Macrophage Markers Do Not Add to the Prediction of Liver Fibrosis by Transient Elastography in Patients With Metabolic Associated Fatty Liver Disease
Background and Aims: Non-invasive fibrosis staging is essential in metabolic associated fatty liver disease (MAFLD). Transient elastography (TE) is a well-established method for liver fibrosis assessment. We have previously shown that the macrophage marker sCD163 is an independent predictor for fibr...
Main Authors: | , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Frontiers Media S.A.
2020-12-01
|
Series: | Frontiers in Medicine |
Subjects: | |
Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2020.616212/full |
id |
doaj-f1afc010af9b48deac15788d69fdfb08 |
---|---|
record_format |
Article |
spelling |
doaj-f1afc010af9b48deac15788d69fdfb082020-12-18T06:15:09ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2020-12-01710.3389/fmed.2020.616212616212Macrophage Markers Do Not Add to the Prediction of Liver Fibrosis by Transient Elastography in Patients With Metabolic Associated Fatty Liver DiseaseKonstantin Kazankov0Konstantin Kazankov1Chiara Rosso2Ramy Younes3Angelo Armandi4Hannes Hagström5Hannes Hagström6Hannes Hagström7Holger Jon Møller8Per Stål9Per Stål10Elisabetta Bugianesi11Henning Grønbæk12Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, DenmarkInstitute of Liver and Digestive Health, University College London, London, United KingdomDepartment of Medical Sciences, Division of Gastroenterology and Hepatology, University of Turin, Turin, ItalyBoehringer Ingelheim International, Gesellschaft mit beschränkter Haftung, Ingelheim, GermanyDepartment of Medical Sciences, Division of Gastroenterology and Hepatology, University of Turin, Turin, ItalyDepartment of Upper GI, Unit of Hepatology, Karolinska University Hospital, Stockholm, SwedenDepartment of Medicine, Clinical Epidemiology Unit, Solna, Karolinska Institutet, Stockholm, SwedenDepartment of Medicine, Huddinge, Karolinska Institutet, Stockholm, SwedenDepartment of Clinical Biochemistry, Aarhus University Hospital, Aarhus, DenmarkDepartment of Upper GI, Unit of Hepatology, Karolinska University Hospital, Stockholm, SwedenDepartment of Medicine, Huddinge, Karolinska Institutet, Stockholm, SwedenDepartment of Medical Sciences, Division of Gastroenterology and Hepatology, University of Turin, Turin, ItalyDepartment of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, DenmarkBackground and Aims: Non-invasive fibrosis staging is essential in metabolic associated fatty liver disease (MAFLD). Transient elastography (TE) is a well-established method for liver fibrosis assessment. We have previously shown that the macrophage marker sCD163 is an independent predictor for fibrosis in MAFLD. In the present study we tested whether the combination of macrophage markers and TE improves fibrosis prediction.Methods: We measured macrophage markers soluble (s)CD163 and mannose receptor (sMR) in two independent cohorts from Italy (n = 141) and Sweden (n = 70) with biopsy-proven MAFLD and available TE.Results: In the Italian cohort, TE and sCD163 showed similar moderate associations with liver fibrosis (rho = 0.56, p < 0.001 and rho = 0.42, p < 0.001, respectively). TE had an area under the Receiver Operating Characteristics curve (AUROC, with 95% CI) for fibrosis; F ≥ 2 = 0.79 (0.72–0.86), F ≥ 3 = 0.81 (0.73–0.89), F4 = 0.95 (0.90–1.0). sCD163 also predicted fibrosis well [F ≥ 2 = 0.71 (0.63–0.80), F ≥ 3 = 0.82 (0.74–0.90), F4 = 0.89 (0.76–1.0)]. However, combining sCD163 