b4aa-42e0-a5e1-45c6a5232821
Roderick, P.
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Parkes, Julie
59dc6de3-4018-415e-bb99-13552f97e984
Guha, I.N.
15ece18d-5a89-4c6d-9c85-9df96dd022e1
Harris, S.
19ea097b-df15-4f0f-be19-8ac42c190028
Rosenberg, W.
1a551f54-b4aa-42e0-a5e1-45c6a5232821
Roderick, P.
dbb3cd11-4c51-4844-982b-0eb30ad5085a

Parkes, Julie, Guha, I.N., Harris, S., Rosenberg, W. and Roderick, P. (2012) Systematic review of the diagnostic performance of serum markers of liver fibrosis in alcoholic liver disease. Comparative Hepatology, 11 (1), 5. (doi:10.1186/1476-5926-11-5). (PMID:23273224)

Record type: Article

Abstract

BACKGROUND: Alcoholic liver disease (ALD) is a significant cause of death and morbidity. Detection of liver fibrosis at an early stage could provide opportunities for more optimal management. Serum markers of liver fibrosis offer an alternative to biopsy. Evidence of the performance of biomarkers in ALD is needed and a systematic review to evaluate available studies was conducted.

METHODS: Electronic databases were searched. Studies were included if they evaluated paired samples of biopsy and serum, and presented data as sensitivity, specificity, or ROC curves.

RESULTS: 15 studies were included- median participant number?=?146 (range 44-1034). Studies differed with respect to patient populations. 6 single markers were evaluated (mostly Hyaluronic Acid), and ten combined panels. Biomarkers could discriminate between people with severe fibrosis/cirrhosis with high diagnostic accuracy- HA (median AUROC 0.79 range 0.69-0.93), panels (median AUROC 0.83 range 0.38-0.95). Significant heterogeneity precluded pooling. Performance was poorer for detecting less severe fibrosis.

CONCLUSIONS: There are limited numbers of small studies evaluating the accuracy of biomarkers in identifying fibrosis on biopsy in ALD. Some showed promise (both HA alone and some panels) in the identification of cirrhosis/severe fibrosis and could be used to rule it out in heavy drinkers. Biomarkers less accurate with less severe fibrosis.

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More information

Published date: 28 December 2012
Keywords: alcoholic liver disease, systematic review, serum markers, liver fibrosis
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 350104
URI: http://eprints.soton.ac.uk/id/eprint/350104
ISSN: 1476-5926
PURE UUID: 444d181b-69de-4d62-bb82-c69b03c0a10d
ORCID for Julie Parkes: ORCID iD orcid.org/0000-0002-6490-395X
ORCID for P. Roderick: ORCID iD orcid.org/0000-0001-9475-6850

Catalogue record

Date deposited: 18 Mar 2013 14:54
Last modified: 09 Nov 2021 02:57

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Contributors

Author: Julie Parkes ORCID iD
Author: I.N. Guha
Author: S. Harris
Author: W. Rosenberg
Author: P. Roderick ORCID iD

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