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Plasma N-terminal propeptide of type III procollagen accurately predicts liver fibrosis severity in children with non-alcoholic fatty liver disease

Plasma N-terminal propeptide of type III procollagen accurately predicts liver fibrosis severity in children with non-alcoholic fatty liver disease
Plasma N-terminal propeptide of type III procollagen accurately predicts liver fibrosis severity in children with non-alcoholic fatty liver disease
Background & Aims We examined the diagnostic performance of plasma N‐terminal propeptide of type III procollagen (PIIINP) levels, aspartate aminotransferase to platelet ratio index (APRI) and Fibrosis‐4 (FIB‐4) score for predicting non‐alcoholic steatohepatitis (NASH) and liver fibrosis stage in children/adolescents with non‐alcoholic fatty liver disease (NAFLD). Methods We enrolled 204 children/adolescents with biopsy‐proven NAFLD at the "Bambino Gesù" Children's Hospital. We measured plasma PIIINP levels using a commercially available enzyme‐linked immunosorbent assay kit and calculated APRI and FIB‐4 scores using standard methods. Results Children with NASH had higher plasma PIIINP levels, APRI and FIB‐4 scores compared with those without NASH (all P < .001). However, PIIINP levels had much better diagnostic performance and accuracy than APRI and FIB‐4 scores for predicting liver fibrosis stage. PIIINP levels correlated with the total NAFLD activity score (NAS) and its constituent components (P < .0001). The risk of either NASH or F ≥ 2 fibrosis progressively increased with increasing PIIINP levels (P < .0001), independent of age, gender, adiposity measures, insulin resistance, NAS score and the patatin‐like phospholipase domain‐containing protein‐3 rs738409 polymorphism. For every 3.6 ng/mL increase in PIIINP levels, the likelihood of having F ≥ 2 fibrosis increased by ~14‐fold (adjusted‐odds ratio 14.1, 95% CI 5.50‐35.8, P < .0001) after adjustment for the aforementioned risk factors. The area under the receiver operating characteristics curve was 0.921 (95% CI 0.87‐0.97) for F ≥ 2 fibrosis, and 0.993 (95% CI 0.98‐1.0) for F3 fibrosis respectively. Conclusions Unlike APRI and FIB‐4 scores, plasma PIIINP levels are a promising, non‐invasive biomarker for diagnosing liver fibrosis stage in children/adolescents with biopsy‐proven NAFLD.
1478-3223
2317-2329
Mosca, Antonella
4e50a763-3812-4b5a-b170-6ca40bd2f79c
Comparcola, Donatella
5492835d-6df2-40b7-808b-67fdf0238837
Romito, Ilaria
7bcbc221-d6a3-4742-8eb8-46dbbb69aa47
Mantovani, Alessandro
19fc8a1f-60fe-403a-b70e-6b6884929e03
Nobili, Valerio
20ac6b68-15f3-463c-b2b6-a0b383a88111
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Alisi, Anna
d230c341-c870-4907-927e-37e6bf4734ba
Targher, Giovanni
043e0811-b389-4922-974e-22e650212c5f
Mosca, Antonella
4e50a763-3812-4b5a-b170-6ca40bd2f79c
Comparcola, Donatella
5492835d-6df2-40b7-808b-67fdf0238837
Romito, Ilaria
7bcbc221-d6a3-4742-8eb8-46dbbb69aa47
Mantovani, Alessandro
19fc8a1f-60fe-403a-b70e-6b6884929e03
Nobili, Valerio
20ac6b68-15f3-463c-b2b6-a0b383a88111
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Alisi, Anna
d230c341-c870-4907-927e-37e6bf4734ba
Targher, Giovanni
043e0811-b389-4922-974e-22e650212c5f

Mosca, Antonella, Comparcola, Donatella, Romito, Ilaria, Mantovani, Alessandro, Nobili, Valerio, Byrne, Christopher, Alisi, Anna and Targher, Giovanni (2019) Plasma N-terminal propeptide of type III procollagen accurately predicts liver fibrosis severity in children with non-alcoholic fatty liver disease. Liver International, 39 (12), 2317-2329. (doi:10.1111/liv.14225).

Record type: Article

Abstract

Background & Aims We examined the diagnostic performance of plasma N‐terminal propeptide of type III procollagen (PIIINP) levels, aspartate aminotransferase to platelet ratio index (APRI) and Fibrosis‐4 (FIB‐4) score for predicting non‐alcoholic steatohepatitis (NASH) and liver fibrosis stage in children/adolescents with non‐alcoholic fatty liver disease (NAFLD). Methods We enrolled 204 children/adolescents with biopsy‐proven NAFLD at the "Bambino Gesù" Children's Hospital. We measured plasma PIIINP levels using a commercially available enzyme‐linked immunosorbent assay kit and calculated APRI and FIB‐4 scores using standard methods. Results Children with NASH had higher plasma PIIINP levels, APRI and FIB‐4 scores compared with those without NASH (all P < .001). However, PIIINP levels had much better diagnostic performance and accuracy than APRI and FIB‐4 scores for predicting liver fibrosis stage. PIIINP levels correlated with the total NAFLD activity score (NAS) and its constituent components (P < .0001). The risk of either NASH or F ≥ 2 fibrosis progressively increased with increasing PIIINP levels (P < .0001), independent of age, gender, adiposity measures, insulin resistance, NAS score and the patatin‐like phospholipase domain‐containing protein‐3 rs738409 polymorphism. For every 3.6 ng/mL increase in PIIINP levels, the likelihood of having F ≥ 2 fibrosis increased by ~14‐fold (adjusted‐odds ratio 14.1, 95% CI 5.50‐35.8, P < .0001) after adjustment for the aforementioned risk factors. The area under the receiver operating characteristics curve was 0.921 (95% CI 0.87‐0.97) for F ≥ 2 fibrosis, and 0.993 (95% CI 0.98‐1.0) for F3 fibrosis respectively. Conclusions Unlike APRI and FIB‐4 scores, plasma PIIINP levels are a promising, non‐invasive biomarker for diagnosing liver fibrosis stage in children/adolescents with biopsy‐proven NAFLD.

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Accepted/In Press date: 17 July 2019
e-pub ahead of print date: 22 August 2019
Published date: 1 December 2019

Identifiers

Local EPrints ID: 432893
URI: http://eprints.soton.ac.uk/id/eprint/432893
ISSN: 1478-3223
PURE UUID: a7ed7ca9-5cbb-4502-83c3-50e984c65121
ORCID for Christopher Byrne: ORCID iD orcid.org/0000-0001-6322-7753

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Date deposited: 31 Jul 2019 16:30
Last modified: 16 Mar 2024 08:03

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Contributors

Author: Antonella Mosca
Author: Donatella Comparcola
Author: Ilaria Romito
Author: Alessandro Mantovani
Author: Valerio Nobili
Author: Anna Alisi
Author: Giovanni Targher

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