and TE did not improve the AUROCs significantly [F ≥ 2 = 0.79 (0.72–0.86), F ≥ 3 = 0.85 (0.78–0.92), F4 = 0.97 (0.93–1.0)]. In the Swedish cohort, TE showed a closer association with fibrosis (rho = 0.73, p < 0.001) than sCD163 (rho = 0.43, p < 0.001) and sMR (rho = 0.46, p < 0.001). TE predicted fibrosis well [F ≥ 2 = 0.88 (0.80–0.97), F ≥ 3 = 0.90 (0.83–0.97), F4 = 0.87 (0.78–0.96)], whereas sCD163 did not (best AUROC 0.75). sMR showed a better prediction [F ≥ 2 = 0.68 (0.56–0.81), F ≥ 3 = 0.82 (0.71–0.92), F4 = 0.79 (0.66–0.93)], but the addition of sMR did not further improve the prediction of fibrosis by TE.Conclusion: In these cohorts of MAFLD patients, TE was superior to macrophage markers for fibrosis prediction and in contrast to our hypothesis the addition of these markers to TE did not improve its predictive capability.https://www.frontiersin.org/articles/10.3389/fmed.2020.616212/fullmacrophagescirrhosisbiomarkersNAFLDFibroscan |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Konstantin Kazankov Konstantin Kazankov Chiara Rosso Ramy Younes Angelo Armandi Hannes Hagström Hannes Hagström Hannes Hagström Holger Jon Møller Per Stål Per Stål Elisabetta Bugianesi Henning Grønbæk |
spellingShingle |
Konstantin Kazankov Konstantin Kazankov Chiara Rosso Ramy Younes Angelo Armandi Hannes Hagström Hannes Hagström Hannes Hagström Holger Jon Møller Per Stål Per Stål Elisabetta Bugianesi Henning Grønbæk Macrophage Markers Do Not Add to the Prediction of Liver Fibrosis by Transient Elastography in Patients With Metabolic Associated Fatty Liver Disease Frontiers in Medicine macrophages cirrhosis biomarkers NAFLD Fibroscan |
author_facet |
Konstantin Kazankov Konstantin Kazankov Chiara Rosso Ramy Younes Angelo Armandi Hannes Hagström Hannes Hagström Hannes Hagström Holger Jon Møller Per Stål Per Stål Elisabetta Bugianesi Henning Grønbæk |
author_sort |
Konstantin Kazankov |
title |
Macrophage Markers Do Not Add to the Prediction of Liver Fibrosis by Transient Elastography in Patients With Metabolic Associated Fatty Liver Disease |
title_short |
Macrophage Markers Do Not Add to the Prediction of Liver Fibrosis by Transient Elastography in Patients With Metabolic Associated Fatty Liver Disease |
title_full |
Macrophage Markers Do Not Add to the Prediction of Liver Fibrosis by Transient Elastography in Patients With Metabolic Associated Fatty Liver Disease |
title_fullStr |
Macrophage Markers Do Not Add to the Prediction of Liver Fibrosis by Transient Elastography in Patients With Metabolic Associated Fatty Liver Disease |
title_full_unstemmed |
Macrophage Markers Do Not Add to the Prediction of Liver Fibrosis by Transient Elastography in Patients With Metabolic Associated Fatty Liver Disease |
title_sort |
macrophage markers do not add to the prediction of liver fibrosis by transient elastography in patients with metabolic associated fatty liver disease |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Medicine |
issn |
2296-858X |
publishDate |
2020-12-01 |
description |
