A novel fibrosis index comprising a non-cholesterol sterol accurately predicts HCV-related liver cirrhosis.

Abstract

Diagnosis of liver cirrhosis is essential in the management of chronic hepatitis C virus (HCV) infection. Liver biopsy is invasive and thus entails a risk of complications as well as a potential risk of sampling error. Therefore, non-invasive diagnostic tools are preferential. The aim of the present study was to create a model for accurate prediction of liver cirrhosis based on patient characteristics and biomarkers of liver fibrosis, including a panel of non-cholesterol sterols reflecting cholesterol synthesis and absorption and secretion. We evaluated variables with potential predictive significance for liver fibrosis in 278 patients originally included in a multicenter phase III treatment trial for chronic HCV infection. A stepwise multivariate logistic model selection was performed with liver cirrhosis, defined as Ishak fibrosis stage 5-6, as the outcome variable. A new index, referred to as Nordic Liver Index (NoLI) in the paper, was based on the model: Log-odds (predicting cirrhosis) = -12.17+ (age × 0.11) + (BMI (kg/m(2)) × 0.23) + (D7-lathosterol (μg/100 mg cholesterol)×(-0.013)) + (Platelet count (x10(9)/L) × (-0.018)) + (Prothrombin-INR × 3.69). The area under the ROC curve (AUROC) for prediction of cirrhosis was 0.91 (95% CI 0.86-0.96). The index was validated in a separate cohort of 83 patients and the AUROC for this cohort was similar (0.90; 95% CI: 0.82-0.98). In conclusion, the new index may complement other methods in diagnosing cirrhosis in patients with chronic HCV infection.

• Authors: Magdalena Ydreborg, Vera Lisovskaja, Martin Lagging, Peer Brehm Christensen, Nina Langeland, Mads Rauning Buhl, Court Pedersen, Kristine Mørch, Rune Wejstål, Gunnar Norkrans, Magnus Lindh, Martti Färkkilä, Johan Westin
• Journal: PloS one (PLoS One) Vol. 9 Issue 4 Pg. e93601 ( 2014) ISSN: 1932-6203 [Electronic] United States
• PMID: 24699777 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Validation Study)

Chemical References

• Biomarkers
• Sterols

Topics

• Biomarkers (blood)
• Female
• Hepatitis C (complications, pathology)
• Humans
• Liver Cirrhosis (complications, pathology)
• Male
• Middle Aged
• Sterols (metabolism)