Serum Biomarkers and Transient Elastography as Predictors of Advanced Liver Fibrosis in a United States Cohort: The Boston Children's Hospital Experience - 24/09/13
, Antonio R. Perez-Atayde, MD 2, Paul D. Mitchell, MS 3, Roshan Raza, MD 1, Nezam H. Afdhal, MD 4, Maureen M. Jonas, MD 1Abstract |
Objective |
To evaluate and compare the ability of serum hyaluronic acid (HA) and human cartilage glycoprotein-39 (YKL-40) values, as well as transient elastography (TE) findings, to predict advanced hepatic fibrosis in a cohort from a single pediatric center.
Study design |
Subjects who underwent liver biopsy analysis within 12 months before enrollment were eligible for this prospective study. HA and YKL-40 measurements were obtained within 1 month of TE. A METAVIR score of F3 or F4 was considered to indicate advanced fibrosis.
Results |
A total of 128 patients (51% males) aged 1.4 months to 27.6 years (22% aged <2 years) were enrolled. Thirty-one subjects had data on only HA and YKL-40 measurements, and 97 subjects had data on both blood tests and TE. For the prediction of advanced fibrosis, the area under the receiver operating characteristic curve (AUC) values were 0.83 for TE, 0.72 for HA, and 0.52 for YKL-40. The AUC of 0.83 for TE was statistically significantly greater than the AUCs for HA (P = .03) and YKL-40 (P < .0001). Optimal cutpoints for predicting F3-F4 fibrosis were 8.6 kPa for TE (P < .0001), 43 ng/mL for HA (P < .0001), and 26.2 ng/mL for YKL-40 (P = .85). The combination of TE and HA was not better than TE alone for predicting advanced fibrosis (P = .15).
Conclusion |
In this study, which evaluated TE, HA, and YKL-40 to predict liver fibrosis in children in the US, YKL-40 had no predictive value and TE was superior to HA, but the addition of HA did not improve the performance of TE. Our data suggest that TE and HA may be useful noninvasive tools for assessing liver fibrosis in children.
Le texte complet de cet article est disponible en PDF.Keyword : ALT, APRI, AST, AUC, GGTP, HA, NAFLD, NPV, PPV, ROC, TE, YKL-40
Plan
| Echosens (Paris, France) provided the FibroScan machine, technical support, and training of investigators for the purpose of this study. N.A. has received research support from and is a consultant/advisory board member for Echosens, which did not have a role in study design, collection/analysis/interpretation of data, writing of the manuscript, or the decision to submit the manuscript for publication. The other authors declare no conflicts of interest. |
Vol 163 - N° 4
P. 1058 - octobre 2013 Retour au numéro
Article précédent
- Health Related Quality of Life in Patients with Biliary Atresia Surviving with their Native Liver
- Shikha S. Sundaram, Estella M. Alonso, Barbara Haber, John C. Magee, Emily Fredericks, Binita Kamath, Nanda Kerkar, Philip Rosenthal, Ross Shepherd, Christine Limbers, James W. Varni, Patricia Robuck, Ronald J. Sokol, Childhood Liver Disease Research and Education Network (ChiLDREN) ?
- Umbilical Hernia Repair Increases the Rate of Functional Gastrointestinal Disorders in Children
- John M. Rosen, Papa N. Adams, Miguel Saps
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?