Background and Aims: Non-invasive fibrosis staging is essential in metabolic associated fatty liver disease (MAFLD). Transient elastography (TE) is a well-established method for liver fibrosis assessment. We have previously shown that the macrophage marker sCD163 is an independent predictor for fibrosis in MAFLD. In the present study we tested whether the combination of macrophage markers and TE improves fibrosis prediction.Methods: We measured macrophage markers soluble (s)CD163 and mannose receptor (sMR) in two independent cohorts from Italy (n = 141) and Sweden (n = 70) with biopsy-proven MAFLD and available TE.Results: In the Italian cohort, TE and sCD163 showed similar moderate associations with liver fibrosis (rho = 0.56, p < 0.001 and rho = 0.42, p < 0.001, respectively). TE had an area under the Receiver Operating Characteristics curve (AUROC, with 95% CI) for fibrosis; F ≥ 2 = 0.79 (0.72–0.86), F ≥ 3 = 0.81 (0.73–0.89), F4 = 0.95 (0.90–1.0). sCD163 also predicted fibrosis well [F ≥ 2 = 0.71 (0.63–0.80), F ≥ 3 = 0.82 (0.74–0.90), F4 = 0.89 (0.76–1.0)]. However, combining sCD163 and TE did not improve the AUROCs significantly [F ≥ 2 = 0.79 (0.72–0.86), F ≥ 3 = 0.85 (0.78–0.92), F4 = 0.97 (0.93–1.0)]. In the Swedish cohort, TE showed a closer association with fibrosis (rho = 0.73, p < 0.001) than sCD163 (rho = 0.43, p < 0.001) and sMR (rho = 0.46, p < 0.001). TE predicted fibrosis well [F ≥ 2 = 0.88 (0.80–0.97), F ≥ 3 = 0.90 (0.83–0.97), F4 = 0.87 (0.78–0.96)], whereas sCD163 did not (best AUROC 0.75). sMR showed a better prediction [F ≥ 2 = 0.68 (0.56–0.81), F ≥ 3 = 0.82 (0.71–0.92), F4 = 0.79 (0.66–0.93)], but the addition of sMR did not further improve the prediction of fibrosis by TE.Conclusion: In these cohorts of MAFLD patients, TE was superior to macrophage markers for fibrosis prediction and in contrast to our hypothesis the addition of these markers to TE did not improve its predictive capability. |
topic |
macrophages cirrhosis biomarkers NAFLD Fibroscan |
url |
https://www.frontiersin.org/articles/10.3389/fmed.2020.616212/full |
work_keys_str_mv |
AT konstantinkazankov macrophagemarkersdonotaddtothepredictionofliverfibrosisbytransientelastographyinpatientswithmetabolicassociatedfattyliverdisease AT konstantinkazankov macrophagemarkersdonotaddtothepredictionofliverfibrosisbytransientelastographyinpatientswithmetabolicassociatedfattyliverdisease AT chiararosso macrophagemarkersdonotaddtothepredictionofliverfibrosisbytransientelastographyinpatientswithmetabolicassociatedfattyliverdisease AT ramyyounes macrophagemarkersdonotaddtothepredictionofliverfibrosisbytransientelastographyinpatientswithmetabolicassociatedfattyliverdisease AT angeloarmandi macrophagemarkersdonotaddtothepredictionofliverfibrosisbytransientelastographyinpatientswithmetabolicassociatedfattyliverdisease AT hanneshagstrom macrophagemarkersdonotaddtothepredictionofliverfibrosisbytransientelastographyinpatientswithmetabolicassociatedfattyliverdisease AT hanneshagstrom macrophagemarkersdonotaddtothepredictionofliverfibrosisbytransientelastographyinpatientswithmetabolicassociatedfattyliverdisease AT hanneshagstrom macrophagemarkersdonotaddtothepredictionofliverfibrosisbytransientelastographyinpatientswithmetabolicassociatedfattyliverdisease AT holgerjonmøller macrophagemarkersdonotaddtothepredictionofliverfibrosisbytransientelastographyinpatientswithmetabolicassociatedfattyliverdisease AT perstal macrophagemarkersdonotaddtothepredictionofliverfibrosisbytransientelastographyinpatientswithmetabolicassociatedfattyliverdisease AT perstal macrophagemarkersdonotaddtothepredictionofliverfibrosisbytransientelastographyinpatientswithmetabolicassociatedfattyliverdisease AT elisabettabugianesi macrophagemarkersdonotaddtothepredictionofliverfibrosisbytransientelastographyinpatientswithmetabolicassociatedfattyliverdisease AT henninggrønbæk macrophagemarkersdonotaddtothepredictionofliverfibrosisbytransientelastographyinpatientswithmetabolicassociatedfattyliverdisease |
_version_ |
1724378715768487936 |